The Hub Q&A with Jennifer Knopp-Sihota

Q&A with Jennifer Knopp-Sihota

Learn more about Dr. Jennifer Knopp-Sihota’s world-class research at Athabasca University.

Athabasca University Shield

Athabasca University News

What grants have you received that are most current and what organizations funded them? 

I have two current grants, one form the Alzheimer Society Research Program (ASRP) for $120,000 and another is from the Canadian Institutes of Health Research (CIHR), Project Grant Program ($577,000).  

The CIHR, Canada’s federal funding agency for health research, is the largest funder of health research in Canada and the Project Grant Program is designed to capture ideas with the greatest potential to advance health-related fundamental or applied knowledge, health research, health care, health systems, and/or health outcomes. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

When were you awarded these funds for your research?

The ASRP grant was awarded in September 2015 until December 2018. 

The CIHR grant was awarded in April 2018 until March 2021.  

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Are the two grants funding the same project? Or do you have two different projects going on? 

The ASRP grant was a pilot study aimed at developing and testing an observational pain assessment scale using routinely collected data from a Resident Assessment Instrument – Minimum Data Set (RAI-MDS) for nursing home residents with advanced dementia. In Canada, most nursing homes monitor quality of care with resident outcome data from the RAI-MDS, which is considered a valid and reliable standardized assessment of resident characteristics and care. In this study we developed a pain scale and determined the feasibility of testing the scale in the nursing home.  

The CIHR Project Grant was awarded for my project called “Improving Pain Assessment in Nursing Home Residents with Dementia.”It was one of eight projects funded out of a total 58 submissions sent from across Canada. This study is a continuation of the pilot study. We are now refining and testing the RAI-MDSbased pain scale on 300 nursing home residents.  

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Can you describe your projects in layman’s terms? 

The number of nursing home residents with advancing dementia continues to grow. However, the ways we manage their troublesome symptoms, like pain, are still less than optimal. As a result, some residents are faced with untreated pain and unnecessary suffering, which further declines their mental and physical function. This often increases their need for care and, therefore, the cost of care.  

To manage their pain successfully, we must first identify it accurately. Asking residents if they have pain is considered the best way for healthcare workers to measure pain. But this is not always possible for residents with more advanced dementias as they are not able to communicate their pain in usual ways, such as speech. For these residents, a useful way to identify their pain is by observing them to detect their behaviours that may be related to pain, such as grimacing or crying.  

The goal of the CIHR research project is to develop and test a rating scale for pain-related behaviours that can be observed in nursing home residents with moderate to severe dementia. Our scale will be based on standard resident information that is regularly collected in Canadian nursing homes. Once we test our new pain rating scale fully, we will determine the best way to help healthcare workers use our scale as they observe residents in their everyday work.  

Our strategy to measure pain with these residents is the first step in recognizing and managing their pain as better pain management can improve their quality of life. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

What did the funding go towards?

The budget is largely for the staff it takes to run the project. Staff are required to coordinate the study, collect data, and statistical consultants. Funding is also used for knowledge translation: giving nursing home staff, residents and their families who are involved with the study, feedback of the results. Some money is also used for open access publications, as well as presenting the results of the studies at academic conferences.

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Have you been working on this subject/these subjects for a long time? Or is this a new venture for you? 

This topic was developed out of my postdoctoral work in 2015-2016, which was done while on a one-year research and study leave from AU with the Translating Research in Elder Care (TREC) program of research at the University of Alberta led by Dr. Carole Estabrooks. TREC is s a research program that develops solutions for improving the quality of care provided to nursing home residents, enriching the work life of their caregivers, and enhancing system efficiency. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

How long have you been with AU? 

Since 2007. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Have you ever received any AU funding in the past? Was it for similar research?

I have received an Academic Research Fund (ARF) award in 2015 that was used for a systematic review: “Interventions for the treatment of pain in nursing home residents: A systematic review and meta-analysis. 

