Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study

Thunborg, Charlotta; Söderlund, Anne; Wågert, Petra von Heideken

doi:10.1080/21679169.2018.1549591

Cited by 4 publications

(8 citation statements)

References 36 publications

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“…The PwD tended to be less resistive to care in the intervention phase than the baseline phase, although the change was not signi cant. Reduced resistive behaviour was noted after a behavioural intervention in a previous study (Thunborg et al, 2019), which may indicate that these behaviours can in uence behavioural interventions.…”

Section: Discussionmentioning

confidence: 67%

“…The design is clinically relevant and features the opportunity to meet the complexity of person transferrelated behavioural problems in care dyads by tailoring and modifying interventions according to the care dyad's changing needs. This study is a replication of a former study by Thunborg et al (2019); however, it was implemented in another setting.…”

Section: Designmentioning

confidence: 93%

“…A transfer situation in an SCU is often constructed of one or two caregivers helping a PwD move, such as from sitting to standing or transferring from a bed to a wheelchair. A transfer situation is often complicated and in uenced by environmental, psychological, and physical factors and could be seen as a complex care dyadic behaviour involving both the PwD and the professional caregiver (Thunborg, Söderlund, & von Heideken Wågert, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…What caregivers do and the way they do it affects the PwD and in uences the PwD's behaviour in a caring situation (Berg, Hallberg, & Norberg, 1998;Holst, Edberg, & Hallberg, 1999). One example is the resistiveness to care (Belzil & Vézina, 2015), which can also be referred to as a transfer situation (Thunborg et al, 2019). If a PwD displays resistiveness to care by striving backwards, for example, the caregivers might experience physical strain (Wångblad, Ekblad, Wijk, & Ivanoff, 2009), which in turn can result in uncompleted transfers and increased reciprocal struggling by the care dyad (Thunborg, von Heideken Wågert, Söderlund, & Götell, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

Lagerlund¹,

Thunborg²,

Sandborgh³

2021

Preprint

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Background:Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads.Methods:This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection.Results:Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved significantly.Conclusions:The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The study is a replication of a previous study in a new clinical setting, which in turn strengthens the generalizability for a functional behavioural analysis-guided intervention for problematic transfer situations in dementia care dyads.

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Section: Discussionmentioning

confidence: 67%

Section: Designmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

Lagerlund¹,

Thunborg²,

Sandborgh³

2021

Preprint

Self Cite

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“…The implementation of Function Focused Care also resulted in a significant decline in resistiveness to care among participants. The decline in resistiveness to care adds to prior findings that providing direct and simple statements and optimizing resident participation in functional activities can decrease resistiveness to care 37‐40 . These techniques are major components of function focused care.…”

Section: Discussionmentioning

confidence: 84%

Testing the Impact of FFC‐AL‐EIT on Psychosocial and Behavioral Outcomes in Assisted Living

Resnick

Boltz

Galik

et al. 2020

J American Geriatrics Society

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BACKGROUND This study tested the impact of Function Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC‐AL‐EIT) on: (1) care interactions between residents and direct care staff; and (2) behavior and psychological symptoms associated with dementia among residents. DESIGN This was a randomized controlled trial. SETTING A total of 59 assisted living facilities in Maryland, Pennsylvania, and Massachusetts participated. PARTICIPANTS The sample included 550 mostly White (98%), female (69%) residents with a mean age of 89.30 (standard deviation = 7.63) years. INTERVENTION The four‐step FFC‐AL‐EIT intervention was implemented by a function focused care nurse facilitator working with a facility champion over 12 months. The steps included: (1) environment and policy assessments; (2) education; (3) establishing resident function focused care service plans; and (4) mentoring and motivating. MEASURES Resident descriptive data (e.g., age, sex, education, and comorbidities), depression, agitation, resistiveness to care, and the quality of care interactions were obtained at baseline and 4 and 12 months. Treatment fidelity data included environment and policy assessments, performance of function focused care by staff, and service plan assessments. RESULTS There was a significant positive treatment effect related to depression, agitation, resistiveness to care, and quality of care interactions with either less decline or some improvement in these behaviors and symptoms in the treatment versus control group. CONCLUSION The study provides some statistical support, which may not necessarily be clinically significant evidence, for psychosocial outcomes of residents and care interactions between staff and residents in assisted living settings.

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Psychometric Properties of Instruments Measuring Dyadic Communication and Environment in Dementia Care: A Systematic Review

Kim

Liu

2021

The Gerontologist

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Background and Objectives A valid and reliable assessment of dementia dyadic communication and environment is essential to understand and facilitate social interaction and quality care. This review described the characteristics and evaluated psychometric properties of instruments that assess dyadic communication and environment between persons living with dementia and their caregivers. Research Design and Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline. Literature published until June 30 th, 2021, was searched. Ten psychometric properties and the ratio of sample size to the number of items were evaluated using the Psychometric Assessment for Self-report and Observational Tool. Results A total of 3,708 scholarly records was identified, and 24 eligible instruments from 48 scholarly records were evaluated. Twenty-two instruments assessed dyadic communication, and two assessed both dyadic communication and environment. Eighteen instruments were developed to assess task-related communication and fifteen for paid (professional) caregivers. All instruments were scored as low psychometric quality (score range = 0 - 7). Behavioral Observation Scoring System was scored the highest (total score = 7), followed by Dyadic Dementia Coding System, Grid for observation of physical and verbal behaviors of caregiver and resident, and Trouble-Indicating Behaviors and Repair (total score = 6, respectively). These instruments had low psychometric evidence for internal consistency, content validity, and structural validity. Discussion and Implications Existing instruments are in the early stages of development and validation in dementia population. Further testing is needed in diverse communication types in paid and unpaid dementia caregiver populations.

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Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study

Cited by 4 publications

References 36 publications

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

Testing the Impact of FFC‐AL‐EIT on Psychosocial and Behavioral Outcomes in Assisted Living

Psychometric Properties of Instruments Measuring Dyadic Communication and Environment in Dementia Care: A Systematic Review

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