- Email: [email protected]
BEHAVIOR MANAGEMENT PROGRAM: A CLUSTER-RANDOMIZED CONTROLLED TRIAL OF ADAPTATION OF THE SWEDISH BPSD-REGISTRY TO JAPANESE DEMENTIA CARE SETTINGS
Poster Presentations: Tuesday, July 18, 2017
as the main cause of dementia. And the results of evaluation with the studied instrument showed a similarity to the original Australian investigation. In the present study the caregivers scored an average of 14,8 correct answers, against an average of 14 correct answers in the original study. It’s was observed that there’s a lack of knowledge about types of dementia, their symptoms and stages.
P3-506
BEHAVIOR MANAGEMENT PROGRAM: A CLUSTER-RANDOMIZED CONTROLLED TRIAL OF ADAPTATION OF THE SWEDISH BPSD-REGISTRY TO JAPANESE DEMENTIA CARE SETTINGS
Miharu Nakanishi1, Atsushi Nishida2, Yasuaki Imai3, Shintaro Inoue4, Yukio Yukari5, Chie Katayama6, Yuki Miyamoto7, Yumi Shindo8, Hideki Ueno9, Junichiro Toya6, Yosuke Takano10, Satoshi Usami11, Tsukasa Sasaki12, 1Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan; 2Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; 3Suzuran Inc., Setagaya-ku, Japan; 4Kokoronohiroba Ltd., Ome-shi, Japan; 5Zaitaku-Sogo-Shien-Center Fukuro, Adachi-ku, Japan; 6 Sakura-shinmachi Urban Clinic, Setagaya-ku, Japan; 7The University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Japan; 8National Center for Geriatrics and Gerontology, Obu-shi, Japan; 9Chiba University Hospital, Welfare and Medical Intelligence, Chiba-shi, Japan; 10Mental Home Clinic Setagaya, Setagaya-ku, Japan; 11University of Tsukuba, Graduate School of Comprehensive Human Sciences, Tsukuba-shi, Japan; 12 The University of Tokyo, Graduate School of Education, Bunkyo-ku, Japan. Contact e-mail: [email protected] Background: Challenging behavior is common and a major source
of distress for people with dementia. The Swedish Behavioral and Psychological Symptoms of Dementia (BPSD) registry is a working tool for professional caregivers focusing on psychosocial interventions to challenging behaviors. The Tokyo metropolitan government piloted an adaptation of the BPSD registry (JBPSD) to home- and community-care settings. We investigated the effects of JBPSD on challenging behavior of people with dementia. Methods: A cluster-randomized controlled trial was conducted with 44 long-term home care providers from three different districts under the Tokyo metropolitan government. A total of 95 professional caregivers were randomized to receive training course of JBPSD. The ongoing monitoring and assessment system was introduced to the providers for repeated measures of the challenging behavior. The Neuropsychiatric Inventory – Nursing Home version (NPI-NH) was used for repeated measures of the incidence and severity of challenging behavior. Random effects linear regression models for challenging behavior, taking account of clustering by caregiver, were performed including potential confounding variables at baseline. Results: One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. At baseline, there were no significant differences between the two groups in age, sex, type of dementia, cognitive impairment, ADL, and prescription of antipsychotics. Conclusions: In this study, we compare the longitudinal change in challenging behaviors of person with dementia between the intervention and control group. We use pre- and post- measurement of NPI-NH scores for the evaluation of efficacy of the JBPSD. P3-507
HOW DO WE MEASURE THE QUALITY OF LIFE OF FAMILY CARERS OF PEOPLE WITH DEMENTIA? DEVELOPMENT AND PRELIMINARY VALIDATION OF C-DEMQOL
P1171
Thomas Page1, Anna Brown1, Stephanie Daley2, Nicolas Farina2, Sube Banerjee2, 1University of Kent, Canterbury, United Kingdom; 2 Brighton and Sussex Medical School, Brighton, United Kingdom. Contact e-mail: [email protected] Background: Dementia has a profound impact on those with the con-
dition and their family carers. The accurate measurement of family carers’ quality of life (QOL) is, therefore, highly important. The purpose of the current research was to specify, develop and validate a condition-specific measure of QOL (C-DEMQOL) of family carers of people with dementia. Methods: C-DEMQOL was initially developed from the findings of two systematic reviews and a qualitative study. The first systematic review identified factors that are associated with carer QOL in dementia. The second systematic review identified existing instruments that measure carer QOL in dementia and other neurodegenerative diseases. A qualitative study involving 41 in-depth individual interviews with carers obtained a set of 12 factors that influence QOL of family carers of people with dementia. A pool of 75 items was generated to measure each of these constructs. Items were pretested on an