Key components of person‐centered care for people with dementia: A systematic review of interventions to design a patient preference study

Abstract

Background: To provide Person-Centered Care (PCC) for People with Dementia (PwD), patient's stated preferences must be known. Data about stated carepreferences among PwD are limited. This study aimed to identify key components of PCC for PwD by a systematic review of PCC-interventions, to inform the construction of a decision model for PwD-preference elicitation. Method: A protocol was registered with PROSPERO (CRD42021225084). A search of the concepts Dementia, Person-Centered Care, and Intervention was performed in PubMed, EMBASE, and Web of Science in Nov2020. Study selection was based on 2-stage screening against eligibility criteria, limited to randomized controlled trials (RCT) and nonrandomized controlled study (NRS) designs. Risk of bias was assessed with version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB2) and the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Information about authors, interventions, and outcomes were extracted and entered into an "Effects Table". The identified PCC-interventions were thus synthesized into intervention categories to form key components of PCC. Result: Searches identified 1781 records. 19 studies (15 RCT, 4 NRS) were included after screening. The quality of the studies varied between low to moderate. The individual interventions covered a wide range of non-pharmacological, psychosocial offers, oftentimes bundled in multi-component intervention-sets. Nine intervention categories, i.e. key components of PCC to inform the construction of a decision model for PwD-preference elicitation, emerged from data synthesis: sensory enhancement/relaxation, social contact, cognitive training, validation and reminiscence, physical activities, environmental adjustments, caregiver training and support, care organization and daily living assistance. Effect measures included i.a. agitation, quality of life, antipsychotic use, depression, neuropsychiatric symptoms and behavior, with mixed results concerning the effect of the PCC interventions. All studies were conducted in nursery home or hospital settings.

Cross-cultural adaptation and psychometric properties of the Chinese version of the Person-Centered Maternity Care Scale

“…Person-centered maternity care is important because having a negative experience is associated with disparities in adverse pregnancy and birth outcomes [ 12 – 14 ], as well as poorer mental health among postpartum women [ 15 ], such as postpartum depression, anxiety, and Post-traumatic Stress Disorder (PTSD) [ 16 ]. Furthermore, evidence suggests that improving person-centered maternity care enhances women’s trust in facility-based care while decreasing patient complaints and medical disputes [ 17 , 18 ]. As such, it is imperative to have a good, valid, and reliable instrument for assessing levels of person-centered maternity care to inform effective strategies to improve maternal health services [ 6 , 19 , 20 ].…”