Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan: a secondary analysis of qualitative and quantitative data
- 13 April 2020
- journal article
- research article
- Published by Wiley in Scandinavian Journal of Caring Sciences
- Vol. 35 (2), 430-441
- https://doi.org/10.1111/scs.12854
Abstract
Background A psychosocial dementia care programme for challenging behaviour (DEMBASE®) was developed in collaboration with a Swedish BPSD‐registry team for in‐home care services use in Japan. The programme consisted of a web‐based tool for the continued assessment of challenging behaviours and interdisciplinary discussion meetings. Effectiveness of the adapted programme was verified through a cluster‐randomised controlled trial. The Tokyo Metropolitan Government provided municipal funding to introduce the programme into daily practice beginning in April 2018. Objectives To investigate both facilitators and barriers associated with programme implementation. Design A secondary analysis of qualitative and quantitative data. Settings Data were collected in naturalistic long‐term care settings from April 2018 to March 2019. Participants A total of 138 professionals and 157 people with dementia participated in the programme. Methods Challenging behaviour in persons with dementia was assessed by professionals using a total Neuropsychiatric Inventory score. Data on expected facilitators and barriers were extracted for qualitative analysis from a debriefing meeting between professionals. Results Of the 157 persons with dementia, 81 (51.6%) received follow‐up behavioural evaluations by March 2019. The average level of challenging behaviour was significantly reduced for 81 persons from baseline to their most recent follow‐up evaluations. Facilitators included ‘programme available for care managers’, ‘visualised feedback on professionals’ work’, ‘affordable for providers and professionals’ and ‘media coverage’. Barriers included ‘professionals from different organisations’, ‘unpaid work’, ‘operation requirement for municipalities’ and ‘conflict with daily benefit‐oriented framework’. Conclusions A follow‐up evaluation was not fully achieved. Further strategies to address barriers may include the development of a benefit‐rewarding scheme for interdisciplinary discussion meetings, an e‐learning system capable of substituting training course portions and a cross‐municipality training course.Keywords
Funding Information
- Tokyo Metropolitan Government (Project Number 29-Fukushi-Hoken-Kourei-Zaitaku 1397)
This publication has 39 references indexed in Scilit:
- Developing the New Interventions for independence in Dementia Study (NIDUS) theoretical model for supporting people to live well with dementia at home for longer: a systematic review of theoretical models and Randomised Controlled Trial evidenceSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2019
- Dementia prevention, intervention, and careThe Lancet, 2017
- An evaluation of palliative care contents in national dementia strategies in reference to the European Association for Palliative Care white paperInternational Psychogeriatrics, 2015
- Features of the Japanese national dementia strategy in comparison with international dementia policies: How should a national dementia policy interact with the public health‐ and social‐care systems?Alzheimer's & Dementia, 2013
- White paper defining optimal palliative care in older people with dementia: A Delphi study and recommendations from the European Association for Palliative CarePalliative Medicine, 2013
- The global prevalence of dementia: A systematic review and metaanalysisAlzheimer's & Dementia, 2013
- The problem with “problem behaviors”: a systematic review of the association between individual patient behavioral and psychological symptoms and caregiver depression and burden within the dementia patient–caregiver dyadInternational Psychogeriatrics, 2012
- Predictors of Nursing Home Admission for Persons with DementiaMedical Care, 2009
- Point and 5‐year period prevalence of neuropsychiatric symptoms in dementia: the Cache County StudyInternational Journal of Geriatric Psychiatry, 2007
- Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stressJournal of Neurology, Neurosurgery & Psychiatry, 2007