P82: A video-based qualitative analysis of case conferences to reduce BPSD

Abstract

Background and objectives:

Case conferences are described as a goal-oriented, systematic method that team members can use to develop person centred treatment actions for a particular care problem. However, not all case conferences have proven to be effective. The Norwegian Targeted Interdisciplinary Model for the Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) is an effective multicomponent model based on case conferences that informs approaches to behavioural and psychological symptoms in residents with dementia. Our aim was to explore how TIME case conferences structured based on cognitive behavioural therapy (CBT) contributed to person-centred actions and how the specific structure of the TIME may have contributed to the effectiveness of the model.

Methods:

We used video observation of six case conferences. Videos in research provide extended opportunities for studying in detail the complexity of interactions that take place in social groups. We analysed these videos by iteratively watching them and performing a thematic cross-case analysis of their transcripts. Based on Habermas’s theory of communicative action, we emphasized what was talked about in the case conferences, and the display of communication between the participants in the case conferences.

Results:

Our findings showed that the theoretical principles behind the TIME, including both person- centred care and the inductive structure of CBT, reflected many aspects of Habermas’s theory of communicative actions. In particular, the TIME case conferences emphasized the lifeworld perspective for both residents, staff, and contributed to what Habermas labelled communicative rationality as a means to develop shared understanding among staff and create person-centred action.

Conclusions:

One causal assumption of how and why the TIME case conferences contributed to the effectiveness of the TIME in reducing BPSD in nursing homes is that the specific inductive structure of the case conferences with the column technique based on the ABC method together with PCC emphasized the importance of the lifeworld for both the resident and the staff. Even though case conferences have been highlighted as useful, it is not indifferent how these case conferences are structured and conducted.