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Dementia care mapping in nursing homes: effects on caregiver attitudes, job satisfaction, and burnout. A quasi-experimental trial

Published online by Cambridge University Press:  30 August 2017

Martin Nikolaus Dichter ,
Diana Trutschel ,
Christian Günter Georg Schwab ,
Burkhard Haastert ,
Tina Quasdorf  and
Margareta Halek
Martin Nikolaus Dichter*
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Diana Trutschel
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany Institute of Computer Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany
Christian Günter Georg Schwab
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Burkhard Haastert
Affiliation:
mediStatistica, Neuenrade, Germany
Tina Quasdorf
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Margareta Halek
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
*
Correspondence should be addressed to: Martin Nikolaus Dichter, German Center for Neurodegenerative Diseases (DZNE), Witten, Germany. Phone: +49 2302 926 253; Fax: +49 2302 926 239. Email: Martin.Dichter@dzne.de.
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Abstract

Background:

The Dementia Care Mapping (DCM) method is an internationally recognized complex intervention in dementia research and care for implementing person-centered care. The Leben-QD II trial aimed to evaluate the effectiveness of DCM with regard to caregivers.

Methods:

The nine participating nursing home units were allocated to three groups: (1) DCM method experienced ≥ 1 year, (2) DCM newly introduced during this trial, and (3) regular rating of residents’ quality of life (control group). Linear mixed models were fit to cluster-aggregated data after 0, 6, and 18 months, adjusting for repeated measurements and confounders. The primary outcome was the Approaches to Dementia Questionnaire (ADQ) score; the secondary outcomes were the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Copenhagen Burnout Inventory (CBI).

Results:

The analysis included 201 caregivers with 290 completed questionnaires (all three data collection time points). The ADQ showed a significant time and time*intervention effect. At baseline, the estimated least-square means for the ADQ were 71.98 (group A), 72.46 (group B), and 71.15 (group C). The non-linear follow-up of group A indicated an estimated-least square means of 69.71 (T1) and 68.97 (T2); for group B, 72.80 (T1) and 72.29 (T2); and for group C, 66.43 (T1) and 70.62 (T2).

Conclusions:

The DCM method showed a tendency toward negatively affecting the primary and secondary outcomes; this finding could be explained by the substantial deviation in adherence to the intervention protocol.

