title: Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.
abstract: BACKGROUND
  Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation.
  
  
  METHODS
  The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes.
  
  
  CONCLUSIONS
  The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention's effect and prepare further studies.
authors.affiliation: Institute of Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany ; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Müller
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bartoszek
authors.affiliation: Institute of Health and Nursing Science, Martin Luther University of Halle-Wittenberg, Halle, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Beutner
authors.affiliation: Institute of Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Klingshirn
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Saal
authors.affiliation: Institute of Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Anna-Janina
authors.initials: AJ
authors.lastname: Stephan
authors.affiliation: Institute of Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany ; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Strobl
authors.affiliation: Institute of Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany ; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany ; Munich Center of Health Sciences - MCHealth, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Grill
authors.affiliation: Institute of Health and Nursing Science, Martin Luther University of Halle-Wittenberg, Halle, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Meyer
mesh_terms: D000368:Aged; D035843:Biomedical Research / Q000379:methods; D003286:Contracture / Q000523:psychology / Q000534:rehabilitation*; D016330:Frail Elderly / Q000523:psychology; D006040:Goals; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D010358:Patient Participation; D010865:Pilot Projects; D011788:Quality of Life; D012107:Research Design; D000078202:Systematic Reviews as Topic
keywords: aged; aged 65 and over; complex intervention; contracture; disabled persons; geriatric rehabilitation; long-term care; nursing homes; participation; quality of life