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Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study

BACKGROUND: Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic tran...

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Autores principales: Lagerlund, Hanna, Thunborg, Charlotta, Sandborgh, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966167/
https://www.ncbi.nlm.nih.gov/pubmed/35351026
http://dx.doi.org/10.1186/s12877-022-02952-5
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author Lagerlund, Hanna
Thunborg, Charlotta
Sandborgh, Maria
author_facet Lagerlund, Hanna
Thunborg, Charlotta
Sandborgh, Maria
author_sort Lagerlund, Hanna
collection PubMed
description BACKGROUND: Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads. METHODS: This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection. RESULTS: Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved. CONCLUSIONS: The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-02952-5.
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spelling pubmed-89661672022-03-31 Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study Lagerlund, Hanna Thunborg, Charlotta Sandborgh, Maria BMC Geriatr Research BACKGROUND: Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads. METHODS: This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection. RESULTS: Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved. CONCLUSIONS: The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-022-02952-5. BioMed Central 2022-03-29 /pmc/articles/PMC8966167/ /pubmed/35351026 http://dx.doi.org/10.1186/s12877-022-02952-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lagerlund, Hanna
Thunborg, Charlotta
Sandborgh, Maria
Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title_full Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title_fullStr Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title_full_unstemmed Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title_short Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
title_sort behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966167/
https://www.ncbi.nlm.nih.gov/pubmed/35351026
http://dx.doi.org/10.1186/s12877-022-02952-5
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