VOICE2 Evaluation v1.0
Research type
Research Study
Full title
VOICE2 dementia communication skills training: a longitudinal case study evaluation.
IRAS ID
325423
Contact name
Rowan Harwood
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
1 years, 4 months, 0 days
Research summary
Research Summary
People with dementia often get distressed when they are in hospital, including being agitated, aggressive or repetitively calling out. They can find it difficult to make clear what they want to say or to understand others. Poor communication can lead to poor care and the way we say things can calm or inflame a difficult situation.
We have studied video and audio-recorded episodes of care for people with dementia, which staff anticipated were going to be difficult. We analysed these video-recordings to identify teachable communication that avoids or resolves distress in practice. We have developed a dementia communication skills training course, and a ‘train-the trainer’ course to teach clinical educators to deliver our course. This study will assess whether this course is valued by the staff attending it; whether it improves their knowledge, skills, and confidence; changes their communication behaviour and has an impact on patient distress.
We will train educators from 3-4 hospitals in England and ask them to provide training to staff on 2 wards (up to 290 staff members across the three hospitals). We will examine whether the educators deliver the course as we intended and by how much it improves staff communication skills. We will measure trainees’ knowledge, and confidence before and after the course. We will observe real-life interactions between staff and their patients before and after the training, rate them using a checklist of communication skills and patient reactions on agitation scales. We will measure the barriers and facilitators to implementing the training. We will interview educators, staff, patients, family carers and managers to find out how the new skills help patients and any barriers to using them in practice.
This training has the potential for substantial impact on patient experience and wellbeing.
This research is funded by the National Institute of Health Research.Summary of Results
We developed communication skills training to try to reduce challenging behaviour among people with dementia in hospital. We tested it on staff on 6 wards in three hospitals. We based the training on what we found worked in practice to avoid or resolve distress in people with dementia. This included 'following the usual rules of conversation', 'dealing with different realities', and 'explaining care that might cause difficulties'. We trained 9 clinical educators who delivered 16 2-day training sessions for 145 staff. Trainees liked the training, said they used it and found it useful in practice. We demonstrated improvements in staff knowledge and confidence. We identified real-life use of the things we taught by observing care on wards. We found some reductions in agitated behaviours on wards. However, in general, evaluating the effectiveness of training is difficult, and, whilst supportive, these findings remain uncertain.REC name
Wales REC 4
REC reference
23/WA/0198
Date of REC Opinion
29 Aug 2023
REC opinion
Further Information Favourable Opinion