independent sample of 25 family carers. Results: Feedback from the pilot study resulted in modifications to the instrument. An amended version of C-DEMQOL was constructed which measures 7 themes: carer health; carer responsibilities; carer personal needs; relationship with the person with dementia; carer role; feelings about future; carer support. A preliminary field test study has been conducted to examine the psychometric properties and construct validity of C-DEMQOL in a sample of 120 carers (co-resident and non-resident). The findings of these analyses are presented. Conclusions: There are very few instruments that exist to measure QOL of family carers of people with dementia. The development of C-DEMQOL will enable evaluation of QOL across the range of caring situations, severity and complexity in dementia. This is important for accurately monitoring carers’ QOL in both research (e.g., in intervention) and in health and social care services. P3-508
EXPLORING QUALITY INDICATORS FOR OLDER PERSONS’ TRANSITIONS IN CARE: A SYSTEMATIC REVIEW AND DELPHI PROCESS
Greta G. Cummings1, Kaitlyn Tate1, Sarah Lee1, Garnet Cummings1, Jayna Holroyd-Leduc2, Colin Reid3, Brian Rowe1, Rowan El-Bialy1, 1 University of Alberta, Edmonton, AB, Canada; 2University of Calgary, Calgary, AB, Canada; 3University of British Columbia, Vancouver, BC, Canada. Contact e-mail: [email protected] Background: Nearly 47 million people live with dementia worldwide today, a number projected to continue growing (Prince et al., 2016). Those with dementia are at increased risk for transitions in care and experience many negative consequences as a result (Callahan et al., 2012). There is a need for quality indicators (QIs) to aid health care personnel in all sectors of the healthcare transition to improve care. Methods: Using a systematic review and Delphi process, we catalogued established QIs to evaluate the quality of care provided to older persons during transitions to and from emergency departments (ED). Our search included articles examining development and testing of quality of care measures for older persons’ transitions across the following settings: residential seniors’ facilities, homes, emergency transport services, emergency departments (EDs), and hospitals. Two reviewers independently screened abstracts and full text articles for indicators using predefined inclusion and exclusion criteria. In preparation for Delphi rounds, extracted indicators were coded by setting, Donabedian framework
as the main cause of dementia. And the results of evaluation with the studied instrument showed a similarity to the original Australian investigation. In the present study the caregivers scored an average of 14,8 correct answers, against an average of 14 correct answers in the original study. It’s was observed that there’s a lack of knowledge about types of dementia, their symptoms and stages.
P3-506
BEHAVIOR MANAGEMENT PROGRAM: A CLUSTER-RANDOMIZED CONTROLLED TRIAL OF ADAPTATION OF THE SWEDISH BPSD-REGISTRY TO JAPANESE DEMENTIA CARE SETTINGS
Miharu Nakanishi1, Atsushi Nishida2, Yasuaki Imai3, Shintaro Inoue4, Yukio Yukari5, Chie Katayama6, Yuki Miyamoto7, Yumi Shindo8, Hideki Ueno9, Junichiro Toya6, Yosuke Takano10, Satoshi Usami11, Tsukasa Sasaki12, 1Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan; 2Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; 3Suzuran Inc., Setagaya-ku, Japan; 4Kokoronohiroba Ltd., Ome-shi, Japan; 5Zaitaku-Sogo-Shien-Center Fukuro, Adachi-ku, Japan; 6 Sakura-shinmachi Urban Clinic, Setagaya-ku, Japan; 7The University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Japan; 8National Center for Geriatrics and Gerontology, Obu-shi, Japan; 9Chiba University Hospital, Welfare and Medical Intelligence, Chiba-shi, Japan; 10Mental Home Clinic Setagaya, Setagaya-ku, Japan; 11University of Tsukuba, Graduate School of Comprehensive Human Sciences, Tsukuba-shi, Japan; 12 The University of Tokyo, Graduate School of Education, Bunkyo-ku, Japan. Contact e-mail: [email protected] Background: Challenging behavior is common and a major source
