Intervention fidelity in postintensive care follow-up consultations at ten sites in the RAPIT-trial: A mixed-methods evaluation
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Intervention fidelity in postintensive care follow-up consultations at ten sites in the RAPIT-trial : A mixed-methods evaluation. / Jensen, Janet F; Overgaard, Dorthe; Bestle, Morten H; Christensen, Doris F; Rattray, Janice; Egerod, Ingrid.
In: Journal of Advanced Nursing, Vol. 75, No. 4, 04.2019, p. 862-875.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Intervention fidelity in postintensive care follow-up consultations at ten sites in the RAPIT-trial
T2 - A mixed-methods evaluation
AU - Jensen, Janet F
AU - Overgaard, Dorthe
AU - Bestle, Morten H
AU - Christensen, Doris F
AU - Rattray, Janice
AU - Egerod, Ingrid
N1 - © 2019 John Wiley & Sons Ltd.
PY - 2019/4
Y1 - 2019/4
N2 - AIM: The aim of the study was to evaluate intervention fidelity of nurses' delivery of the RAPIT recovery program for postintensive care patients.BACKGROUND: Interventions addressing patient problems after intensive care lack description of the process of delivery and the evidence of their effectiveness. This is needed to understand how these interventions work.DESIGN: Multistage intervention framework in a mixed-methods design. Intervention fidelity strategies were assessed for intervention design, training, delivery, receipt, and enactment with quantitative and qualitative methods inspired by the Medical Research Council and the National Institutes of Health Fidelity Framework.METHODS: Data collection was embedded in a multicenter randomized controlled trial to explore intervention fidelity of a recovery program (December 2012-February 2017). Ten Danish intensive care units participated in the RAPIT-trial including 386 patients and 27 nurses. Quantitative data covered training and delivery. Qualitative data explored design, quality of delivery, receipt, and enactment seen from nurses' and patients' perspectives. Data were analysed statistically and by systematic deductive-inductive thematic analysis.FINDINGS: A framework for participatory enactment of a complex intervention was developed and demonstrated delivery with high consistent fidelity across sites. Low delivery doses and variations were related to the program, patient, provider nurses and context.CONCLUSION: Our study provides insight into the process of intervention fidelity of a nurse-led postintensive care recovery program and potentially enables professionals to understand key factors in cross-site implementation. Although we demonstrate consistent delivery and variations suggest that some patients may benefit more than others.
AB - AIM: The aim of the study was to evaluate intervention fidelity of nurses' delivery of the RAPIT recovery program for postintensive care patients.BACKGROUND: Interventions addressing patient problems after intensive care lack description of the process of delivery and the evidence of their effectiveness. This is needed to understand how these interventions work.DESIGN: Multistage intervention framework in a mixed-methods design. Intervention fidelity strategies were assessed for intervention design, training, delivery, receipt, and enactment with quantitative and qualitative methods inspired by the Medical Research Council and the National Institutes of Health Fidelity Framework.METHODS: Data collection was embedded in a multicenter randomized controlled trial to explore intervention fidelity of a recovery program (December 2012-February 2017). Ten Danish intensive care units participated in the RAPIT-trial including 386 patients and 27 nurses. Quantitative data covered training and delivery. Qualitative data explored design, quality of delivery, receipt, and enactment seen from nurses' and patients' perspectives. Data were analysed statistically and by systematic deductive-inductive thematic analysis.FINDINGS: A framework for participatory enactment of a complex intervention was developed and demonstrated delivery with high consistent fidelity across sites. Low delivery doses and variations were related to the program, patient, provider nurses and context.CONCLUSION: Our study provides insight into the process of intervention fidelity of a nurse-led postintensive care recovery program and potentially enables professionals to understand key factors in cross-site implementation. Although we demonstrate consistent delivery and variations suggest that some patients may benefit more than others.
KW - Adult
KW - Aftercare/standards
KW - Critical Care/standards
KW - Critical Care Nursing/standards
KW - Delivery of Health Care/standards
KW - Female
KW - Humans
KW - Intensive Care Units
KW - Male
KW - Middle Aged
KW - Quality of Life
U2 - 10.1111/jan.13949
DO - 10.1111/jan.13949
M3 - Journal article
C2 - 30644124
VL - 75
SP - 862
EP - 875
JO - Journal of Advanced Nursing
JF - Journal of Advanced Nursing
SN - 0309-2402
IS - 4
ER -
ID: 235150131