Assessment of treatment fidelity and competency Sample Clauses

Assessment of treatment fidelity and competency. ‌ All nurses who participated in the D6 study were required by protocol to record their treatment consultations with participants digitally. A sample of recordings from nurses in the intervention arm from shortly after the end of training was used to assess competency. Another sample of recordings from both trial arms that was representative of participants’ treatment receipt was selected in order to assess fidelity. The definition, assessment, and difficulties of addressing treatment fidelity in research studies have been extensively discussed elsewhere in the literature (Xxxxxx and Xxxxxxxx, 2006; Xxxxxxxxx and XxXxxxx, 2010; Xxxxxxxx and Xxxxxx, 2011). A definition that is consistently used, and will be used for the purpose of this chapter, is that fidelity comprises both adherence and competence (Xxxxxxxx and Xxxxxx, 2011). Adherence refers to whether the appropriate procedures were followed for that clinical intervention whereas competence refers to whether these procedures were implemented to an adequate level. The Motivational Interviewing Treatment Integrity (MITI) Scale, version 3.1.1 (Xxxxxx et al., 2005, 2010), was used to measure competence and skills used in both groups of nurses. A Global Spirit score is intended to capture the overall demonstration of MI principles, and a Global Empathy score is intended to capture the extent to which the clinician understands, or attempts to understand the patient’s perspective. Further measures of clinician behaviours include the use of simple reflections, complex reflections, open questions, and closed-ended questions. Scores are also calculated for MI adherent and non-adherent counselling behaviours. The possible ranges and threshold levels for subscales (as specified by the scale’s authors) are given in Table 3.1. The Behaviour Change Counselling Index (XXXXX) (Xxxx et al., 2005) was designed to assist trainers in assessing a clinician’s competence in using behaviour change counselling in consultations. It was included here in order to assess nurses’ competence in eliciting patients’ thoughts and cognitions, therefore addressing the CBT element of the interven- tion. XXXXX comprises 11 items which are scored from zero to four (0=“action carried out not at all”; 1=“minimally”; 2=“to some extent‘”; 3=“a good deal”; 4=“a great deal”). The mean of these is used as the overall Practitioner Score.
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