Determining the Impacts of Educational Intervention based on PLST Extended Care on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

Abstract

BackgroundPsychological events in people with dementia (PWD) lead to behavioral disorders that require targeted planning for caregivers on how to adapt to these behaviors. A progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of people with dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered stress threshold extended (PLSTE) model on the caregiving of people with dementia (PWD) in Isfahan, Iran.MethodsThis exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth nonstructured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command and then analyzed. The researcher designed a multisectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by a panel of experts, and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. This educational intervention was designed and managed for the first time in our community. None of the caregivers agreed to refuse to receive the educational content, So the evaluation of the program lacks a randomized controlled group. The data were collected immediately and one month after the educational intervention using a questionnaire.ResultsAccording to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class and then the related intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).ConclusionConsidering the impacts of this intervention, educating caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of society, to improve the knowledge and practice of caregivers in caregiving skills and appropriate exposure to challenging behaviors people with dementia (CBPWD).Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir