Person-centred collaboration with relatives in long-term care facilities

In Switzerland, around 65% of people in long-term care have dementia, which is associated with individual suffering and a high overall care requirement. Internationally, there is consensus that so-called ‘person-centred care’ is the optimal form of care for people in nursing homes. It is noteworthy that no comprehensive systematic efforts have been made in German-speaking countries to advance the implementation of this approach in long-term care. In the context of the socio-political challenges in the field of long-term care, such as underfunding and staff shortages, collaboration with relatives requires immediate attention. ERNA will address this by promoting person-centred practices in Swiss nursing homes to improve team functionality and foster collaboration with relatives.

The aim of this study is to enable teams in Swiss nursing homes to work with relatives in a person-centred way. This is done in two steps:

1) Development of a framework for person-centred collaboration with relatives in Swiss nursing homes through the participation of those concerned and the public.

2) Testing a person-centred intervention to promote cooperation with relatives in Swiss nursing homes.

ERNA consists of two work packages:

WP1: Involvement of those concerned and the public in a framework concept for person-centred cooperation with relatives in Swiss nursing homes.

WP2: A clinical trial investigating whether person-centred intervention to promote collaboration with relatives improves team performance.

The clinical trial uses a randomised controlled crossover design (RCT) to examine its endpoints during WP2. Teams in Swiss nursing homes will be randomly assigned to one of two possible sequences (N = 44). A linear mixed model will be applied to each of the four co-primary endpoints, using period, treatment, and interaction between period and treatment as fixed effects and subjects as random sections. In the crossover analysis, the interaction effect between period and treatment is confused with the sequence (group) effect. Following the principles of action research, patient and public focus groups will evaluate the clinical relevance of the intervention to promote person-centred care in WP2. The focus groups will be evaluated using Mayring's content-analytical approach. The study will be conducted over 36 months.