A posture and mobility training package for care home staff: results of a cluster randomised controlled feasibility trial (the PATCH trial)

Age Ageing. 2020 Aug 24;49(5):821-828. doi: 10.1093/ageing/afaa046.

Abstract

Background: provision of care for care home residents with complex needs is challenging. Physiotherapy and activity interventions can improve well-being but are often time-limited and resource intensive. A sustainable approach is to enhance the confidence and skills of staff who provide care. This trial assessed the feasibility of undertaking a definitive evaluation of a posture and mobility training programme for care staff.

Design and setting: a cluster randomised controlled feasibility trial with embedded process evaluation. Ten care homes in Yorkshire, United Kingdom, were randomised (1:1) to the skilful care training package (SCTP) or usual care (UC).

Participants: residents who were not independently mobile.

Intervention: SCTP-delivered by physiotherapists to care staff.

Objectives and measurements: key objectives informed progression to a definitive trial. Recruitment, retention and intervention uptake were monitored. Data, collected by a blinded researcher, included pain, posture, mobility, hospitalisations and falls. This informed data collection feasibility and participant safety.

Results: a total of 348 residents were screened; 146 were registered (71 UC, 75 SCTP). Forty two were lost by 6 months, largely due to deaths. While data collection from proxy informants was good (>95% expected data), attrition meant that data completion rates did not meet target. Data collection from residents was poor due to high levels of dementia. Intervention uptake was variable-staff attendance at all sessions ranged from 12.5 to 65.8%. There were no safety concerns.

Conclusion: care home and resident recruitment are feasible, but refinement of data collection approaches and intervention delivery are needed for this trial and care home research more widely.

Keywords: cluster randomised trial; long-term care; older people; posture and mobility; staff training.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls* / prevention & control
  • Feasibility Studies
  • Humans
  • Physical Therapy Modalities
  • Posture*
  • United Kingdom