Erratum to: Association between pain, neuropsychiatric symptoms, and physical function in dementia: a systematic review and meta-analysis

Dalen-Kok, Annelore H van; Pieper, Marjoleine J.C.; Waal, Margot de; Lukas, Albert; Husebo, Bettina S.; Achterberg, Wilco P.

doi:10.1186/s12877-015-0085-1

Cited by 8 publications

(3 citation statements)

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“…The relationships found between QOL and pain and comorbidity is highly relevant to improve QOL in persons with dementia in LTCFs. Since pain can be related to neuropsychiatric behavior, this may influence QOL [46,47,48]. Treatment of pain and optimization of symptom control for patients with a psychiatric disorder or pulmonary disease may result in a higher QOL, which is also suggested by studies in the general population [49].…”

Section: Discussionmentioning

confidence: 99%

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Klapwijk

Caljouw

Pieper

et al. 2016

Dement Geriatr Cogn Disord

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Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

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Section: Discussionmentioning

confidence: 99%

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Klapwijk

Caljouw

Pieper

et al. 2016

Dement Geriatr Cogn Disord

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“…Although both pain and challenging behaviour are highly prevalent in dementia [ 4 ], it is the entanglement between the two that makes their relationship, as well as its assessment and treatment, complex and challenging [ 2 5 6 ]. To help healthcare professionals deal with these complex problems and challenges, Kovach et al, 2006 developed the Serial Trial Intervention (STI) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Stepwise, Multidisciplinary Intervention for Pain and Challenging Behaviour in Dementia (STA OP!): A Process Evaluation

Pieper¹,

Achterberg²,

Steen³

et al. 2018

International Journal of Integrated Care

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Background:A stepwise, multidisciplinary and multicomponent intervention (called STA OP!) was implemented in Dutch nursing home units, which included a comprehensive multidisciplinary team training. A cluster-randomised controlled trial showed that the intervention reduced symptoms of pain and challenging behaviour.Objective(s):To describe the experiences around the implementation of the intervention; to examine the extent to which the STA OP! intervention was delivered and implemented as intended (at the level of the team, and the individual resident/professional); and to understand factors influencing the implementation process.Methods:A process evaluation was performed using a mixed-methods design encompassing several data sources. Quantitative data (i.e. from the written evaluations by healthcare professionals, management, and the research database) were analysed using descriptive statistics. Qualitative data (i.e. semi-structured interviews, notes, completed intervention forms, and written evaluations) were analysed according to the principles of thematic analysis. The implementation process and the influencing factors were categorised according to the i) organisational level, ii) the team level, and iii) the level of the individual resident/professional.Results:In total, 39.2% of the residents with pain and/or challenging behaviour were treated following the stepwise approach of the STA OP! intervention. The training manual and forms used were found to be relevant and feasible. Factors inhibiting the implementation process at the i) organisational level concerned instability of the organisation and the team (e.g. involvement in multiple projects/new innovations, staff turnover/absence of essential disciplines, and/or high workload). At the team level (ii), we found that presence of a person with a motivational leadership style facilitated the implementation. Also, interdisciplinary cooperation through the design/setting of the multidisciplinary training, securing the intervention by use of clear agreements, and written reporting or transfers facilitated implementation. At the individual level (iii), perceived value of the stepwise working method, and enhanced awareness facilitated the implementation.Conclusion:Although the intervention was not implemented as planned, the intervention empowered healthcare professionals and increased their awareness of the signals of pain and challenging behaviour. Future implementation of the intervention should start on units with a motivational leader, and specific features of the organisation and the team should be considered to facilitate implementation, e.g. stability, support, and shared focus to change.

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“…Pain and agitation can be measured, and studies reveal that treatment of pain reflects on levels of agitation ( 14 , 17 , 37 ). However, the human body displays non-holonomic behavior as a system (future states are dependent on present and past states), and instant measurements (performed at a specific moment in time) only tell part of the story, as they cannot produce information about the state of the patient, past or future.…”

Section: Methodsmentioning

confidence: 99%

Understanding Pain and Agitation Through System Analysis Algorithms in People With Dementia. A Novel Explorative Approach by the DIGI.PAIN Study

et al. 2022

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BackgroundMany people with dementia (PwD) live and die with undiagnosed and untreated pain and are no longer able to report their suffering. Several pain assessment tools have been developed, tested, and implemented in clinical practice, but nursing home patients are reported to be still in pain. Clinicians and research groups worldwide are seeking novel approaches to encode the prediction, prevalence, and associations to pain in PwD.ParticipantsThe data in this analysis are acquired from the COSMOS study, a cluster-randomized controlled trial (2014 to 2015), aimed to improve the quality of life in nursing home patients (N = 723) through the implementation of a multicomponent intervention. We utilize baseline data of PwD (N = 219) with complete datasets of pain and agitation.MethodSystems analysis explores the relationship between pain and agitation using the Mobilization-Observation-Behavior-Intensity-Dementia (MOBID-2) Pain Scale, Cohen-Mansfield Agitation Inventory (CMAI), and Neuropsychiatric Inventory-Nursing Home version (NPI-NH). For each patient, the individualized continuous time trajectory, and rates of change of pain and agitation are estimated. We determine the relationship between these rates by analyzing them across the entire group.ResultsWe found that the new analysis method can generate individualized estimations for pain and agitation evolution for PwD, as well as their relationship. For 189 of 219 PwD, results show that whenever pain increases or decreases, agitation does too, with the same rate. The method also identifies PwD for whom pain or agitation remains constant while the other varies over time, and patients for whom agitation and pain do not change together. The algorithm is scalable to other variables and compatible with wearable devices and digital sensors.ConclusionWe presented a new approach to clinical data analysis using systems concepts and algorithms. We found that it is possible to quantify and visualize relationships between variables with a precision only dependent on the precision of measurements. This method should be further validated, but incipient results show great potential, especially for wearable-generated continuous data.

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Erratum to: Association between pain, neuropsychiatric symptoms, and physical function in dementia: a systematic review and meta-analysis

Cited by 8 publications

References 0 publications

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Implementation of a Stepwise, Multidisciplinary Intervention for Pain and Challenging Behaviour in Dementia (STA OP!): A Process Evaluation

Understanding Pain and Agitation Through System Analysis Algorithms in People With Dementia. A Novel Explorative Approach by the DIGI.PAIN Study

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