Determining the Impacts of Educational Intervention based on PLST Extended Care model on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

Abstract Background: Psychological events in People with Dementia (PWD) lead to behavioral disorders which require targeted planning for caregivers on how to adapt to these behaviors. Progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of People with Dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered Stress threshold extended (PLSTE) model on the caregiving of People with Dementia (PWD) in Isfahan, Iran. Methods: This exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth non-structured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command in a word and then analyzed. The researcher designed a multi-sectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by the panel of experts and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. The data were collected immediately and one month after the educational intervention using a questionnaire. Results: According to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class, and then the related Intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).Conclusion: Considering the impacts of this intervention, educating the caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of the society, to improve knowledge and practice of caregivers in caregiving skills and appropriate exposure to Challenging Behaviors People with Dementia (CBPWD). Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir

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Determining the Impacts of Educational Intervention based on PLST Extended Care model on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

10.21203/rs.3.rs-969790/v1 ◽

2021 ◽

Author(s):

Fereshteh Zamani-Alavijeh ◽

Shakiba Zahed ◽

Maryam Emami ◽

Shahrzad Bazargan-Hejazi ◽

Majid Barekatain ◽

...

Keyword(s):

Mixed Methods ◽

Educational Intervention ◽

Intervention Program ◽

Challenging Behaviors ◽

Mixed Methods Study ◽

Care Model ◽

People With Dementia ◽

Stress Threshold ◽

Progressively Lowered Stress Threshold ◽

The Mean

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Determining The Impacts of Educational Intervention Based on PLST Extended Care On Caregiving Methods and Improved Exposure To Challenging Behaviors of People With Dementia (PWD): A Mixed-Methods Study

10.21203/rs.3.rs-969789/v1 ◽

2021 ◽

Author(s):

Fereshteh Zamani-Alavijeh ◽

Shakiba Zahed ◽

Maryam Emami ◽

Shahrzad Bazargan-Hejazi ◽

Majid Barekatain ◽

...

Keyword(s):

Mixed Methods ◽

Educational Intervention ◽

Intervention Program ◽

Challenging Behaviors ◽

Mixed Methods Study ◽

People With Dementia ◽

Stress Threshold ◽

Progressively Lowered Stress Threshold ◽

The Mean ◽

Psychological Events

Abstract Background: Psychological events in people with dementia (PWD) lead to behavioral disorders that require targeted planning for caregivers on how to adapt to these behaviors. A progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of people with dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered stress threshold extended (PLSTE) model on the caregiving of people with dementia (PWD) in Isfahan, Iran.Methods: This exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth nonstructured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command and then analyzed. The researcher designed a multisectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by a panel of experts, and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. The data were collected immediately and one month after the educational intervention using a questionnaire.Results: According to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class and then the related intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).Conclusion: Considering the impacts of this intervention, educating caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of society, to improve the knowledge and practice of caregivers in caregiving skills and appropriate exposure to challenging behaviors people with dementia (CBPWD).Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir

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Determining the Impacts of Educational Intervention based on PLST Extended Care on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

10.21203/rs.3.rs-969789/v2 ◽

2021 ◽

Author(s):

Fereshteh Zamani-Alavijeh ◽

Shakiba Zahed ◽

Maryam Emami ◽

Shahrzad Bazargan-Hejazi ◽

Majid Barekatain ◽

...

Keyword(s):

Mixed Methods ◽

Educational Intervention ◽

Intervention Program ◽

Challenging Behaviors ◽

Mixed Methods Study ◽

Educational Content ◽

People With Dementia ◽

Stress Threshold ◽

Progressively Lowered Stress Threshold ◽

The Mean

Abstract BackgroundPsychological events in people with dementia (PWD) lead to behavioral disorders that require targeted planning for caregivers on how to adapt to these behaviors. A progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of people with dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered stress threshold extended (PLSTE) model on the caregiving of people with dementia (PWD) in Isfahan, Iran.MethodsThis exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth nonstructured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command and then analyzed. The researcher designed a multisectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by a panel of experts, and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. This educational intervention was designed and managed for the first time in our community. None of the caregivers agreed to refuse to receive the educational content, So the evaluation of the program lacks a randomized controlled group. The data were collected immediately and one month after the educational intervention using a questionnaire.ResultsAccording to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class and then the related intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).ConclusionConsidering the impacts of this intervention, educating caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of society, to improve the knowledge and practice of caregivers in caregiving skills and appropriate exposure to challenging behaviors people with dementia (CBPWD).Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir

