Background
Methods
Design
Participants
Demographics
Materials and procedure
Materials
Procedure
Theoretical element | Research Method | Measuring Method | |
---|---|---|---|
Questionnaires | Focus group | ||
Dose delivered | Which aspects of MRC are applied? | x | x |
Fidelity | Is MRC applied according to its core principles? | – | x |
Exposure | To what extent are participants stimulated to be physically active? | – | x |
Satisfaction | Are the staff and family carers satisfied with (the execution of) MRC? | x | x |
Barriers | What barriers are experienced? | – | x |
Statistical analysis
Results
Comparisons at baseline
Intervention group (n = 37) | Control group (n = 24) | |
---|---|---|
Age, mean (SD)
| 86.51 (7.1) | 84.21 (4.7) |
Age, range | 69–100 | 70–92 |
Gender (female), n (%) | 30 (81.1) | 17 (70.8) |
MMSE, mean (SD)*
| 9.75 (5.1) | 6.52 (5.2) |
Diagnosis, n (%)*
| ||
Alzheimer’s disease | 21 (56.8) | 13 (54.2) |
Vascular dementia | 2 (5.4) | 5 (20.8) |
Mixed vascular and Alzheimer | 1 (2.7) | 5 (20.8) |
Other/unknown | 13 (35.1) | 1 (4.2) |
Group | T0
N = 61
n
int = 37
n
con = 24
M(SD)
| T1 N = 61
n
int = 37
n
con = 24
M(SD)
| T2
N = 55
n
int = 36
n
con = 19
M(SD)
| T3
N = 49
n
int = 31 n
con = 18
M(SD)
| T4
N = 44
n
int = 29
n
con = 15
M(SD)
| |
---|---|---|---|---|---|---|
Barthel index | Int. | 9.38(5.37) | 9.16(4.76) | 8.72(4.96) | 8.55(5.57) | 8.86(5.28) |
Con. | 8.50(5.79) | 7.54(5.28) | 8.89(5.43) | 8.17(5.84) | 8.27(5.65) | |
Qualidem | ||||||
care relationship | Int. | 14.46(3.98) | 14.27(4.33) | 14.58(4.00) | 14.61(3.84) | 14.86(4.21) |
Con. | 12.58(4.01) | 13.25(3.85) | 12.32(3.48) | 12.50(4.38) | 11.67(3.66) | |
positive affect | Int. | 14.51(3.66) | 14.16(3.89) | 14.17(3.08) | 14.61(3.78) | 14.21(3.42) |
Con. | 13.63(3.19) | 13.96(2.71) | 14.32(2.96) | 13.39(3.18) | 14.93(2.25) | |
negative affect | Int. | 5.43(2.49) | 5.38(2.70) | 5.25(2.53) | 5.90(2.45) | 5.55(2.38) |
Con. | 5.79(2.62) | 5.54(2.15) | 5.32(2.31) | 5.06(2.90) | 4.47(2.33) | |
restless tense behavior | Int. | 4.27(2.81) | 4.08(2.87) | 4.19(2.84) | 4.42(3.05) | 4.52(2.95) |
Con. | 4.21(2.28) | 4.17(2.35) | 4.47(2.78) | 4.00(2.68) | 4.07(2.66) | |
positive self-image | Int. | 5.89(2.48) | 5.59(2.82) | 5.72(2.72) | 6.71(2.37) | 6.07(2.74) |
Con. | 6.88(2.07) | 7.08(1.53) | 6.68(1.42) | 6.78(2.16) | 4.33(2.38) | |
social relations | Int. | 11.73(4.05) | 11.62(3.78) | 11.92(3.89) | 12.06(4.29) | 11.97(3.91) |
Con. | 10.46(4.30) | 10.00(4.56) | 10.95(3.94) | 10.28(4.24) | 10.87(3.89) | |
social isolation | Int. | 5.62(2.37) | 5.32(2.47) | 5.53(2.22) | 5.94(2.35) | 6.00(2.49) |
Con. | 5.38(2.14) | 5.21(1.87) | 5.21(1.87) | 4.83(2.20) | 4.60(1.92) | |
feeling at home | Int. | 9.24(2.64) | 9.68(2.52) | 9.50(2.31) | 10.06(1.91) | 10.10(2.68) |
Con. | 8.54(2.67) | 8.88(2.77) | 7.84(2.85) | 8.17(3.42) | 7.93(3.47) | |