of distress for people with dementia. The Swedish Behavioral and Psychological Symptoms of Dementia (BPSD) registry is a working tool for professional caregivers focusing on psychosocial interventions to challenging behaviors. The Tokyo metropolitan government piloted an adaptation of the BPSD registry (JBPSD) to home- and community-care settings. We investigated the effects of JBPSD on challenging behavior of people with dementia. Methods: A cluster-randomized controlled trial was conducted with 44 long-term home care providers from three different districts under the Tokyo metropolitan government. A total of 95 professional caregivers were randomized to receive training course of JBPSD. The ongoing monitoring and assessment system was introduced to the providers for repeated measures of the challenging behavior. The Neuropsychiatric Inventory – Nursing Home version (NPI-NH) was used for repeated measures of the incidence and severity of challenging behavior. Random effects linear regression models for challenging behavior, taking account of clustering by caregiver, were performed including potential confounding variables at baseline. Results: One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. At baseline, there were no significant differences between the two groups in age, sex, type of dementia, cognitive impairment, ADL, and prescription of antipsychotics. Conclusions: In this study, we compare the longitudinal change in challenging behaviors of person with dementia between the intervention and control group. We use pre- and post- measurement of NPI-NH scores for the evaluation of efficacy of the JBPSD. P3-507
HOW DO WE MEASURE THE QUALITY OF LIFE OF FAMILY CARERS OF PEOPLE WITH DEMENTIA? DEVELOPMENT AND PRELIMINARY VALIDATION OF C-DEMQOL
P1171
Thomas Page1, Anna Brown1, Stephanie Daley2, Nicolas Farina2, Sube Banerjee2, 1University of Kent, Canterbury, United Kingdom; 2 Brighton and Sussex Medical School, Brighton, United Kingdom. Contact e-mail: [email protected] Background: Dementia has a profound impact on those with the con-
dition and their family carers. The accurate measurement of family carers’ quality of life (QOL) is, therefore, highly important. The purpose of the current research was to specify, develop and validate a condition-specific measure of QOL (C-DEMQOL) of family carers of people with dementia. Methods: C-DEMQOL was initially developed from the findings of two systematic reviews and a qualitative study. The first systematic review identified factors that are associated with carer QOL in dementia. The second systematic review identified existing instruments that measure carer QOL in dementia and other neurodegenerative diseases. A qualitative study involving 41 in-depth individual interviews with carers obtained a set of 12 factors that influence QOL of family carers of people with dementia. A pool of 75 items was generated to measure each of these constructs. Items were pretested on an independent sample of 25 family carers. Results: Feedback from the pilot study resulted in modifications to the instrument. An amended version of C-DEMQOL was constructed which measures 7 themes: carer health; carer responsibilities; carer personal needs; relationship with the person with dementia; carer role; feelings about future; carer support. A preliminary field test study has been conducted to examine the psychometric properties and construct validity of C-DEMQOL in a sample of 120 carers (co-resident and non-resident). The findings of these analyses are presented. Conclusions: There are very few instruments that exist to measure QOL of family carers of people with dementia. The development of C-DEMQOL will enable evaluation of QOL across the range of caring situations, severity and complexity in dementia. This is important for accurately monitoring carers’ QOL in both research (e.g., in intervention) and in health and social care services. P3-508
EXPLORING QUALITY INDICATORS FOR OLDER PERSONS’ TRANSITIONS IN CARE: A SYSTEMATIC REVIEW AND DELPHI PROCESS
Greta G. Cummings1, Kaitlyn Tate1, Sarah Lee1, Garnet Cummings1, Jayna Holroyd-Leduc2, Colin Reid3, Brian Rowe1, Rowan El-Bialy1, 1 University of Alberta, Edmonton, AB, Canada; 2University of Calgary, Calgary, AB, Canada; 3University of British Columbia, Vancouver, BC, Canada. Contact e-mail: [email protected] Background: Nearly 47 million people live with dementia worldwide today, a number projected to continue growing (Prince et al., 2016). Those with dementia are at increased risk for transitions in care and experience many negative consequences as a result (Callahan et al., 2012). There is a need for quality indicators (QIs) to aid health care personnel in all sectors of the healthcare transition to improve care. Methods: Using a systematic review and Delphi process, we catalogued established QIs to evaluate the quality of care provided to older persons during transitions to and from emergency departments (ED). Our search included articles examining development and testing of quality of care measures for older persons’ transitions across the following settings: residential seniors’ facilities, homes, emergency transport services, emergency departments (EDs), and hospitals. Two reviewers independently screened abstracts and full text articles for indicators using predefined inclusion and exclusion criteria. In preparation for Delphi rounds, extracted indicators were coded by setting, Donabedian framework