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Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study

BMC Geriatrics ◽

10.1186/s12877-021-02125-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jung-Hee Kim ◽

Seonmin Park ◽

Hyeongji Lim

Keyword(s):

Virtual Reality ◽

Nursing Homes ◽

Intervention Program ◽

Psychological Symptoms ◽

Likert Scale ◽

Psychological Needs ◽

Second Phase ◽

People With Dementia ◽

The Mean ◽

Behavioral And Psychological Symptoms

Abstract Background The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. Methods In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale. Results In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. Conclusions The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

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The Transmural Trauma Care Model can be implemented well but some barriers and facilitators should be considered during implementation: a mixed methods study

Journal of Physiotherapy ◽

10.1016/j.jphys.2021.08.017 ◽

2021 ◽

Author(s):

Suzanne H Wiertsema ◽

Marianne H Donker ◽

Johanna M van Dongen ◽

Edwin Geleijn ◽

Frank W Bloemers ◽

...

Keyword(s):

Mixed Methods ◽

Trauma Care ◽

Mixed Methods Study ◽

Barriers And Facilitators ◽

Care Model

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Strengthening nursing role and functions in stroke rehabilitation 24/7: A mixed-methods study assessing the feasibility and acceptability of an educational intervention programme

Nursing Open ◽

10.1002/nop2.202 ◽

2018 ◽

Vol 6 (1) ◽

pp. 162-174 ◽

Cited By ~ 1

Author(s):

Mia Ingerslev Loft ◽

Ingrid Poulsen ◽

Bente Martinsen ◽

Lone Lunbak Mathiesen ◽

Helle Klingenberg Iversen ◽

...

Keyword(s):

Mixed Methods ◽

Educational Intervention ◽

Stroke Rehabilitation ◽

Mixed Methods Study ◽

Intervention Programme ◽

Nursing Role

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Experiences of informal caregivers of people with dementia with nursing care in acute hospitals: A descriptive mixed‐methods study

Journal of Advanced Nursing ◽

10.1111/jan.15042 ◽

2021 ◽

Vol 77 (12) ◽

pp. 4887-4899

Author(s):

Annette Keuning‐Plantinga ◽

Petrie Roodbol ◽

Barbara C. Munster ◽

Evelyn J. Finnema

Keyword(s):

Mixed Methods ◽

Nursing Care ◽

Informal Caregivers ◽

Mixed Methods Study ◽

People With Dementia ◽

Acute Hospitals

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A mental health intervention program for the oocyte donors: protocol for a mixed methods study

Reproductive Health ◽

10.1186/s12978-020-0864-9 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Elham Adib Moghaddam ◽

Ashraf Kazemi ◽

Gholamreza Kheirabadi ◽

Seyyed Mehdi Ahmadi

Keyword(s):

Mental Health ◽

Mixed Methods ◽

Intervention Program ◽

Health Intervention ◽

Mixed Methods Study ◽

Mental Health Intervention ◽

Oocyte Donors

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3361 Feasibility, Acceptability, and Appropriateness of an Insertable Vaginal Cup to Manage Urinary Incontinence Among Women with Obstetric Fistula in Ghana: A Mixed Methods Study

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.105 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 44-45

Author(s):

Nessa E Ryan

Keyword(s):

Urinary Incontinence ◽

Mixed Methods ◽

Repeated Measures ◽

Obstetric Fistula ◽

Mixed Methods Study ◽

Relative Advantage ◽

Self Management ◽

Future Research ◽

Leakage Reduction ◽

The Mean

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.

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