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PEOPLE@HES-SO – Directory and Skills inventory

PEOPLE@HES-SO
Directory and Skills inventory

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Spichiger Frank

Spichiger Frank

Assistenzprofessor FH

Main skills

Nurse (End-of-Life Care)

Nursing research

Qualitative Research

Quantitative Methods

R

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  • Publications

Main contract

Assistenzprofessor FH

Desktop: 5.48

Haute école de santé - Fribourg
Route des Arsenaux 16a, 1700 Fribourg, CH
HEdS-FR

As a researcher and clinician in nursing, I am committed to developing and testing complex nursing interventions to enhance the quality of care provided in long-term care facilities. With a particular focus on person-centred care for people with dementia, I have dedicated my career to palliative and end-of-life care.

My research expertise encompasses quantitative and qualitative methods, allowing me to design and conduct studies that reflect the complexity of nursing interventions. Through statistical analysis and data interpretation, I can provide a comprehensive understanding of the impact of nursing interventions on people with dementia. Additionally, I am experienced in qualitative research methods, such as interviews and focus groups, which enable me to capture the unique perspectives and experiences of patients, family members, and frontline staff.

With a deep understanding of the long-term care context, I am highly skilled in designing and conducting research studies tailored to the target population's needs. My expertise in palliative care nursing, coupled with my passion for making a difference in the lives of vulnerable individuals, makes me an invaluable asset to any team.

Whether collaborating with fellow researchers or working directly with frontline staff and patients, I am committed to using evidence-based practices to drive positive change in nursing.

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Ongoing

Improving PERsoN-centred DementiA Care in Long-term Care Facilities: Development and Evaluation of a Family-based Framework via Patient and Public Involvement and Engagement - ERNA
AGP

Role: Collaborator

Requérant(e)s: FR-HEDS-recherche, Koppitz Andrea, FR-HEDS-recherche

Financement: Velux Stiftung

Description du projet : Improving PERsoN-centred DementiA Care in Long-term Care Facilities: Development and Evaluation of a Family-based Framework via Patient and Public Involvement and Engagement - ERNA

Research team within HES-SO: Zahner Stefanie , Mooser François , Kipfer Stephanie , Koppitz Andrea , Spichiger Frank , Schilling Tonia

Partenaires académiques: FR-HEDS-recherche; Koppitz Andrea, FR-HEDS-recherche

Durée du projet: 01.05.2023 - 30.04.2027

Montant global du projet: 418'500 CHF

Statut: Ongoing

Completed

Improving PERsoN-centred DementiA Care in Long-term Care Facilities: Development and Evaluation of a Family-based Framework via Patient and Public Involvement and Engagement - ERNA
AGP

Role: Collaborator

Requérant(e)s: FR-HEDS-recherche

Financement: HES-SO Rectorat

Description du projet : Improving PERsoN-centred DementiA Care in Long-term Care Facilities: Development and Evaluation of a Family-based Framework via Patient and Public Involvement and Engagement - ERNA

Research team within HES-SO: Mooser François , Koppitz Andrea , Spichiger Frank

Partenaires académiques: FR-HEDS-recherche

Durée du projet: 01.01.2022 - 29.04.2022

Montant global du projet: 11'000 CHF

Statut: Completed

2025

Internal consistency and structural validity of the Swiss easy-read integrated palliative care outcome scale for people with dementia :
Scientific paper ArODES
a secondary exploratory factor analysis

Frank Spichiger, André Meichtry, Philip Larkin, Andrea Koppitz

BMC Palliative Care,  2025, 24, 49, 1-14

Link to the publication

Summary:

Background : The Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) was developed as a promising person-centred proxy measure of symptoms and concerns. We used the Swiss-German easy-read version, a measure designed to be completed individually by family members and frontline staff caring for people with dementia. In this secondary data analysis of multicentre trial data, we investigate the IPOS-Dem’s structural validity and internal consistency of the version. Methods A total of 257 people with dementia were assessed by frontline staff, while family members assessed 118 people residing in one of 23 participating Swiss-German long-term care facilities. Each IPOS-Dem version, corresponding to the two rater populations (family members and frontline staff), underwent exploratory factor analysis separately, using data from one assessment per person with dementia. A minimum residual solution with varimax rotation was calculated to determine the factor structure. Item reduction decisions were based on factor loadings and indices for internal consistency. Results The construct validity of the Swiss-German easy-read IPOS-Dem for frontline staff is demonstrated by two factors: Dementia Interaction and Physical Impact (Cronbach’s α = 0.83) and Dementia Emotional and Behavioural Impact (Cronbach’s α = 0.81). Four factors, with Cronbach’s α ranging from 0.77 to 0.86, were computed for the family member version: Dementia Interaction Impact, Easy-to-Assess Dementia Physical Impact, Hard-to-Assess Dementia Physical Impact and Dementia Emotional and Behavioural Impact. Conclusions Like other reduced patient-related outcome measures, palliative care measures and their parent instrument IPOS we identified subscales in the easy-read IPOS-Dem that describe a psychosocial impact and a physical impact. Differences in the internal structure of the family and staff versions of the IPOS-Dem likely stem from variations in observation intervals, roles and perspectives, with family members often focusing on loss and past experiences whereas staff may equate quality of life with quality of care leading to differing ratings. However, the identified internal consistency indices between 0.77 and 0.86 indicate acceptable internal consistency for the subscales and the IPOS-Dem should be taken forward for further psychometric evaluation.