having something to do | Int. | 2.24 (1.91) | 2.62(1.93) | 2.25(1.92) | 2.29(1.85) | 2.66(1.97) |
Con. | 1.92(1.56) | 1.79(1.25) | 2.11(1.79) | 2.22(1.56) | 2.53(1.46) | |
mean total QoL | Int. | 16.94(4.09) | 16.86(5.08) | 16.83 (4.71) | 17.85 (4.81) | 17.72 (4.95) |
Con. | 16.32(3.47) | 16.33(2.32) | 16.21 (1.93) | 15.77 (2.75) | 15.03 (3.08) |
Intervention effect
Intervention vs. control | Crude Model | Adjusted Model | ||
---|---|---|---|---|
Beta(95% CI) |
p-value | Beta(95% CI) |
p-value | |
Barthel index | 0.62(−0.42;1.67) | 0.24 | 0.27(−0.83;1.37) | 0.62 |
Qualidem | ||||
care relationship | 0.71(−0.72;2.15) | 0.32 | 0.69(−0.85;2.23) | 0.37 |
positive affect | −0.15(−1.38;1.08) | 0.81 | −0.44(1.74;0.85) | 0.50 |
negative affect | 0.48(−0.28;1.24) | 0.21 | 0.56(−0.28;1.39) | 0.19 |
restless tense behaviour | 0.23(−0.80;1.26) | 0.66 | 0.02(−1.07;1.11) | 0.97 |
positive self-image | 0.15(−0.72;1.01) | 0.74 | 0.28(−0.67;1.24) | 0.55 |
social relations | 1.12(−0.19;2.43) | 0.09 | 1.01(−0.37;2.38) | 0.15 |
social isolation | 0.47(−0.29;1.23) | 0.22 | 0.72(−0.04;1.47) | 0.06 |
feeling at home | 0.94(−0.04;1.93) | 0.06 | 0.84(−0.25;1.94) | 0.13 |
having something to do | 0.17(−0.44;0.77) | 0.58 | 0.09(−0.55;0.74) | 0.78 |
mean total QoL | 0.96(−0.52;2.43) | 0.20 | 0.95(−0.65;2.56) | 0.24 |
Intervention vs. Control | T1 | T2 | T3 | T4 | |||||
---|---|---|---|---|---|---|---|---|---|
Model | B(95% CI) |
p
| B(95% CI) |
p
| B(95% CI) |
p
| B(95% CI) |
p
| |
Barthel Index | Cru. | 0.88(−0.38;2.14) | 0.17 | 0.05(−1.28.;1.38) | 0.94 | 0.49(−0.88;1.87) | 0.48 | 1.32(−0.12;2.76) | 0.07 |
Adj. | 0.30(−0.99;1.60) | 0.81 | −0.29(−1.65;1.07) | 0.67 | 0.29(−1.11;1.68) | 0.69 | 1.31(−0.15;2.78) | 0.08 | |
Qualidem | |||||||||
Care relationship | Cru. | −0.13(−1.83;1.57) | 0.88 | 1.16(−0.64;2.95) | 0.21 | 1.08(−0.77;2.93) | 0.25 | 1.32(−0.62;3.26) | 0.18 |
Adj. | 0.17(−1.60;1.94) | 0.85 | 1.11(−0.73;2.96) | 0.24 | 0.64(−1.26;2.53) | 0.51 | 1.12(−0.87;3.10) | 0.27 | |
Positive affect | Cru. | −0.24(−1.70;1.21) | 0.74 | −0.26(−1.79;1.28) | 0.74 | 0.89(−0.70;2.47) | 0.27 | −1.09(−2.75;0.56) | 0.19 |
Adj. | −0.45(−1.97;1.07) | 0.56 | −0.64(−2.23;0.95) | 0.43 | 0.53(−1.11;2.17) | 0.52 | −1.40(−3.12;0.31) | 0.11 | |
Negative affect | Cru. | 0.06(−0.91;1.03) | 0.90 | 0.11(−0.91;1.14) | 0.83 | 1.18(−0.12;2.24) | 0.03 | 1.00(−0.11;2.12) | 0.08 |
Adj. | 0.02(−1.01;1.05) | 0.97 | 0.27(−0.81;1.36) | 0.62 | 1.34(−0.22;2.46) | 0.02 | 1.08(−0.11;2.26) | 0.72 | |
Restless tense- behavior | Cru. | −0.12(−1.32;1.07) | 0.84 | 0.03(−1.23;1.29) | 0.96 | 0.77(−0.53;2.06) | 0.24 | 0.48(−0.87;1.82) | 0.48 |
Adj. | −0.41(−1.68;0.85) | 0.52 | −0.06(−1.38;1.26) | 0.93 | 0.58(−0.76;1.93) | 0.40 | 0.25(−1.16;1.66) | 0.73 | |
Positive self-image | Cru. | −0.91(−1.95;0.13) | 0.09 | −0.36(−1.46;0.75) | 0.52 | 0.59(−0.55;1.73) | 0.31 | 2.35(1.15;3.55) |
0.00
|