Keywords

nursing homesdementiacaregiverattitudesjob satisfactionburnoutperson-centered caredementia care mappingpsychosocial intervention
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 1993 - 2006
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Barbosa, A., Sousa, L., Nolan, M. and Figueiredo, D. (2015). Effects of person-centered care approaches to dementia care on staff: a systematic review. American Journal of Alzheimer's Disease and other Dementias, 30, 713–722.Google Scholar
Bartholomeyczik, S. et al. (2006). Guidelines for Handling Challenging Behavior in People with Dementia Living in Nursing Homes [Rahmenempfehlungen zum Umgang mit herausforderndem Verhalten bei Menschen mit Demenz in der stationären Altenhilfe]. Berlin: German Ministery of Health.Google Scholar
Borritz, M. and Kristensen, T. (2001). Copenhagen Burnout Inventory: Normative Data from a Representative Danish Population on Personal Burnout and Results from the PUMA Study on Personal Burnout, Work Burnout, and Client Burnout. Copenhagen: National Institute of Occupational Health.Google Scholar
Brooker, D. J. and Surr, C. (2006). Dementia Care Mapping (DCM): initial validation of DCM 8 in UK field trials. International_Journal_of_ Geriatric_Psychiatry, 21, 1018–1025.Google Scholar
Brooker, D. (2004). What is person-centred care in dementia?. Reviews in Clinical Gerontology, 13, 215–222.Google Scholar
Brooker, D. (2007). Person Centred Dementia Care: Making Services Better. London: Jessica Kingsley.Google Scholar
Brown, H. and Prescott, R. (2006). Applied Mixed Models in Medicine. Statistics in Practice. Hoboken: John Wiley & Sons.Google Scholar
Bsi (2010). PAS 800: 2010. Use of Dementia Care Mapping for Improved Person-Centred Care in a Care Provider Organisation – Guide. London: BSI-British Standards Institution.Google Scholar
Chenoweth, L. et al. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol, 8, 317– 325.CrossRefGoogle ScholarPubMed
Dichter, M. N. et al. (2013). Scalability and internal consistency of the German version of the dementia-specific quality of life instrument QUALIDEM in nursing homes – a secondary data analysis. Health and Quality of Life Outcomes, 11, 91.CrossRefGoogle ScholarPubMed
Dichter, M. N. et al. (2015). Dementia care mapping: effects on residents' quality of life and challenging behavior in German nursing homes. A quasi-experimental trial. International Psychogeriatric, 27, 1875–1892.Google Scholar
Ettema, T. P., Dröes, R. M., De Lange, J., Mellenbergh, G. J. and Ribbe, M. W. (2007). QUALIDEM: development and evaluation of a dementia specific quality of life instrument. International Journal of Geriatric Psychiatry . . . Scalability, Reliability and Internal Structure, 22, 549–556.Google Scholar
Fritsch, T. et al. (2009). Impact of TimeSlips, a creative expression intervention program, on nursing home residents with dementia and their caregivers. Gerontologist, 49, 117–127.Google Scholar
Halek, M., Dichter, M. N., Quasdorf, T., Riesner, C. and Bartholomeyczik, S. (2013). The effects of dementia care mapping on nursing home residents' quality of life and staff attitudes: design of the quasi-experimental study Leben-QD II. BMC Geriatrics, 13, 53.CrossRefGoogle ScholarPubMed
Hazelhof, T. J., Schoonhoven, L., Van Gaal, B. G., Koopmans, R. T. and Gerritsen, D. L. (2016). Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis. International Nursing Review, 63, 507–516.Google Scholar
Jeon, Y. H. et al. (2012). Staff outcomes from the caring for aged dementia care resident study (CADRES): a cluster randomised trial. International Journal of Nursing Studies, 49, 508–518.Google Scholar
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Berkshire, UK: Open University Press.Google Scholar
Kristensen, T. S., Hannerz, H., Hogh, A. and Borg, V. (2005). The copenhagen psychosocial questionnaire–a tool for the assessment and improvement of the psychosocial work environment. Scandinavian Journal of Work, Environment & Health, 31, 438–449.Google Scholar
Kuemmerling, A., Hasselhorn, H. M. and Tackenberg, P. (2003). Psychometric properties of the scales used in the NEXT-Study. In Hasselhorn, H. M., Tackenberg, P. and Müller, B. H., (eds.), Working Conditions and Intent to Leave the Profession Among Nursing Staff in Europe (pp. 237–258). Stockhom: The National Institute for Working Life and The Swedish Trade Unions in Co-operation.Google Scholar
Lintern, T. C. (2001). Quality in dementia care: evaluating staff attitudes and behaviour. PhD Thesis, University of Wales Bangor.Google Scholar
Lintern, T. (2009). Improving Quality in Dementia Care . Relationships between Care Staff Attitudes, Behaviour and Resident Quality of Life. Saarbrücken: VDM Verlag.Google Scholar
