Healthcare professionals' experiences of using a biopsychosocial approach to understand behavioural and psychological symptoms of dementia: A qualitative interview study

Abstract

Background: Biopsychosocial approaches to understanding behavioural and psychological (otherwise known as "non-cognitive" or "neuropsychiatric") symptoms of dementia tend to be conducted by specialist psychology professionals. To increase service users' access to these approaches, healthcare professionals from nursing and allied health disciplines are being trained to use them. However, little is known about healthcare professionals' experiences of implementing biopsychosocial approaches in everyday practice.Objectives: To explore nursing and allied healthcare professionals' views of using the "Newcastle Model," which is a biopsychosocial approach to understanding behavioural and psychological symptoms of dementia.Method: Thirteen community mental healthcare professionals from nursing, social work and occupational therapy backgrounds were interviewed about their views and experiences of using the Newcastle Model to understand and work with behavioural and psychological symptoms of dementia. Data were analysed using thematic analysis.Results: Five themes were identified. The first theme reflected the perceived positive value of taking a more psychosocial approach to understanding behavioural and psychological symptoms of dementia. The second theme reported participants' expressions of low confidence in using the approach, as well as their reported difficulties in prioritising it. The third theme highlighted the perceived time-consuming nature of the approach, and the adaptations that some staff made to increase its practicality. The fourth theme highlighted the importance of working in collaboration with those who provided direct care and support to the person with dementia. The final theme reflected participants' positive view of the effectiveness of the approach for delivering person-centred care Conclusion: Community healthcare professionals valued the integration of a biopsychosocial approach into their practice, although identified key implementation barriers.

Formulation‐led care in care homes: Staff perspectives on this psychological approach to managing behaviour in dementia care

“…Working together formed another pertinent theme within the present study and was also identified within Steele et al’s (2021) study exploring community mental health staff members’ experiences of carrying out formulations with care home staff. Participants within the present study discussed feeling that the psychologist had not attained a true perspective of the resident in question as the care staff had not been suitably involved in the information gathering process.…”

“…If staff do not understand the purpose or the nature of the formulation developed, they are unlikely to appreciate the value of recommendations arising within from the process. Previous research has suggested that one of the key barriers to carrying out effective formulation is information generated from formulations not being fed into care planning (Steele et al, 2021). These findings suggest that managing staff expectations and engaging staff in a way that recognises the perspectives that they themselves bring is a way of overcoming this barrier, supported by psychological theory.…”

“…Whilst best practice guidelines advocate for psychologists to develop formulations with staff teams due to their specialist training (NICE, 2018), Steele et al (2021) suggest that community health-care professionals can be trained to utilise this biopsychosocial approach in their clinical practice. Therefore, where effective professional relations have been established between community staff and care teams, other health-care professionals such as mental health nurses may be suitably placed to facilitate discussions around formulation.…”

“…Notably, the nursing staff recruited within the study had all received at least 2 years of caregiving training which is not representative of the majority of care staff. Steele et al (2021) explored a novel approach of training community mental health team staff to carrying out formulations with care home staff. The study found that community mental health staff valued using formulations with care home staff but highlighted a number of different barriers to integrating formulation within their routine practice including time limitations and perceived low confidence in using the approach.…”

Psychosocial Supports Offered to People with Psychotic Disorders by Community Members in Temeke District, Tanzania

“…At least one-quarter of people in Sub-Saharan Africa have experienced a psychotic disorders at some point in their lives (Galvin & Byansi, 2020;Roberts, Smith, Cluver, Toska, & Sherr, 2021). The WHO"s slogan of 2004, which stated that "no health without mental health," wants mental health to be viewed in biological, psychological, and sociological domains through a model known as the biopsychosocial approach (Vigo, et al, 2016;Ng et al, 2021;Peña-Vargas, Armaiz-Peña, & Castro-Figueroa, 2021;Steele, Berry, & Brown, 2022). The slogan also insists on the involvement of the entire community in the improvement of the mental wellbeing of those suffering from mental illnesses.…”