Lynn Chenoweth1, Ian Forbes2, Richard Fleming3, Madeleine T King4, Jane Stein-Parbury5, Georgina Luscombe6, Patricia Kenny7, Yun-Hee Jeon8, Marion Haas7, Henry Brodaty9. 1. Aged and Extended Care Nursing,Faculty of Health,University of Technology,Sydney,NSW,Australia. 2. Faculty of Design,Architecture and Building,University of Technology Sydney,Sydney,NSW,Australia. 3. Dementia Training Study Centre,University of Wollongong,Wollongong,Australia. 4. Director Quality of Life Research Centre,University of Sydney,Sydney,NSW,Australia. 5. Faculty of Health,University of Technology,Sydney,NSW,Australia. 6. Sydney Medical School,University of Sydney,Sydney,NSW,Australia. 7. Centre for Health Economics Research and Evaluation,University of Technology,Sydney,NSW,Australia. 8. Faculty of Nursing and Midwifery,University of Sydney,Sydney,NSW,Australia. 9. School of Psychiatry,University of New South Wales,Sydney,Australia.
Abstract
BACKGROUND: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. METHODS: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. RESULTS: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%. CONCLUSION: The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369.
RCT Entities:
BACKGROUND: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. METHODS: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. RESULTS: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%. CONCLUSION: The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369.
Authors: Stephanie L Harrison; Suzanne M Dyer; Kate E Laver; Rachel K Milte; Richard Fleming; Maria Crotty Journal: Cochrane Database Syst Rev Date: 2022-03-07
Authors: Elizaveta Sopina; Lynn Chenoweth; Tim Luckett; Meera Agar; Georgina M Luscombe; Patricia M Davidson; Constance D Pond; Jane Phillips; Stephen Goodall Journal: Qual Life Res Date: 2018-09-05 Impact factor: 4.147
Authors: Claire E Sexton; Kaarin J Anstey; Filippo Baldacci; C J Barnum; Anna M Barron; Kaj Blennow; Henry Brodaty; Samantha Burnham; Fanny M Elahi; Jürgen Götz; Yun-Hee Jeon; Maya Koronyo-Hamaoui; Susan M Landau; Nicola T Lautenschlager; Simon M Laws; Darren M Lipnicki; Hanzhang Lu; Colin L Masters; Wendy Moyle; Akinori Nakamura; Giulio Maria Pasinetti; Naren Rao; Christopher Rowe; Perminder S Sachdev; Peter R Schofield; Einar M Sigurdsson; Kate Smith; Velandai Srikanth; Cassandra Szoeke; Malú G Tansey; Rachel Whitmer; Donna Wilcock; Tien Y Wong; Lisa J Bain; Maria C Carrillo Journal: Alzheimers Dement Date: 2021-05-31 Impact factor: 16.655