The Impact of Culture Change on Elders’ Behavioral Symptoms: A Longitudinal Study

Burack, Orah R.; Weiner, Audrey S.; Reinhardt, Joann P.

doi:10.1016/j.jamda.2012.02.006

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…Of the 19 interventional studies on PCC, there were 15 RCTs and four non-RCTs, of which three studies had insufficient raw data to allow for meta-analysis. 24 – 26 Therefore, 16 studies underwent meta-analysis ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…DiNapoli et al 28 carried out individualized social activities intervention. Eleven care staff-directed studies: eleven of the 19 studies 10 , 26 , 31 – 39 included staff education and training on empathy and person-centeredness and feedback for care staff, with long intervention duration that ranged from 3 months to 2 years. Five out of 10 studies conducted follow-up that allowed evaluation of intervention durability and outcomes.…”

Section: Resultsmentioning

confidence: 99%

“… 32 , 35 , 37 , 39 Except for one study, 35 continuous support and feedback were ensured by regular meeting with researchers or external experts in intervention designs. One study 26 reported that a cultural change model-based intervention was performed, consisting of staff education and organizational structure changes.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

Kim

Park

2017

CIA

288

229

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BackgroundPerson-centered care is a holistic and integrative approach designed to maintain well-being and quality of life for people with dementia, and it includes the elements of care, the individual, the carers, and the family.AimA systematic literature review and meta-analysis were undertaken to investigate the effectiveness of person-centered care for people with dementia.MethodsLiterature searches were undertaken using six databases including Medline, EMBASE, CINAHL, PsycINFO, Cochrane Database, and KoreaMed using the following keywords: cognition disorder, dementia, person-centered care, patient-centered care, client-centered care, relationship-centered care, and dementia care. The searches were limited to interventional studies written in English and Korean and included randomized controlled studies and noncontrolled studies for people with dementia living in any setting.ResultsNineteen interventional studies, including 3,985 participants, were identified. Of these, 17 studies were from long-term care facilities and two studies were from homecare settings. The pooled data from randomized controlled studies favored person-centered care in reducing agitation, neuropsychiatric symptoms, and depression and improving the quality of life. Subgroup analysis identified greater effectiveness of person-centered care when implemented for people with less severe dementia. For agitation, short-term interventions had a greater effect (standardized mean difference [SMD]: −0.434; 95% conference interval [CI]: −0.701 to −0.166) than long-term interventions (SMD: −0.098; 95% CI: −0.190 to 0.007). Individualized activities resulted in a significantly greater beneficial effect than standard care (SMD: 0.513; 95% CI: −0.994 to −0.032). However, long-term, staff education, and cultural change interventions had a greater effect on improving the quality of life for people with dementia (SMD: 0.191; 95% CI: 0.079 to 0.302).ConclusionThis systematic review and meta-analysis provided evidence for person-centered care in clinical practice for people with dementia. Person-centered care interventions were shown to reduce agitation, neuropsychiatric symptoms, and depression and to improve the quality of life. Person-centered care interventions can effectively reduce agitation for a short term using intensive and activity-based intervention. However, an educational strategy that promotes learning and skill development of internal care staff is needed to enhance patient’s quality of life and to ensure the sustainability of the effects of behavioral problems. The feasibility and effectiveness of the intervention, the severity of patient disease, and intervention type and duration should be considered as part of an intervention design.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

Kim

Park

2017

CIA

288

229

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“…One study offered training only [ 91 ], and one changed staff responsibilities and care procedures [ 93 ]. The remaining studies combined training with other intervention components such as mentoring or support [ 86 , 87 , 89 , 92 , 97 , 99 , 100 , 102 ] and audit and feedback [ 86 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes

et al. 2015

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BackgroundWe systematically reviewed interventions that attempted to change staff practice to improve long-term care resident outcomes.MethodsStudies met criteria if they used a control group, included 6 or more nursing home units and quantitatively assessed staff behavior or resident outcomes. Intervention components were coded as including education material, training, audit and feedback, monitoring, champions, team meetings, policy or procedures and organizational restructure.ResultsSixty-three unique studies were broadly grouped according to clinical domain—oral health (3 studies), hygiene and infection control (3 studies), nutrition (2 studies), nursing home acquired pneumonia (2 studies), depression (2 studies) appropriate prescribing (7 studies), reduction of physical restraints (3 studies), management of behavioral and psychological symptoms of dementia (6 studies), falls reduction and prevention (11 studies), quality improvement (9 studies), philosophy of care (10 studies) and other (5 studies). No single intervention component, combination of, or increased number of components was associated with greater likelihood of positive outcomes. Studies with positive outcomes for residents also tended to change staff behavior, however changing staff behavior did not necessarily improve resident outcomes. Studies targeting specific care tasks (e.g. oral care, physical restraints) were more likely to produce positive outcomes than those requiring global practice changes (e.g. care philosophy). Studies using intervention theories were more likely to be successful. Program logic was rarely articulated, so it was often unclear whether there was a coherent connection between the intervention components and measured outcomes. Many studies reported barriers relating to staff (e.g. turnover, high workload, attitudes) or organizational factors (e.g. funding, resources, logistics).ConclusionChanging staff practice in nursing homes is possible but complex. Interventionists should consider barriers and feasibility of program components to impact on each intended outcome.

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“…The regular workshops aim to motivate and inspire the participants both to provide high-quality care and to continue the training programme. There is growing evidence of the positive effect of training programmes in enhancing person-centred dementia care on patient outcomes, such as neuropsychiatric symptoms and quality of life (Burack, Weiner, & Reinhardt, 2012;Chenoweth et al, 2009;Rokstad et al, 2013;Sloane et al, 2004;Spector et al, 2013).…”

Section: Person-centred Carementioning

confidence: 99%

The impact of the Dementia ABC educational programme on competence in person‐centred dementia care and job satisfaction of care staff

Rokstad

Døble

Engedal

et al. 2016

Int J Older People Nursing

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The Impact of Culture Change on Elders’ Behavioral Symptoms: A Longitudinal Study

Cited by 21 publications

References 31 publications

Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes

The impact of the Dementia ABC educational programme on competence in person‐centred dementia care and job satisfaction of care staff

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