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Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study

OBJECTIVE: To explore the experiences of healthcare professionals working in falls prevention and memory assessment services in providing assessments and interventions for falls risk reduction in people with dementia. DESIGN: This is a qualitative study using 19 semistructured interviews. Interviews...

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Autores principales: Burgon, Clare, Darby, Janet, Pollock, Kristian, van der Wardt, Veronika, Peach, Tamsin, Beck, Lyndsay, Logan, Pip, Harwood, Rowan H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377506/
https://www.ncbi.nlm.nih.gov/pubmed/30755449
http://dx.doi.org/10.1136/bmjopen-2018-025702
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author Burgon, Clare
Darby, Janet
Pollock, Kristian
van der Wardt, Veronika
Peach, Tamsin
Beck, Lyndsay
Logan, Pip
Harwood, Rowan H
author_facet Burgon, Clare
Darby, Janet
Pollock, Kristian
van der Wardt, Veronika
Peach, Tamsin
Beck, Lyndsay
Logan, Pip
Harwood, Rowan H
author_sort Burgon, Clare
collection PubMed
description OBJECTIVE: To explore the experiences of healthcare professionals working in falls prevention and memory assessment services in providing assessments and interventions for falls risk reduction in people with dementia. DESIGN: This is a qualitative study using 19 semistructured interviews. Interviews were analysed through thematic analysis. SETTING: Community-based falls and memory assessment services in the East Midlands, UK. PARTICIPANTS: Nurses (n=10), physiotherapists (n=5), occupational therapists (n=3) and a psychiatrist (n=1). RESULTS: Three substantive themes were identified: challenges posed by dementia, adaptations to make falls prevention appropriate for people with dementia and organisational barriers. Patients’ poor recall, planning and increased behavioural risk associated with dementia were key problems. Healthcare professionals provided many suggestions on how to overcome these challenges, such as adapting exercise interventions by using more visual aids. Problems associated with cognitive impairment created a need for additional support, for instance longer interventions, and supervision by support workers, to enable effective intervention, yet limited resources meant this was not always achievable. Communication between mental and physical health teams could be ineffective, as services were organised as separate entities, creating a reliance on third parties to be intermediaries. Structural and organisational factors made it difficult to deliver optimal falls prevention for people living with dementia. CONCLUSIONS: Healthcare professionals experience challenges in providing falls prevention to people with dementia at the individual and organisational levels. Interventions can be adapted for people with dementia, but this requires additional resources and improved integration of services. Future research is needed to develop and test the effectiveness and cost-effectiveness of such services.
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spelling pubmed-63775062019-03-05 Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study Burgon, Clare Darby, Janet Pollock, Kristian van der Wardt, Veronika Peach, Tamsin Beck, Lyndsay Logan, Pip Harwood, Rowan H BMJ Open Qualitative Research OBJECTIVE: To explore the experiences of healthcare professionals working in falls prevention and memory assessment services in providing assessments and interventions for falls risk reduction in people with dementia. DESIGN: This is a qualitative study using 19 semistructured interviews. Interviews were analysed through thematic analysis. SETTING: Community-based falls and memory assessment services in the East Midlands, UK. PARTICIPANTS: Nurses (n=10), physiotherapists (n=5), occupational therapists (n=3) and a psychiatrist (n=1). RESULTS: Three substantive themes were identified: challenges posed by dementia, adaptations to make falls prevention appropriate for people with dementia and organisational barriers. Patients’ poor recall, planning and increased behavioural risk associated with dementia were key problems. Healthcare professionals provided many suggestions on how to overcome these challenges, such as adapting exercise interventions by using more visual aids. Problems associated with cognitive impairment created a need for additional support, for instance longer interventions, and supervision by support workers, to enable effective intervention, yet limited resources meant this was not always achievable. Communication between mental and physical health teams could be ineffective, as services were organised as separate entities, creating a reliance on third parties to be intermediaries. Structural and organisational factors made it difficult to deliver optimal falls prevention for people living with dementia. CONCLUSIONS: Healthcare professionals experience challenges in providing falls prevention to people with dementia at the individual and organisational levels. Interventions can be adapted for people with dementia, but this requires additional resources and improved integration of services. Future research is needed to develop and test the effectiveness and cost-effectiveness of such services. BMJ Publishing Group 2019-02-11 /pmc/articles/PMC6377506/ /pubmed/30755449 http://dx.doi.org/10.1136/bmjopen-2018-025702 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Qualitative Research
Burgon, Clare
Darby, Janet
Pollock, Kristian
van der Wardt, Veronika
Peach, Tamsin
Beck, Lyndsay
Logan, Pip
Harwood, Rowan H
Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title_full Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title_fullStr Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title_full_unstemmed Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title_short Perspectives of healthcare professionals in England on falls interventions for people with dementia: a qualitative interview study
title_sort perspectives of healthcare professionals in england on falls interventions for people with dementia: a qualitative interview study
topic Qualitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377506/
https://www.ncbi.nlm.nih.gov/pubmed/30755449
http://dx.doi.org/10.1136/bmjopen-2018-025702
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