Adj. | −0.71(−1.83;0.41) | 0.21 | −0.29(−1.47;0.89) | 0.63 | 0.85(−0.37;2.07) | 0.17 | 2.36(1.09;3.64) |
0.00
| |
Social relations | Cru. | 0.71(−0.77;2.20) | 0.34 | 1.02(−0.53;2.57) | 0.19 | 1.67(0.08;3.25) | 0.04 | 1.39(−0.25;3.03) | 0.10 |
Adj. | 0.67(−0.88;2.22) | 0.40 | 0.97(−0.64;2.58) | 0.24 | 1.45(−0.21;3.10) | 0.08 | 1.21(−0.51;2.91) | 0.17 | |
Social isolation | Cru. | −0.03(−0.96;0.91) | 0.96 | 0.27(−0.73;1.26) | 0.60 | 1.02(−0.01;2.05) | 0.05 | 0.94(−0.14;2.03) | 0.09 |
Adj. | 0.31(−0.63;1.26) | 0.51 | 0.51(−0.49;1.51) | 0.31 | 1.21(−0.17;2.24) | 0.02 | 1.09(−0.00;2.18) | 0.05 | |
Feeling at home | Cru. | 0.44(−0.73;1.62) | 0.46 | 1.09(−0.16;2.34) | 0.09 | 1.40(0.12;2.69) | 0.03 | 1.21(−0.13;2.56) | 0.08 |
Adj. | 0.35(−0.92;1.63) | 0.58 | 0.97(−0.38;2.31) | 0.16 | 1.34(−0.77;1.92) | 0.39 | 1.05(−0.40;2.51) | 0.15 | |
Having something to do | Cru. | 0.63(−0.10;1.36) | 0.09 | 0.06(−0.71;0.83) | 0.87 | −0.23(−1.03;0.56) | 0.56 | −0.06(−0.89;0.77) | 0.89 |
Adj. | 0.51(−0.26;1.27) | 0.19 | 0.00(−0.80;0.81) | 0.99 | −0.25(−1.07;0.58) | 0.56 | −0.14(−1.01;0.73) | 0.75 | |
Mean total QoL | Cru. | 0.11 (−1.55;1.77) | 0.90 | 0.58 (−1.16;2.32) | 0.51 | 1.96 (0.18;3.74) | 0.03 | 2.04 (0.20;3.88) | 0.03 |
Adj. | 0.14 (−1.65;1.93) | 0.88 | 1.39 (−0.61;3.39) | 0.17 | 1.96 (0.05;3.86) | 0.04 | 1.89 (−0.09;3.86) | 0.06 |
Compliance to the intervention
Process evaluations
Theoretical element | Nursing Staffa
| Family Caregiversa
| Focus groupb
|
---|---|---|---|
Dose delivered (scale 1 to 5)ª | 3.54 | – | 3.21 |
Fidelity (scale 1 to 5)ª | – | – | 3.24 |
Exposure (scale 1 to 5)ª | – | – | 3.27 |
Satisfaction (scale 1 to 10)b
| 6.86 | 6.45 | 6.88 |
Experienced benefits of MRC (%) | 78.6 | 22.2 | – |
Willing to continue with MRC (%) | 92.90 | 89.50 | – |
Domain | Example from a participant who could walk independently |
---|---|
1.Living conditions | Client tidies up her apartment herself and puts the laundry onto her bed. The cleaning is done by the service agency. Client can independently prepare breakfast and can take the warm food from the pan onto the plate. |
2. Participation | Client likes to go to almost all activities and likes to be busy. Client likes to go outside. Client can be stimulated to activities and physical activity when offered in the form of a game. |
3. Mental well-being and autonomy | Stimulate client to do as much as possible herself. Regularly ask client what she wants and how she would like it. |
4. Physical well-being and health | Client can wash herself. When waking up client, offer her a warm wash cloth. Client selects her clothes herself and showers on Monday. When taking a shower, escort client to the shower and regulate the temperature of the shower. Leave a towel on the floor to prevent slipping. Then, client can shower independently. Client goes to the toilet independently and walks independently without any help. |