Comparison of student nurses' expectations and newly qualified nurses' experiences regarding clinical practice :
Scientific paper ArODES
a secondary analysis of a cross-sectional survey

Andrea Koppitz, Frank Spichiger, Anita Keller-Senn, Marika Bana, Claudia Huber, Derek Christie, Thomas Bucher, Thomas Volken

Journal of Advanced Nursing,  2025, 81, January, 1, 237-248

Link to the publication

Summary:

Aim: To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. Design: A secondary explorative analysis of a cross-sectional survey. Methods: The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates. Results: The student nurses' overall expectations included the following top two prioritized aspects: ‘contributing to something important’ and ‘adequate time to spend with patients’. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in ‘adequate time to spend with patients’, ‘work–life balance’ and experiencing ‘good management’. Conclusion: The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work–life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses. Implications for the Profession and/or Patient Care: The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. Impact: Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing.

Person profile dementia intervention in long-term care :
Scientific paper ArODES
a stepped-wedge cluster-randomized trial

Frank Spichiger, Andrea L Koppitz, Florian Riese, Stephanie Kipfer, Stephanie Kipfer, Martin Nagl-Cupal, Andreas Büscher, Thomas Volken, Philip Larkin, André Meichtry

Journal of the American Medical Directors Association,  2025, 26, 1, 1-8

Link to the publication

Summary:

Objectives: We aimed to assess the efficacy of a person-centered care intervention in improving quality of life (QoL) for people with dementia in long-term care facilities. Design: This study was a stepped-wedge cluster-randomized clinical trial of monthly person-centered outcome measurements, followed by collaborative nurse-led person profile interventions involving nursing staff and family members, compared with monthly person-centered outcome measurements alone. Setting and Participants: We included people with a medical diagnosis of Alzheimer’s disease or vascular dementia or with clinical symptoms of dementia from 23 long-term care facilities in the German speaking part of Switzerland. Q 6 Methods: The primary outcome was QoL, as assessed using the QUALIDEM. Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis. Results: We recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34e3.86; P < .001; total QUALIDEM intervention: 67; 95% CI, 64.8e69.1 vs 64.4; 95% CI, 62.3e66.4 for the control). We also found positive effects of the intervention on all secondary outcomes. Conclusions and Implications: Once-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. Thus, our findings suggest a potential benefit to the broader implementation of person profiles involving nursing staff and family members in long-term care facilities.

2024

lmproving caring quality for people with dementia in nursing homes using IPOS-Dem
Doctoral thesis ArODES

Frank Spichiger

2024,  Lausanne : Université de Lausanne, Faculté de biologie et médecine.  168 p.

Koppitz, Andrea, Larkin, Philip

Link to the publication

Summary:

Delivering person-centred care to those with advanced dementia in nursing homes presents numerous challenges. When caring for people with dementia, frontline staff may face situations ranging from insufficient symptom management to a compromised quality of life. Using systematic assessment instruments have been described as ways for potentially enhancing person-centred care and caring for people with dementia. However, in Switzerland, specific symptom recognition measures for people with dementia remain unavailable, and their efficacy remains untested. This thesis presents the translation and psychometric testing of a measure developed for assessing common symptoms in people with dementia. The Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) underwent a six-step translation and cultural adaptation to Swiss-German nursing home settings through the use of easy-read principles. However, its inter-rating reliability among frontline staff was found to be suboptimal, with kappa values ranging between .15 (95% CI .08-.22) and .38 (95% CI .30-.48). Although aggregate IPOS-Dem scores might serve research needs when averaged across two measures, its application remains a central component of a complex nursing intervention trialled in a broader project. The unique challenges of researching this context and demographic influenced the overarching project’s design and the subsequent psychometric evaluation of IPOS-Dem. IPOS-Dem can improve caring for people with dementia and can be recommended for research purposes. For clinical practice, the development of a manual to help discern the different symptoms can be recommended. The development and application of tools like IPOS-Dem underscore the global urgency to enhance caring for the rapidly growing population of people with dementia. The insights from this thesis not only lay the groundwork for future refinement of IPOS-Dem, but also emphasise the importance of the rigorous evaluation of clinical tools. The collaboration with ProInfirmis and adoption of easy-read principles further highlight the potential to democratise and improve healthcare communication, which is crucial for vulnerable patient populations.

