Project 171104

Stroke is a leading cause of death in Canada, yet more than 80% of Ontario patients survive. These 300,000 patients who survive each year typically live with substantial limitations and 20% are admitted to a long-term care facility. Some of these patients cannot express their needs, leading to many difficult situations, agitation and depression. Staff in long-term care have not been taught how to interact with these patients and have limited strategies to help patients. In response to this need, we developed a patient-centred communication intervention for nursing staff caring for patients with strokes who have communication impairments. The goals of this study are to determine if the intervention has an effect on: 1) The patient's quality of life, depression, agitation, and satisfaction with care; and 2) The nursing staff's attitudes and knowledge to care for stroke patients with a communication impairment. The researchers will select 6 units in 3 different nursing homes. One unit will be an intervention unit, the other unit will be a control unit. The staff on the intervention unit will receive the intervention. All patients with communication impairments who have been in the facility for more than 1 year will be able to participate, and all nursing staff can participate. The intervention consists of three parts: 1) Development of an individualized communication plan for each patient; 2) One-day workshop for staff; and 3) Staff support system to provide assistance when using the communication plans in practice. Outcome measures from all the participants will be collected before the intervention takes place at 1 month, 3 months and 6 months after the intervention. The study will take 3 years to complete and will involve 114 patients and 114 nursing staff. Teaching nursing staff to communicate better with patients with communication impairments has the potential to significantly improve services provided for people surviving a stroke in Canada living in LTC.

quasi-experimental design to evaluate a patient-centred communication intervention in long-term care