(Knopp-Sihota, J. A., Patel, P., & Estabrooks, C. A. (2016). Interventions for the treatment of pain in nursing home residents: A systematic review and meta-analysis. J Am Med Dir Assoc, 17(12), 1163.e19-1163.e28.) 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Why are you interested in studying the pain of nursing home residents with dementia? 

Pain is a modifiable symptom that, if appropriately identified, can be treated and reduced. Nursing home residents who cannot communicate their pain are at greater risk for under-recognition and under-treatment of pain, increased suffering and harmful effects that include prescribing unnecessary antipsychotic medications and lead to an increased demand of care and cost. Current pain assessment methods greatly underestimate pain in cognitively impaired residents. Developing our new method of measure that uses observable behaviours as likely indicators of pain, is a critical improvement of quality of life for these residents. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Is it only residents with dementia that your current study is studying?

Yes, residents who cant verbally communicate their pain in typical ways (i.e., self report). 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

What made you focus on dementia? 

Between 70 and 80 per cent of nursing home residents have dementia. Their advancing age, loss of family and other supports, and severe communication difficulties make them among our most vulnerable and at-risk citizens. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Does your project involve AU students at all?  

No, this project does not involve AU students. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Where are you at with your research project? How many more months, years, to go?

The ASRP grant is now finished and we are in the process of disseminating the findings via academic publications. The CIHR project has just started. We are currently working with a scale development expert in the Department of Education Psychology at the University of Alberta to further refine and improve the pain scale. To do this, we accessed data from the Canadian Institute for Health Information. This data contains de-identified information on thousands of residents from across Canada and will allow us to do the required statistical analysis of the scale (psychometric testing) and determine the usefulness of the scale.  

The next step is to compare our RAI-MDSbased scale to another bedside observational scale that is currently considered the “gold standard. The gold standard, or PACSLAC-II, is a bedside, inperson scale. There currently is no observational pain scale available in the RAI-MDS, which is why we are developing one. 

After testing is complete, we will conduct focus groups and interviews to determine how best to implement our scale into routine practice within nursing homes.

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Are the results you’ve gotten so far surprising, or proving what you thought before? 

It is too soon to comment on this as we have not done the gold standard validation yet. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Will the project’s results create more of a local AU impact? Provincial? National? International?

Project outcomes are broadly transferable to Canadian and international practice and, more importantly, have strong potential to substantially influence and improve resident health outcomes and overall quality of care in the global health system. 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

Are you working with others on the project? Please name them. 

I am the primary investigator.  

Co-Investigators are: 

Dr. Malcolm DoupeAssociate Professor, University of Manitoba 

Dr. Carole Estabrooks Professor, University of Alberta  

Dr. Matthias Hoben – Assistant Professor, University of Alberta 

Dr. Sharon Kaasalainen – Professor, McMaster University 

Dr. Deborah Parker – Professor, University of Technology, Sydney, Australia 

Dr. Jeff Poss – Adjunct Professor, University of Waterloo 

Dr. Genevieve Thompson – Associate Professor, University of Manitoba 

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

How does this project fit in with your teaching schedule? 

I teach in the Nurse Practitioner graduate program in the Faculty of Health Disciplines. With the exception of three, one-week on-site courses a year, my teaching is done asynchronously via Moodle. This allows me the flexibility to work closely on my research as well as maintain an active presence with my students.

Dr. Jennifer Knopp-Sihota

Athabasca University Shield

Athabasca University News

What’s next for you, and/or, this project? 

Findings of the CIHR study will inform development of an observational pain assessment protocol followed by a comprehensive research plan and future study proposal to disseminate, implement, and then evaluate the scale and effectiveness of resulting care protocols. 

My next closely related project is aimed at reducing responsive behaviours in nursing home residents with advanced dementia. To do this, we will introduce plush animals and touch quilts to these nursing home residents and observe the effect on reducing behaviours and use of psychotropic drugs.

Dr. Jennifer Knopp-Sihota

Published:
  • October 6, 2019