scholarly journals Evaluation of Carer Strain and Carer Coping with Medications for People with Dementia after Discharge: Results from the SMS Dementia Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 248
Author(s):  
Remia Bruce ◽  
Wendy Murdoch ◽  
Ashley Kable ◽  
Kerrin Palazzi ◽  
Carolyn Hullick ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Medication Management ◽  
Unplanned Admission ◽  
Dose Administration ◽  
People With Dementia ◽  
Safety Strategies ◽  
Quasi Experimental ◽  
Medication Intervention ◽  
And Coping ◽  
The Impact

This study reports carer strain and coping with medications for people with dementia with an unplanned admission to hospital, and it evaluates the impact of a safe medication intervention on carer coping and carer strain. This was a quasi-experimental pre/post-controlled trial that included a survey of carers about managing medications for people with dementia after discharge. For 88 carers who completed surveys, 33% were concerned about managing medications, and 40% reported difficulties with medication management, including resistive behaviours by people with dementia. Dose administration aids were used by 72% of carers; however, only 15% reported receiving a recent home medicines review by a community pharmacist. High carer strain was reported by 74% of carers. Carer comments described many issues that contributed to high carer stress, as well as their engagement in vigilant activities to maintain medication safety. Strategies that can contribute to carers managing medications and reducing their strain include an increased use of dose administration aids, increased provision of home medicines reviews, and increased education of health professionals to provide adequate support and education about managing medications.

scholarly journals An evaluation of Cognitive Stimulation Therapy sessions for people with dementia and a concomitant support group for their carers

Dementia ◽  
2016 ◽  
Vol 16 (8) ◽  
pp. 985-1003 ◽  
Author(s):  
Jan Bailey ◽  
Paul Kingston ◽  
Simon Alford ◽  
Louise Taylor ◽  
Edward Tolhurst
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Qualitative Data ◽  
Cognitive Stimulation ◽  
Structured Interviews ◽  
Post Intervention ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Quasi Experimental ◽  
The Impact

This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.

Stress as Experienced by People with Dementia: An Interpretative Phenomenological Analysis

Dementia ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 1427-1445 ◽  
Author(s):  
Barbara K Sharp
Keyword(s):  
Interpretative Phenomenological Analysis ◽  
Sense Of Self ◽  
Phenomenological Analysis ◽  
People With Dementia ◽  
Health And Social Care ◽  
Self Worth ◽  
And Coping ◽  
Study Participants ◽  
Person With Dementia ◽  
The Impact

Health and social care research on stress in dementia has predominantly considered the stress experienced by family and professional carers. Focus on the person with dementia has frequently laid emphasis on the impact of stress-related behaviour on others and how such behaviour might be ‘managed’. This paper describes a qualitative study which gives voice to people with dementia on the subject of stress and responds to the need for a better understanding of stress as it is experienced by people with dementia themselves. An interpretative phenomenological analysis was conducted on data collected from a purposive sample of people diagnosed with varying types of dementia from across Scotland. Discussions across five focus groups consisting of 21 participants with dementia in total generated data which was audio and video recorded, and analysed thematically. Five key themes emerged, described in the participants’ own words, which were: (1) ‘Something’s torn, your life’s torn’; (2) ‘Families can bring stress’; (3) ‘It’s the stress of living with dementia’; (4) ‘A whole new set of rules’; and (5) ‘It’s our lives and we’ll get it under control ourselves’. These themes reflect experiences of loss, challenges to one’s sense of self, relationship dynamics, living with the symptoms of dementia, learning to do things differently and establishing coping mechanisms that provide control. Study participants illustrated individual potential for adapting and coping with some of the most stressful aspects of living with dementia, challenging assumptions of inevitable fixed decline and progressive vulnerability to stress. Participants describe a process of recovery in their perceptions of self-worth, purpose and value in life following diagnosis.

