Process evaluation of prevention in long-term care facilities - resident and therapist perspectives on the benefits and acceptance of preventive speech and swallowing sessions

长期护理机构预防工作的过程评估——居民和治疗师对预防性言语和吞咽训练课程的益处和接受度的看法

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Abstract

BACKGROUND: Current demographic trends make the prevention and delay of diseases and their consequences particularly relevant for older adults. A German intervention study developed a programme to prevent swallowing difficulties and language decline among individuals residing in long-term care facilities. As part of the process evaluation, this study assessed residents' satisfaction with this programme and the extent to which therapists considered the exercises feasible and beneficial for the target group. METHODS: A mixed-method process evaluation was conducted. Participating residents completed a Likert-scale questionnaire to assess their satisfaction with the intervention, its organisational aspects and materials, volitional devices, and their personal success. Quantitative data were analysed descriptively using SPSS. Furthermore, seven qualitative interviews were conducted with the speech-language therapists (SLTs) who administered the sessions. These interviews were analysed using Mayring's method of content analysis, with MAXQDA software. Subsequently, a comparative analysis was conducted between the qualitative and quantitative findings. RESULTS: All 56 participating residents (86% female, mean age = Ø 82 years) reported high levels of satisfaction. The SLTs demonstrated a high degree of adherence to the intervention manual and reported positive impacts on participants' performance in swallowing and semantic exercises, as well as on the transfer of these exercises into daily life. Additionally, participants were described as having increased awareness of their limitations in swallowing and speech. Potential improvements were identified with regard to the intervention materials, group composition, and organisational aspects. CONCLUSION: Residents expressed satisfaction with the preventive intervention, which SLTs described as both feasible and beneficial. However, adjustments would need to be made to accommodate the target group's general impairments. Furthermore, positive group effects were observed, including enhanced communication, reduced loneliness and greater social participation. TRIAL REGISTRATION: The trial was registered with DRKS (German register for clinical trials) in 27,062,023 (study ID DRKS00031594) and the WHO International Clinical Trials Registry Platform (secondary register).

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