Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-27T02:26:27.321Z Has data issue: false hasContentIssue false
  • English
  • Français

PerCEN trial participant perspectives on the implementation and outcomes of person-centered dementia care and environments

Published online by Cambridge University Press:  26 August 2015

Lynn Chenoweth ,
Yun-Hee Jeon ,
Jane Stein-Parbury ,
Ian Forbes ,
Richard Fleming ,
Janet Cook ,
Seong Cheah ,
Stephanie Fletcher  and
Leonie Tinslay
Lynn Chenoweth*
Affiliation:
Aged and Extended Care Nursing, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
Yun-Hee Jeon
Affiliation:
Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia
Jane Stein-Parbury
Affiliation:
Aged and Extended Care Nursing, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
Ian Forbes
Affiliation:
Faculty of Design, Architecture and Building, University of Technology Sydney, Sydney, New South Wales, Australia
Richard Fleming
Affiliation:
Dementia Training Study Centre, University of Wollongong, Wollongong, New South Wales, Australia
Janet Cook
Affiliation:
Aged and Extended Care Nursing, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
Seong Cheah
Affiliation:
Aged and Extended Care Nursing, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
Stephanie Fletcher
Affiliation:
Public Health Department, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
Leonie Tinslay
Affiliation:
Aged and Extended Care Nursing, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
*
Correspondence should be addressed to: Prof. Lynn Chenoweth, Aged Care and Extended Practice Nursing, Faculty of Health, University of Technology Sydney, PO Box 222, Lindfield, Sydney, New South Wales 2070, Australia. Phone: +61-2-9514-5710; Fax: +61-2-9369-0285. Email: Lynnette.Chenoweth@uts.edu.au.
Get access

Abstract

Background:

Well-being and various forms of agitation in people with dementia can be improved in a person-centered long-term care setting. Data obtained during the Person-Centered Dementia Care and Environment (PerCEN) randomized controlled trial shed light on the factors that influenced the adoption and outcomes of person-centered interventions in long-term care from the perspective of study participants.

Methods:

Data were obtained from PerCEN participants: individual semi-structured interviews with care managers (29), nurses and care staff (70); telephone surveys with family members (73); staff reports of care approaches; and 131 field note entries recorded by the person-centered care and environment facilitators. Data were interpreted inductively using content analysis, code building, theme development, and synthesis of findings.

Results:

All data sources confirmed that, when adopted, the person-centered model increased the number and variety of opportunities for resident interaction, improved flexibility in care regimens, enhanced staff's attention to resident needs, reduced resident agitation, and improved their well-being. Barriers and enablers for the person-centered model related to leadership, manager, staff and family appreciation of the model, staff's capacity, effective communication and team work among direct care staff, care service flexibility, and staff education on how to focus care on the person's well-being.

Conclusions:

Successful knowledge translation of the person-centered model starts with managerial leadership and support; it is sustained when staff are educated and assisted to apply the model, and, along with families, come to appreciate the benefits of flexible care services and teamwork in achieving resident well-being. The Australian New Zealand Clinical Trials Registry number is ACTRN 12608000095369.

Keywords

Key words: dementianursingquality of lifeperson-centered carecare environment
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 12 , December 2015 , pp. 2045 - 2057
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Australia. (2013). Quality of Residential Aged Care: The Consumer Perspective. Canberra, Australia: Alzheimer's Australia.Google Scholar
Boetcher, I. F., Kemeny, B., DeShon, R. P. and Stevens, A. B. (2004). Educating caregivers for person-centered dementia care. A system to develop staff behaviors for person-centered care. Alzheimer's Care Quarterly, 5, 188–196.Google Scholar
Brooker, D. (2007). Person-Centred Dementia Care: Making Services Better. London, UK: Jessica Kingsley.Google Scholar
Brownie, S. and Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions in Aging, 8, 1–10.Google Scholar
Chenoweth, L. et al. (2014). PerCEN: a cluster randomised controlled trial of person-centred care and environment outcomes for people with dementia. International Psychogeriatrics, 26, 1147–1160.Google Scholar
Chenoweth, L. et al. (2009). Caring for Aged Dementia Care Residents study (CADRES): a cluster-randomised trial of person-centred care in dementia. Lancet Neurology, 8, 317–325.Google Scholar
Chenoweth, L. et al. (2011). Person-Centred Dementia Care and Environment (PerCEN): study protocol of a cluster randomised controlled group trial of client and care outcomes in the residential dementia care setting. Worldviews on Evidence-Based Nursing, 8, 153–165.Google Scholar
Dobbins, M. et al. (2009). A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implementation Science, 4, 23. Available at: http://www.implementationscience.com/content/4/1/23; last accessed 27 April 2009.Google Scholar
Fleming, R. (2011). An environmental audit tool suitable for use in homelike facilities for people with dementia (EAT). Australasian Journal on Ageing, 30, 108–112.Google Scholar
Fleming, R., Goodenough, B., Low, L.-F., Chenoweth, C. and Brodaty, B. (2014). The relationship between the quality of the built environment and the quality of life of people with dementia in residential care. Dementia. The International Journal of Social Research and Practice (Online), doi:10.1177/1471301214532460 Google Scholar
Graham, I. D. (2012). End of Grant Knowledge Translation and Integrated Knowledge Translation. Available at: http://www.cihr-irsc.gc.ca/e/38654.html; accessed 19 May 2015.Google Scholar
Ivers, N. et al. (2012). Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, Issue 6. art. No. CD000259. doi:10.1002/14651858.CD000259.pub3.Google Scholar
Jeon, Y.-H., Simpson, J. M., Chenoweth, L., Ciunich, M. and Kendig, H. (2013). The effectiveness of an aged care specific leadership and management program on workforce, work environment and care quality outcomes: design of a cluster randomized controlled trial. Implementation Science, 8, 126–135.Google Scholar
Kitwood, T. and Bredin, K. (1992). Towards a theory of dementia care: personhood and well-being. Ageing and Society, 12, 269–287.Google Scholar
McCormack, B. and McCance, T. V. (2006). Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56, 472–479.Google Scholar
Norbergh, K. G., Dahl, A., Hellzen, O. and Apslund, K. (2006). Nurse's attitudes towards people with dementia: the semantic differential technique. Nursing Ethics, 13, 264–274.Google Scholar
QSR International. (2008). NVivo Version 8.0. Melbourne, Australia: QRSI.Google Scholar
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 1136–1139.Google Scholar
Stein-Parbury, J., Chenoweth, L. and Jeon, Y.-H. (2012). Implementing person-centred care in residential dementia care. Clinical Gerontologist, 35, 404–424.Google Scholar
Tong, A., Sainsbury, P. and Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349–357.Google Scholar
Winzelberg, G. S., Williams, C. S., Preisser, J. S., Zimmerman, S. and Sloane, P. D. (2005). Factors associated with nursing assistant quality of life ratings for residents with dementia in long-term care facilities. The Gerontologist, 45, 106–114.Google Scholar
World Health Organization (WHO) (2015). Global action on dementia, WHO Ministerial Conference, Geneva, Switzerland, 16–17 March.Google Scholar
Supplementary material: File

Chenoweth supplementary material S1

Supplemental Figure

Download Chenoweth supplementary material S1(File)
File 78.5 KB