Barriers to and facilitators for the use of an evidence‐based occupational therapy guideline for older people with dementia and their carers

Leven, Netta Van’t; Graff, Maud; Kaijen, Marleen; Swart, B.J.M. de; Rikkert, Marcel G M Olde; Vernooij-Dassen, M.J.F.J.

doi:10.1002/gps.2782

Cited by 32 publications

(42 citation statements)

References 22 publications

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“…The interventions in the included studies involved intensive training in adhering to study protocol (up to 80 hours). Translational research studies in dementia care have provided approximately 3 days of training to occupational therapists (Gitlin, Jacobs & Earland, 2010;Van't Leven et al 2011). This training needs to be available for both students and clinicians and supported by healthcare organizations.…”

Section: Discussionmentioning

confidence: 99%

“…Further research must be conducted to systematically identify the barriers and enablers to implementation of evidence based occupational therapy in different countries. A study reported by Van't Leven et al (2012) involved training occupational therapists in the Community Occupational Therapy in Dementia (COTiD) intervention ( Van't Leven et al, 2012). Focus groups were conducted to explore barriers to implementation of the program.…”

Section: Discussionmentioning

confidence: 99%

“…There is a real and immediate need for this information. Surveys of occupational therapists indicate that they self-report a lack of knowledge and confidence in using current research evidence in dementia care and that many perceive that further training would be useful (Bennett et al, 2011;Van't Leven et al, 2011).…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Laver

Clemson

Bennett

et al. 2014

Physical & Occupational Therapy In Geriatrics

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Aims: Behaviors of concern and psychological symptoms such as depression, apathy, agitation, wandering, and resistance to care are common in people with dementia and can be challenging for the caregiver to manage. This narrative review summarizes details of interventions found to be effective in reducing behaviors of concern and psychological symptoms. Methods: This review is based on an existing metaanalysis. The published meta-analysis included a large number of studies which ranged in efficacy. Studies were only included in this review if a moderate or large positive effect was found (Cohen's d ≥ 0.40). Information regarding the main aims of the intervention, dose, type of health professional providing the intervention, and the components of the intervention program were extracted. Results: Interventions with a positive effect contained multiple components including caregiver education, skills training, and engagement in meaningful occupations. Several of the interventions were delivered by an occupational therapist or were developed with extensive input from occupational therapists. Conclusion: This paper provides a description of effective interventions and can be utilized to guide the implementation of evidence-based practice in dementia care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Laver

Clemson

Bennett

et al. 2014

Physical & Occupational Therapy In Geriatrics

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“…Only 16 studies (regarding a total of 8 interventions) (7,8,21,22,23,49,52,53,54,55,63,70,93,94,122 and 123) discussed changes on how intervention staff delivered the neurological rehabilitation intervention over time. However, this was not described in detail.…”

Section: Recruitmentmentioning

confidence: 99%

Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research

2016

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ObjectiveTo systematically review how process evaluations are currently designed, what methodologies are used and how are they developed alongside or within neurological rehabilitation trials.MethodsThis mixed-methods systematic review had two evidence streams: stream I, studies reporting process evaluations alongside neurorehabilitation trials research and stream II, methodological guidance on process evaluation design and methodology. A search strategy was designed for each evidence stream. Data regarding process evaluation core concepts and design issues were extracted using a bespoke template. Evidence from both streams was analysed separately and then synthesised in a final overarching synthesis proposing a number of recommendations for future research.ResultsA total of 124 process evaluation studies, reporting on 106 interventions, were included in stream I evidence. 30 studies were included as stream II evidence. Synthesis 1 produced 9 themes, and synthesis 2 identified a total of 8 recommendations for process evaluation research. The overall synthesis resulted in 57 ‘synthesis recommendations’ about process evaluation methodology grouped into 9 research areas, including the use of theory, the investigation of context, intervention staff characteristics and the delivery of the trial intervention.ConclusionsThere remains no consensus regarding process evaluation terminology within the neurological rehabilitation field. There is a need for process evaluations to address the nature and influence of context over time. Process evaluations should clearly describe what intervention staff bring to a trial, including skills and experience prior to joining the research. Process evaluations should monitor intervention staff's learning effects and the possible impact that these may have on trial outcomes.

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“…Van't Leven et al [11] reported that the COTiD was not sufficiently used by occupational therapists who had learned it in a COTiD guideline course at Radboud University. They ascribed this to difficulties in actually implementing the rather complicated treatment, and that therapists had less competence in treating clients at home according to the guidelines.…”

Section: Literature Reviewmentioning

confidence: 99%

Effectiveness of an Occupation-Based Home-Visit Program for Clients with Dementia and Caregivers: A Pilot Study

et al. 2017

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Several studies have been implemented on home-visit occupational therapy based on activities or occupations for clients with dementia and their caregivers, but all have been conducted abroad; none have taken place in Japan. Therefore, we performed a pilot study of the effectiveness of an occupation-based home-visit program for clients with dementia and their caregivers using single cohort design. The results of our analysis of participants' (n = 9) data indicated that the home-visit program could improve the behavioral and psychological symptoms of dementia, particularly apathy, among clients with dementia, as well as caregivers' needs or what caregivers expected of clients. Additionally, the program tended to decrease caregivers' care burden. The implications of the study are discussed in light of further research on this program.

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Barriers to and facilitators for the use of an evidence‐based occupational therapy guideline for older people with dementia and their carers

Abstract: This study generates knowledge for applying innovations in health care settings. Improvement of the OTs' knowledge and self-confidence is needed for using the guideline. We expect that more competent OTs will motivate their physicians and managers to use this successful COTiD intervention.

Cited by 32 publications

References 22 publications

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Unpacking the Evidence: Interventions for Reducing Behavioral and Psychological Symptoms in People with Dementia

Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research

Effectiveness of an Occupation-Based Home-Visit Program for Clients with Dementia and Caregivers: A Pilot Study

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