Paper
Saturday, 22 July 2006
This presentation is part of : Research Strategies and Instruments
Use of the Serial Trial Intervention in a Randomized Controlled Trial
Christine R. Kovach, PhD, RN, Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA and Linda Sauer, Nursing, Marquette University, Milwaukee, WI, USA.
Learning Objective #1: describe nonpharmacological and pharmacological interventions used to treat discomfort in people with advanced dementia.
Learning Objective #2: describe methodological issues involved in researching tailored interventions, and methods for deconstructing the intervention.
To address the problems of physical and affective pain in people with dementia, the effectiveness of an innovative sequential clinical protocol, the Serial Trial Intervention (STI), for comfort assessment and management was studied. A double-blinded randomized experiment was conducted in 14 nursing homes with 114 subjects. This presentation describes the use of the intervention by the treatment group. The majority of residents (n = 34, 60%) had five or more physical parameters assessed (Possible range 0-28). Fifty-one abnormal physical parameters were found in 23 residents; 7 had musculoskeletal pain, 1 had pain from peripheral neuropathy, 3 had pneumonia and 4 had urinary tract infections. Seven people received intervention to treat positive physical assessment findings. These targeted interventions were effective for 6 subjects (85.7%). Targeted interventions given in response to affective need were considerably less effective, yielding improvement in behavioral symptoms for only 3 of 15 subjects (20%). Non-pharmacological intervention trials were effective for 47.9% of subjects receiving this type of intervention (23 of 48 subjects). Trials of analgesics yielding improvements for 75% (15 of 20) of subjects. Five individuals received a trial of psychotropics (effective for 4, 80%) and five subjects were forwarded for consultation. In total, 93% of the subjects who received the STI had improvement in behavioral symptoms of 50% or more as perceived by the nurse.

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