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The aim of this study is to examine two implementation strategies (external facilitation and educational outreach visit) when introducing nutritional guidelines in the elderly care setting and to evaluate the results of the implementation by clinical outcome measures of the nursing home residents.
The hypothesis is that the residents affected by the external facilitation strategy will stay stable in the measured clinical outcomes, while the residents influenced by the educational outreach visit will deteriorate during the implementation process.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| External facilitator | Experimental | The external facilitation is a one year multifaceted intervention, including support, guidance, practice audit and feedback, training targeted to a team of practitioners involving the unit manager, the nurses and diet aides at the nursing home. The facilitator is a researcher and dietician. |
|
| Educational outreach visit | Active Comparator | The outreach visit is a three hour lecture about the nutritional guidelines targeted to a team of practitioners including the unit manager, the nurses and diet aides at the nursing home. The trained person giving the lecture is a researcher and dietician. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| A one year multifaceted implementation strategy | Other |
| ||
| A three hour lecture about the guidelines |
| Measure | Description | Time Frame |
|---|---|---|
| Nutritional status | Nutritional status is assessed with the Mini Nutritional Assessment-Short Form tool | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Functional status | Functional status is assessed with ADL (Activities in Daily Living) Barthel index. | 2 years |
| Cognitive status | Cognitive status is assessed with Short Portable Mental Status Questionnaire (SPMSQ). |
| Measure | Description | Time Frame |
|---|---|---|
| Biochemical markers | Blood samples are collected for analysis of vitamin D, albumin, CRP (C-reactive protein), insulin-like growth factor 1 (IGF-1), creatinine and cystatin C, which gives biochemical information on the nutritional status, inflammation activity and renal function. | 2 years |
| Morbidity |
Inclusion Criteria:
Exclusion Criteria:
- persons in terminal stage of life
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| Name | Affiliation | Role |
|---|---|---|
| Tommy Cederholm, Prof | Uppsala University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Uppsala University | Uppsala | Uppsala County | 75185 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25560819 | Derived | Torma J, Winblad U, Saletti A, Cederholm T. Strategies to implement community guidelines on nutrition and their long-term clinical effects in nursing home residents. J Nutr Health Aging. 2015 Jan;19(1):70-6. doi: 10.1007/s12603-014-0522-4. |
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| Other |
|
| 2 years |
| Health-related Quality of Life | Health-related Quality of Life is assessed with EQ-5D. | 2 years |
Morbidity is assessed with Charlson Comorbidity Index (CCI). |
| 2 years |