The Emergence of the Person in Dementia Research

1997 ◽  
Vol 17 (5) ◽  
pp. 597-607 ◽  
Author(s):  
MURNA DOWNS
Keyword(s):  
Support Groups ◽  
Sense Of Self ◽  
Medical Model ◽  
Disease Process ◽  
People With Dementia ◽  
Dementia Research ◽  
The Individual ◽  
And Coping ◽  
Person With Dementia ◽  
The Impact

The purpose of this review is to identify and explore the emerging attention being paid to the individual in dementia research. Following a brief introduction, the review will examine literature which recognises three aspects of the person with dementia: the individual's sense of self; the person's rights; and the value to be gained from a concern with the perspectives of people with dementia. To date the medical model has dominated dementia research. This model tends to reduce the person with dementia to his/her neurobiology or neuropsychology (Cotrell and Schulz 1993). The experience and manifestation of dementia has been attributed solely to the disease process, with a consequent neglect of the psychosocial context surrounding the individual (Lyman 1989). Research on the psychosocial aspects of dementia has concentrated on family carers. Keady (1996) provides a useful categorisation of this research into the following topics: gender and coping style; marital relationships and the impact of dementia; access to information and services; participation in and effectiveness of support groups; adjustment and circumstances surrounding admission into care; and perception of own health needs. No literature focuses on people with dementia.

scholarly journals A Community Resource Referral Intervention for Informal Caregivers of People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 148-149
Author(s):  
Kelly Boyd ◽  
Kate Doyle ◽  
Soo Borson ◽  
Elbert Huang ◽  
Stacy Lindau ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Text Message ◽  
High Volume ◽  
Eligibility Criteria ◽  
Dementia Caregivers ◽  
Black African ◽  
People With Dementia ◽  
Caregiver Needs ◽  
Caregiver Interventions ◽  
The Impact

Abstract The National Alzheimer’s Project Act (PL-111-375) calls for connecting dementia caregivers to community resources, but few caregiver interventions have focused on this component of support. CRx-D is a theory-driven, scalable intervention that addresses common caregiver needs through: (1) education to normalize needs, (2) coaching on resource activation and (3) tools to promote access, including a printed list of nearby resources (“HealtheRx-D”), an online resource finder, proactive and ongoing text message support. We pretested the intervention arm of CRx-D among 10 caregivers of PWD to assess appropriateness, feasibility and fidelity. Patients presenting for care at 3 outpatient clinics were screened for eligibility, enrolled and given the intervention (12/19-01/20). Of 1,038 patients approached, 12 were caregivers of PWD; 10/12 met all eligibility criteria. All 10 eligible caregivers were enrolled in the study. Caregivers were, on average, 49 years old (range, 29-65), primarily female (n=8), Black/African American (n=9), and half were children of PWD (n=5). At baseline, several caregivers indicated unmet caregiving or health needs (caregiving education [n=7], free/affordable meals [n=5] and financial assistance [n=5]) indicating the intervention’s appropriateness. Intervention components were delivered as intended to all caregivers, although one caregiver provided a landline so could not receive texts. A scalable resource referral intervention for caregivers is appropriate. Delivery is feasible with high fidelity. Identifying caregivers at the point of their own healthcare requires high volume screening. These findings will inform a randomized controlled trial of 344 caregivers of PWD to evaluate the impact of CRx-D on caregiver self-efficacy and satisfaction with care.

scholarly journals Educational Interventions for Nursing Students to Develop Communication Skills with Patients: A Systematic Review

2020 ◽  
Vol 17 (7) ◽  
pp. 2241 ◽  
Author(s):  
Lorena Gutiérrez-Puertas ◽  
Verónica V. Márquez-Hernández ◽  
Vanesa Gutiérrez-Puertas ◽  
Genoveva Granados-Gámez ◽  
Gabriel Aguilera-Manrique
Keyword(s):  
Systematic Review ◽  
Nursing Students ◽  
Communication Skills ◽  
Controlled Trial ◽  
Experimental Studies ◽  
Educational Interventions ◽  
Patient Centered ◽  
Randomized Controlled ◽  
Quasi Experimental ◽  
The Impact

Introduction: Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients. Methods: A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed. Results: Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students. Conclusions: This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.

