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A Feasibility Evaluation of the Need-Centered Watch-Assess-Need Intervention-Think Education and Training Program for Behavioral and Psychological Symptoms of Dementia

摘要


Background: Despite the high prevalence of dementia among residents living in long-term care facilities in Taiwan, most care providers in these facilities have not received adequate training to deal with the behavioral and psychological symptoms of dementia (BPSD). An original care and management model for BPSD has been developed, and model-based recommendations for an education and training program have been made. However, empirical testing has not yet been conducted to determine the efficacy of this program. Purpose: This study was designed to evaluate the feasibility of using the Watch-Assess-Need intervention-Think (WANT) education and training program for BPSD in long-term care settings. Methods: A mixed-method design was used. Twenty care providers and 20 corresponding care receivers (residents with dementia) from a nursing home in southern Taiwan were enrolled. Data were collected using a variety of measurement tools, including the Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia, Attitude towards Dementia Care Scale, and Dementia Behavior Disturbance Self-efficacy Scale. Qualitative data, including care-provider perspectives on the efficacy of the WANT education and training program, were also collected. Repeated measures were conducted on the results of quantitative data analysis, whereas content analysis was performed on the results of qualitative data analysis. Results: Findings indicate that the program relieves agitated behavior ( p = .01), alleviates depression in those with dementia ( p < .001), and enhances care-provider attitudes toward dementia care ( p = .01). However, no significant improvement was found in self-efficacy among the care providers ( p = .11). In terms of qualitative outcomes, care providers indicated they perceived improved self-efficacy in managing BPSD, improved ability to view problems from a more need-centered perspective, improved attitudes toward dementia and patients' BPSD, and decreased care burden and stress. Conclusions/Implications for Practice: The study found the WANT education and training program to be feasible in clinical practice. Because of this program's simple and easy-to-remember characteristics, it is recommended that it be vigorously promoted to care providers in both long-term institutional and home care settings to help them effectively address the BPSD.

參考文獻


Uei, S.-L., & Yang, M.-S. (2013). The care burden, self-efficacy in managing behavioral problems of family caregivers for demented patients, and effects of case management intervention [Unpublished doctoral dissertation, Kaohsiung Medical University]. https://doi.org//10.6832/KMU.2013.00023 (Original work published in Chinese)
Yang, Y. Y. (2020). The development and feasibility evaluation of the person need-centered WANT care management model for behavioral and psychological symptoms of dementia [Unpublished doctoral dissertation, National Cheng Kung University]. https://doi.org/10.6844/NCKU202000510 (Original work published in Chinese)
Abrams, J. A., Tabaac, A., Jung, S., & Else-Quest, N. M. (2020). Considerations for employing intersectionality in qualitative health research. Social Science & Medicine, 258, Article 113138. https://doi.org/10.1016/j.socscimed.2020.113138
Alexopoulos, G. S., Abrams, R. C., Young, R. C., & Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23(3), 271-284. https://doi.org/10.1016/0006-3223(88)90038-8
Arain, M., Campbell, M. J., Cooper, C. L., & Lancaster, G. A. (2010). What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Medical Research Methodology, 10, Article No. 67. https://doi.org/10.1186/1471-2288-10-67

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