Lintern, T., Woods, B. and Phair, L. (2000). Training is not enough to change care practice. Journal of Dementia Care, 8, 15–17.Google Scholar
Livingston, G. et al. (2014). A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia. Health Technol Assess, 18, 1–226.Google Scholar
Luppa, M. et al. (2010). Prediction of institutionalization in the elderly. A systematic review. Age Ageing, 39, 31–38.CrossRefGoogle ScholarPubMed
Mccormack, B., Karlsson, B., Dewing, J. and Lerdal, A. (2010). Exploring person-centredness: a qualitative meta-synthesis of four studies. Scandinavien Journal of Caring Sciences, 24, 620–634.CrossRefGoogle ScholarPubMed
Mccormack, B. and Mccance, T. V. (2006). Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56, 472–9.Google Scholar
Mds (2009). Basics of MDK-quality Tests in Residential Care for the Elderly [Grundlagen der MDK-Qualitätsprüfungen in der stationären Altenpflege]. Essen: The National Association of Statutory Health Insurance Funds (GKV Spitzenverband).Google Scholar
Nubling, M., Stossel, U., Hasselhorn, H. M., Michaelis, M. and Hofmann, F. (2006). Measuring psychological stress and strain at work – evaluation of the COPSOQ questionnaire in Germany. Psychosocial Medicine, 3, Doc05.Google ScholarPubMed
Prince, M. et al. (2015). World Alzheimer Report 2015 . The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer's Disease International.Google Scholar
Quasdorf, T. et al. (2017). Implementing dementia care mapping to develop person-centred care: results of a process evaluation within the Leben-QD II trial. Journal of Clinical Nursing, 26, 751–765.Google Scholar
R Core Team (2014). R: A Language and Environmental for Statistical Computing. Vienna: Foundation for Statistical Computing.Google Scholar
Rogers, C. (1961). On Becoming a Person. Boston: Houghton Mifflin.Google Scholar
Rokstad, A. M. et al. (2013). The effect of person-centred dementia care to prevent agitation and other neuropsychiatric symptoms and enhance quality of life in nursing home patients: a 10-Month randomized controlled trial. Dementia and Geriatric Cognitive Disorders, 36, 340–353.CrossRefGoogle ScholarPubMed
Schäufele, M., Köhler, L., Lode, S. and Weyerer, S. (2009). Menschen mit Demenz in stationären Altenpflegeeinrichtungen: aktuelle Versorgungssituation. In Schneekloth, U. and Wahl, H. W., (eds.), People with Dementia in Nursing Homes: Current Care Situation. In Care Needs and Care Situation of Aged People in Nursing Homes. Dementia, Caregivers and Volunteers: Example for “Good Practice” [Pflegebedarf und Versorgungssituation bei älteren Menschen in Heimen. Demenz, Angehörige und Freiweillige, Beispiele für “Good Practice”] (pp. 159–219). Stuttgart: Kohlhammer Verlag.Google Scholar
Schmidt, S. G., Dichter, M. N., Palm, R., Müller, B. H. and Hasselhorn, H. M. (2012). Distress experienced by nurses in response to the challenging behaviour of residents – evidence from German nursing homes. Journal of Clinical Nursing, 21, 3134–3142, doi 10.1111/jcn.12066.CrossRefGoogle Scholar
Schrijnemaekers, V. J. et al. (2003). Effects of emotion-oriented care on work-related outcomes of professional caregivers in homes for elderly persons. Journal of Gerontology B Psychological Sciences Social Sciences, 58, S50–S57.CrossRefGoogle ScholarPubMed
Schwab, C. G. G. (2013). Constructvalidity and internal consistency of the Dementia-specific burden instrument (BelaDem) in nursing homes [Konstruktvalidität und interne Konsistenz des Instrumentes "Belastungserleben im Umgang mit Demenz (BelaDem) in der stationären Altenhilfe]. Master Unpublished Master Thesis, Witten/Herdecke University.Google Scholar
Selbaek, G., Engedal, K. and Bergh, S. (2013). The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. Journal of the American Medical Directors Association, 14, 161–169.CrossRefGoogle ScholarPubMed
Van de Ven, G. et al. (2012). Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial. BMC Geriatrics, 12, 1.Google Scholar
Van de Ven, G. et al. (2013). Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial. PLoS One, 8, e67325.Google Scholar
Van de Ven, G. et al. (2014). Dementia Care mapping in nursing homes: a process analysis. In Van de Ven, G. (ed.), Effectiveness and Costs of Dementia Care Mapping Intervention in Dutch Nursing Homes (pp. 77–92). Nijmegen: Radboud University Nijmegen.Google Scholar
Van Weert, J. C., Van Dulmen, A. M., Spreeuwenberg, P. M., Bensing, J. M. and Ribbe, M. W. (2005). The effects of the implementation of snoezelen on the quality of working life in psychogeriatric care. International Psychogeriatrics, 17, 407–427.Google Scholar