Britt Appelhof1, Christian Bakker2, Jeannette C L van Duinen-van den IJssel3, Sandra A Zwijsen4, Martin Smalbrugge4, Frans R J Verhey5, Marjolein E de Vugt5, Sytse U Zuidema6, Raymond T C M Koopmans7. 1. Department of Primary and Community Care, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands; Archipel, Landrijt, Knowledge Center for Specialized Care, Eindhoven, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands. Electronic address: Britt.Appelhof@radboudumc.nl. 2. Department of Primary and Community Care, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; Florence, Mariahoeve, Center for Specialized Care in Young-Onset Dementia, The Hague, the Netherlands. 3. Department of Primary and Community Care, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands. 4. Department of General Practice and Elderly Care Medicine / Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands. 5. School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, the Netherlands. 6. Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. 7. Department of Primary and Community Care, Radboud University Nijmegen, Medical Centre, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; De Waalboog "Joachim en Anna", Center for Specialized Geriatric Care, Nijmegen, the Netherlands.
Abstract
OBJECTIVES: A process evaluation was performed for an intervention aimed at improvement of the management of neuropsychiatric symptoms in young-onset dementia. Data about sample quality and intervention quality was evaluated to better understand internal and external validity. In addition, data about the implementation strategy and factors affecting implementation were evaluated to improve further implementation of the intervention. DESIGN: A model proposed by Leontjevas and colleagues consisting of first-order (validity) and second-order (implementation) data was used. SETTING AND PARTICIPANTS: Care units delivering specialized treatment and support for residents with young-onset dementia. MEASURES: A description of the recruitment, randomization procedure, and intervention reach was carried out to determine sample quality. To determine intervention quality, data on satisfaction, relevance, feasibility, and fidelity were collected through a questionnaire and reports logged on the server of the web-based intervention. A description of the implementation strategy was provided. Barriers and facilitators for implementation were collected by a questionnaire and analyzed by deductive content analysis. RESULTS: Care units varied in size and were recruited from different geographical regions in the Netherlands. The informed consent rate of the residents was 87.7%. The majority of the nursing home staff were satisfied with the intervention. However, parts of the intervention were perceived as less relevant for their own organization. The feasibility of the intervention was considered low. The fidelity differed between care units. The implementation strategy did not overcome all barriers. Factors affecting implementation covered 3 themes: organizational aspects, culture of the organization, and aspects of the intervention. CONCLUSIONS: In general, our results showed sufficient internal and external validity, warranting further effect analyses. Adaptations to specific steps of the care program should be considered to increase feasibility and sustainability. In addition, integration of the care program into the electronic health records is expected to further improve implementation.
OBJECTIVES: A process evaluation was performed for an intervention aimed at improvement of the management of neuropsychiatric symptoms in young-onset dementia. Data about sample quality and intervention quality was evaluated to better understand internal and external validity. In addition, data about the implementation strategy and factors affecting implementation were evaluated to improve further implementation of the intervention. DESIGN: A model proposed by Leontjevas and colleagues consisting of first-order (validity) and second-order (implementation) data was used. SETTING AND PARTICIPANTS: Care units delivering specialized treatment and support for residents with young-onset dementia. MEASURES: A description of the recruitment, randomization procedure, and intervention reach was carried out to determine sample quality. To determine intervention quality, data on satisfaction, relevance, feasibility, and fidelity were collected through a questionnaire and reports logged on the server of the web-based intervention. A description of the implementation strategy was provided. Barriers and facilitators for implementation were collected by a questionnaire and analyzed by deductive content analysis. RESULTS: Care units varied in size and were recruited from different geographical regions in the Netherlands. The informed consent rate of the residents was 87.7%. The majority of the nursing home staff were satisfied with the intervention. However, parts of the intervention were perceived as less relevant for their own organization. The feasibility of the intervention was considered low. The fidelity differed between care units. The implementation strategy did not overcome all barriers. Factors affecting implementation covered 3 themes: organizational aspects, culture of the organization, and aspects of the intervention. CONCLUSIONS: In general, our results showed sufficient internal and external validity, warranting further effect analyses. Adaptations to specific steps of the care program should be considered to increase feasibility and sustainability. In addition, integration of the care program into the electronic health records is expected to further improve implementation.
Authors: Claudia M Groot Kormelinck; Charlotte F van Teunenbroek; Sytse U Zuidema; Martin Smalbrugge; Debby L Gerritsen Journal: BMC Geriatr Date: 2021-07-03 Impact factor: 3.921
Authors: Charlotte F van Teunenbroek; Kim Verhagen; Martin Smalbrugge; Anke Persoon; Sytse U Zuidema; Debby L Gerritsen Journal: BMC Geriatr Date: 2020-05-06 Impact factor: 3.921
Authors: Iris van Venrooij; Jan Spijker; Gerben J Westerhof; Ruslan Leontjevas; Debby L Gerritsen Journal: Int J Environ Res Public Health Date: 2019-12-17 Impact factor: 3.390