What influences the sustainability of an effective psychosocial intervention for people with dementia living in care homes? A 9 to 12-month follow-up of the perceptions of staff in care homes involved in the WHELD randomised controlled trail.
Adult
Attitude of Health Personnel
Combined Modality Therapy
Delivery of Health Care
/ methods
Dementia
/ psychology
Female
Focus Groups
Follow-Up Studies
Health Services for the Aged
Humans
Male
Middle Aged
Nursing Homes
Psychotherapy
/ methods
Qualitative Research
Quality of Life
Self Efficacy
United Kingdom
care homes
dementia
interventions
qualitative
staff
sustainability
Journal
International journal of geriatric psychiatry
ISSN: 1099-1166
Titre abrégé: Int J Geriatr Psychiatry
Pays: England
ID NLM: 8710629
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
26
06
2018
accepted:
25
01
2019
pubmed:
2
2
2019
medline:
21
12
2019
entrez:
2
2
2019
Statut:
ppublish
Résumé
The study aims to understand the factors that care home staff felt enabled or hindered them in continuing to use the well-being and health for people with dementia (WHELD) psychosocial approach in their care home and investigate whether there was sustained activity 9 to 12 months after the study ended. This qualitative study is part of a wider clinical trial, which demonstrated effectiveness of a psychosocial intervention on quality of life outcomes and neuropsychiatric symptoms for residents. Forty-seven care home staff within nine care homes in the United Kingdom participated in focus groups, between 9 and 12 months after the intervention had finished. Inductive thematic analysis was used to identify themes and interpret the data. The findings highlighted that staff continued to use a range of activities and processes acquired through the research intervention, after the study had ended. Three overarching themes were identified as influential: "recognising the value" of the approach for residents and staff, "being well practiced" with sufficient support and opportunity to consolidate skills prior to the withdrawal of the researchers, and "taking ownership of the approach" to incorporate it as usual care. The WHELD approach can be sustained where the value of the approach is recognised, and sufficient support is provided during initial implementation for staff to build skills and confidence for it to become routine care. Further follow-up is required to understand longer term use and the impact for residents.
Identifiants
pubmed: 30706523
doi: 10.1002/gps.5066
pmc: PMC6594193
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
674-682Subventions
Organisme : Department of Health
ID : RP-PG-0608-10133
Pays : United Kingdom
Organisme : Department of Health
ID : RPPG-060-10133
Pays : United Kingdom
Informations de copyright
© 2019 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.
Références
Selbaek G, Engedal K, Bergh S. The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. J Am Med Dir Assoc. 2013;14(3):161-169.
Gordon AL, Franklin M, Bradshaw L, Logan P, Elliiott R, Gladman J. Health status of UK care home residents: a cohort study. Age Ageing. 2014;43(1):97-103. https://doi.org/10.1093/ageing/aft077
Corbett A, Smith J, Creese B, Ballard C. Treatment of behavioral and psychological symptoms of Alzheimer's disease. Curr Treat Options Neurol. 2012;14(2):113-125.
Ballard C, Fossey J, Chithramohan R, et al. Quality of care in private sector and NHS facilities for people with dementia: cross sectional survey. BMJ. 2001;323(7310):426-427.
Cabinet Office. Prime Minister's Challenge on Dementia 2020. 21 February 2015. https://www.gov.uk/government/publications/prime-ministers-challenge-on-dementia-2020
World Health Organisation (WHO). Global Action on Dementia. First WHO Ministerial Conference. Switzerland: Geneva; 2015 16-17 March. http://www.who.int/mental_health/neurology/dementia/ministerial_conference_2015_report/en/.
Kuske B, Hanns S, Luck T, Angermeyer M, Behrens J, Riedel-Heller S. Nursing home staff training in dementia care: a systematic review of evaluated programs. Int Psychogeriatr. 2007;19(5):818-841.
Fossey J, Masson S, Stafford J, Lawrence V, Corbett A, Ballard C. The disconnect between evidence and practice: a systematic review of person-centred interventions and training manuals for care home staff working with people with dementia. Int J Geriatr Psychiatry. 2014;29(8):797-807. https://doi.org/10.1002/gps.4072
Rapaport P, Livingston G, Murray J, Mulla A, Cooper C. Systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia. BMJ Open. 2017;7(2):e014177. https://doi.org/10.1136/bmjopen-2016-014177
Ayleward S, Stolee P, Keat N, Johncox V. Effectiveness of continuing education in long-term care: a literature review. Gerontologist. 2003;43(2):259-271. https://doi.org/10.1093/geront/43.2.259
Livingston G, Kelly L, Lewis-Holmes E, et al. Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials. Br J Psychiatry. 2014;205(6):436-442.
Virani T, Lemieux-Charles L, Davis D, Berta W. Sustaining change: once evidence-based practices are transferred, what then? Longwoods Review. 2009;6(4):89-96.
Hendricks Brown C, Curran G, Palinkas L, et al. An overview of research and evaluation designs for dissemination and implementation. Annu Rev Public Health. 2017;381-322.
Kitson A, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARIHS framework: theoretical and practical challenges. Implement Science. 2008;3:1. https://doi.org/10.1186/1748-5908-3-1
Glasgow R, Vogt T, Boles S. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322-1327.
Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science. 2009;4(1):50 https://doi.org/10.1186/1748-5908-4-50
Cammer A, Morgan D, Stewart N, et al. The hidden complexity of long-term care: how context mediates knowledge translation and use of best practices. Gerontologist. 2014;54(6):1013-1023.
Ballard C, Corbett A, Orrell M, et al. Impact of person-centred care training and person-centred activities on quality of life, agitation and antipsychotic use in people with dementia living in nursing homes: a cluster-randomized controlled trial of the WHELD intervention. PLoS Med. 2018;15(2):e1002500. https://doi.org/10.1371/journal.pmed.1002500
Lawrence V, Fossey J, Ballard C, Moniz-Cook E, Murray J. Improving quality of life for people with dementia in care homes: making psychosocial interventions work. Br J Psychiatry. 2012;201(5):344-351.
Lawrence V, Fossey J, Ballard C, Ferreira N, Murray J. Helping staff to implement psychosocial interventions in care homes: augmenting existing practices and meeting needs for support. Int J Geriatr Psychiatry. 2016;31(3):284-293. https://doi.org/10.1002/gps.4322
Ballard C, Orrell M, Sun Y, et al. Impact of antipsychotic review and non-pharmacological intervention on antipsychotic use, neuropsychiatric symptoms and mortality in people with dementia living in nursing homes: WHELD-a factorial cluster randomised controlled trial. Am J Psychiatry. 2016;173(3):252-262. https://doi.org/10.1176/appi.ajp.2015.15010130
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.
Glaser B. Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. California: Sociology Press; 1978.
Lehr JK, Rice RE. Organisational measures as a form of knowledge management: a multi theoretic, communication-based exploration. Journal of American Society for Information Science and Technology. 2002;53(12):1060-1073.
Szulanski G. The process of knowledge transfer: a dichronic analysis of stickiness. Organ Behav Hum Decis Process. 2000;82(1):9-27.
Chenoweth L, Jeon Y, Stein-Parbury J, Forbes I. PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments. Int Psychogeriatr. 2015;27(12):2045-2057.
Holloway I, Wheeler S. Qualitative Research in Nursing and Healthcare. 3rd ed. Oxford: Wiley-Blackwell; 2010.