We report proportions of eligible HCWs receiving any intervention (reach), number of sessions attended (dose; attending ≥4/6 main sessions was predefined as adhering), intervention fidelity and adherence of clients and carers to NIDUS-Family (attending all 6-8 planned sessions). We interviewed HCWs, managers, family carers and facilitators. We integrated and thematically analysed, at the homecare agency level, qualitative interview and intervention recording data.
32/141 (23%) of eligible HCWs and 7/42 (17%) of family carers received any intervention; most who did adhered to the intervention (89% and 71%). Intervention fidelity was high. We analysed interviews with 20/44 HCWs, 3/4 managers and 3/7 family carers, as well as intervention recordings involving 32/44 HCWs. All agencies reported structural challenges in supporting intervention delivery. Agencies with greater management buy-in had higher dose and reach. HCWs valued NIDUS-Professional for enabling group reflection and peer support, providing practical, actionable care strategies and increasing their confidence as practitioners.
NIDUS-Professional was valued by HCWs. Agency management, culture and priorities were key barriers to implementation; we discuss how to address these in a future trial.
方法:我们报告接受任何干预(范围)的合格HCWs的比例,参加会议的次数(剂量;参加≥4/6次主要会议被预定为坚持),客户和护理人员对NIDUS-Family的干预忠实度和依从性(参加所有6-8次计划的会议)。我们采访了HCWs,经理,家庭照顾者和促进者。我们进行了整合和主题分析,在家庭护理机构层面,定性访谈和干预记录数据。
结果:32/141(23%)的合格HCWs和7/42(17%)的家庭护理人员接受了任何干预;大多数坚持干预的人(89%和71%)。干预的保真度很高。我们分析了20/44HCWs的采访,3/4经理和3/7家庭照顾者,以及涉及32/44HCWs的干预记录。所有机构都报告了在支持干预措施交付方面的结构性挑战。管理层较多的机构有更高的剂量和覆盖面。HCW重视NIDUS-Professional,以实现组反射和对等支持,提供实用,可操作的护理策略,并增加他们作为从业者的信心。
结论:NIDUS-Professional被HCWs重视。机构管理,文化和优先事项是实施的主要障碍;我们将讨论如何在未来的试验中解决这些问题.