2023

Inter-rating reliability of the Swiss easy-read integrated palliative care outcome scale for people with dementia
Scientific paper ArODES

Frank Spichiger, Thomas Volken, Philip Larkin, André Anton Meichtry, Andrea Koppitz

PloS one,  18, 8, 1-16

Link to the publication

Summary:

The Integrated Palliative Care Outcome Scale for People with Dementia is a promising instrument for nursing home quality improvement and research in dementia care. It enables frontline staff in nursing homes to understand and rate the needs and concerns of people with dementia. We recently adapted the measure to include easy language for users from various educational backgrounds. This study examines the inter-rating reliability of the Integrated Palliative Care Outcome Scale for People with Dementia for frontline staff in nursing homes. 317 frontline staff members in 23 Swiss nursing homes assessed 240 people with dementia from a convenience sample. Reliability for individual items was computed using Fleiss Kappa. The individual Integrated Palliative Care Outcome Scale for People with Dementia items showed kappa values between .38 (95% CI .3–.48) and .15 (95% CI .08–.22). For the experimental IPOS-Dem sum score, a dependability index of .57 was found. The different ratings and time between ratings explain less than 2% of the variance in the sum score. The different nursing homes make up 12% and the people with dementia make up 43% of the sum score variance. The dependability study indicates that an experimental IPOS-Dem sum score could be acceptable for research by averaging two ratings.

2022

Pain Interventions for people with dementia :
Scientific paper ArODES
a quasi-experimental study

Frank Spichiger, Thomas Volken, Georg Bosshard, Nicole Zigan, Geneviève Blanc, Andreas Büscher, Martin Nagl Cupal, Mathieu Bernard, Eve Rubli Truchard, Philip Larkin, Andrea Koppitz

BMC Palliative Care,  2022, vol 21, no. 228, pp. 1-11

Link to the publication

Summary:

Background: Due to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia. Methods: Using a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data. Results: We found that on-site case studies support frontline staff with pain management and assessment. Repeated refection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time. Conclusion: This feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs. Trial registration: The study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726).

Prevention admission into nursing homes (PAN) :
Scientific paper ArODES
study protocol for an explorative, prospective longitudinal pilot study

Andrea L. Koppitz, Susanne Suter Riederer, Gabriela Bieri Brünig, Heike Geschwinder, Anita Keller Senn, Frank Spichiger, Thomas Volken

BMC Geriatrics,  2022, vol. 22, no. 227

Link to the publication

Integrated Palliative Outcome Scale for People with Dementia: easy language adaption and translation
Scientific paper

Spichiger Frank, Keller-Senn Anita, Thomas Volken, Philip Larkin, Koppitz Andrea

Journal of Patient-Reported Outcomes, 2022 , vol.  6, no  14

Link to the publication

Summary:

In this article, we report the cultural adaption and translation of the Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) into a Swiss-German easy language version for proxy assessment of people with dementia living in Swiss nursing homes. The Swiss-German easy language version of the IPOS-Dem was developed and culturally adapted in a six-phase process from the German IPOS-Dem using recommended guidelines. With nursing home staff and laypeople, the conceptual definition and relevance of IPOS-Dem items were established during phase I. Phase II encompassed the completion of forward translations. Independent native speakers blind to the original scale translated and back-translated the Swiss-German easy language version. The resulting IPOS-Dem version was then blindly back-translated in phase III. Experts reviewed all resulting translations in phase IV to produce a pre-final IPOS-Dem version. Finally, the phase V cognitive debriefing involved two focus groups assessing the pre-final IPOS-Dem version. Phase V included cognitive interviews with laypeople (n = 2), family members of those with dementia (n = 4) and staff from different care contexts (n = 12).

2021

Improving caring quality for people with dementia in nursing homes using IPOS-Dem :
Scientific paper ArODES
a stepped-wedge cluster randomized controlled trial protocol

Frank Spichiger, Andrea L. Koppitz, Susanne De Wolf-Linder, Fliss E.M. Murtagh, Thomas Volken, Philip Larkin

Journal of Advanced Nursing,  2021, vol. 77, no. 10, pp. 4234-4245

Link to the publication

Summary:

Aims We aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia-based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members. Background Swiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes. Design We will conduct a stepped-wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS-Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points. Methods The study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS-Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS-Dem sum-score. The Zürich Ethics Committee approved the study in 2019 (2019-01847). Impact The results of this study will contribute to improving the effectiveness of person-centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS-Dem and related case studies. The use of IPOS-Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade.

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