Knowledge mobilisation in sub-Saharan Africa: an impact evaluation of CPDL in improving primary school children’s performance

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Miriam Mason ◽  
David Galloway
Keyword(s):  
Experimental Design ◽  
School Improvement ◽  
Impact Evaluation ◽  
Controlled Trial ◽  
Sub Saharan Africa ◽  
Design Development ◽  
Knowledge Mobilisation ◽  
Content Type ◽  
Quasi Experimental ◽  
The Impact

PurposeA non-governmental organisation (NGO) with schools in Sierra Leone prioritises admission of the most disadvantaged children but nevertheless achieves high educational and social standards. These schools were asked to provide continuing professional development and learning (CPDL) for other schools. This paper aims to report the design, development and delivery of CPDL which aimed to mobilise effective practices more widely. It also reports the design and results of an impact evaluation.Design/methodology/approachIt was recognised that CPDL delivered by foreigners would be (1) unaffordable in this impoverished West African country and (2) culturally inappropriate. It was therefore delivered by local teachers from the NGO's own schools. Most had obtained no formal teaching qualification. They were trained to collect data using a quasi-experimental design for an impact evaluation of children's attendance and literacy. A total of five schools participated in the CPDL, with ten control schools.FindingsA largely unqualified team succeeded in mobilising knowledge in the experimental schools. Children's attendance in experimental schools improved over that in control schools. Performance in literacy also improved significantly and was maintained at follow-up.Research limitations/implicationsFindings of the impact evaluation are seen as indicative rather than causal because a quasi-experimental study was conducted rather than a randomised controlled trial.Originality/valueThis lies in (1) teachers in schools with a severely disadvantaged intake providing a structured programme of CPDL for teachers in other schools; (2) school improvement through knowledge mobilisation in CPDL; (3) an impact evaluation with a quasi-experimental design showing improvement in children's performance.

scholarly journals The Interactive Relationship between Pain, Psychosis, and Agitation in People with Dementia: Results from a Cluster-Randomised Clinical Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Torstein F. Habiger ◽  
Elisabeth Flo ◽  
Wilco P. Achterberg ◽  
Bettina S. Husebo
Keyword(s):  
Pain Treatment ◽  
Controlled Trial ◽  
Neuropsychiatric Symptoms ◽  
Intervention Group ◽  
Opioid Analgesics ◽  
Cluster Randomised Controlled Trial ◽  
Psychotic Symptoms ◽  
Cluster Randomised ◽  
People With Dementia ◽  
The Impact

Background. Neuropsychiatric symptoms are common in people with dementia, and pain is thought to be an important underlying factor. Pain has previously been associated with agitation, and pain treatment has been shown to ameliorate agitated behaviour. So far, the association between pain and psychosis and the effect of pain treatment on psychotic symptoms is unclear. Furthermore, the impact of opioid treatment on psychosis is not established.Aim. To investigate the efficacy of a stepwise protocol for treating pain (SPTP) on psychosis and agitation measured with the Neuropsychiatric Inventory, Nursing Home version, and to explore the impact of opioid analgesics on psychosis.Method. Secondary analyses are from a cluster-randomised controlled trial including 352 patients with advanced dementia and agitation from 18 nursing homes in Western Norway. The intervention group received pain treatment according to SPTP.Results. Pain was associated with disinhibition (adjusted OR: 1.21, 95% CI: 1.10–1.34) and irritability (adjusted OR: 1.10, 95% CI: 1.01–1.21) at baseline. Pain treatment reduced agitation (p< 0.001, df = 1; 300) and aberrant motor behaviour (p= 0.017, df = 1; 300). Psychosis was reduced in people with at least one symptom at baseline (p= 0.034, df = 1; 135). The use of opioid analgesics did not increase psychotic symptoms.Study Registration. This trial is registered with ClinicalTrials.gov (NCT01021696), Norwegian Medicines Agency, EudraCT (EudraCTnr: 2008-007490-20).

scholarly journals Memory and communication support strategies in dementia: Effect of a training program for informal caregivers

2012 ◽  
Vol 24 (12) ◽  
pp. 1927-1942 ◽  
Author(s):  
Jacki Liddle ◽  
Erin R. Smith-Conway ◽  
Rosemary Baker ◽  
Anthony J. Angwin ◽  
Cindy Gallois ◽  
...  
Keyword(s):  
Training Program ◽  
Controlled Trial ◽  
Informal Caregivers ◽  
Training Group ◽  
Well Being ◽  
Care Recipient ◽  
Control Group ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

ABSTRACTBackground: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated.Methods: A pre-test/post-test controlled trial was undertaken with caregiver–care-recipient dyads living in the community. Measures of the carers’ knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured.Results: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers’ knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups.Conclusions: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

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