Systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia.
Systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia.
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DOI：
10.1136/bmjopen-2016-014177
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发表时间：
2017-02-09
期刊：
影响因子：
2.9
通讯作者：
Cooper C
中科院分区：
文献类型：
--
作者：
Rapaport P;Livingston G;Murray J;Mulla A;Cooper C
本综述旨在了解心理社会干预的哪些要素与痴呆症患者的改善结果相关，以告知护理院的实施情况。对定性和定量干预研究进行了系统回顾。我们纳入了评估心理社会干预措施的主要研究，这些干预措施培训了护理之家的工作人员提供特定的干预措施，或试图改变工作人员向痴呆症患者提供护理的方式，并报告了工作人员和居民的定性或定量结果。我们检索了MEDLINE、PsychINFO和EMBASE电子数据库，并手动检索了截至2016年5月的参考文献。纳入的论文质量由2位作者独立评定，使用来自标准标准的操作性检查表。我们讨论了分歧并达成了共识。我们进行了定量的叙述性综合和定性结果的主题性综合，以找到什么是立即有效的，并在持续变化。我们确定了49篇符合预定标准的论文。我们发现，缺乏更高质量的定量证据表明，在心理社会干预结束后，效果可以持续，没有证据表明干预措施在6个月后继续发挥作用。 定性研究结果表明，工作人员重视干预措施，重点是了解，理解和与痴呆症居民联系。干预措施的成功要素包括互动式培训、培训后支持，旨在培训大多数工作人员、事后保留书面材料以及将干预措施纳入日常护理。心理社会干预可以改善护理院痴呆症工作人员和居民的结果;然而，许多试验结果是有限的。定性研究结果的综合突出了工作人员重视和感觉改善护理的干预措施的核心组成部分。这些研究结果提供了有用的证据，为制定可持续的，有效的心理社会干预措施在护理院。CRD 42015017621。
This review aims to understand what elements of psychosocial interventions are associated with improved outcomes for people with dementia to inform implementation in care homes. A systematic review of qualitative and quantitative intervention studies was undertaken. We included primary research studies evaluating psychosocial interventions that trained care home staff to deliver a specific intervention or that sought to change how staff delivered care to residents with dementia and reported staff and resident qualitative or quantitative outcomes. We searched MEDLINE, PsychINFO and EMBASE electronic databases and hand-searched references up to May 2016. Quality of included papers was rated independently by 2 authors, using operationalised checklists derived from standard criteria. We discussed discrepancies and reached consensus. We conducted a narrative synthesis of quantitative and a thematic synthesis of qualitative findings to find what was effective immediately and in sustaining change. We identified 49 papers fulfilling predetermined criteria. We found a lack of higher quality quantitative evidence that effects could be sustained after psychosocial interventions finished with no evidence that interventions continued to work after 6 months. Qualitative findings suggest that staff valued interventions focusing on getting to know, understand and connect with residents with dementia. Successful elements of interventions included interactive training, post-training support, aiming to train most staff, retaining written materials afterwards and building interventions into routine care. Psychosocial interventions can improve outcomes for staff and residents with dementia in care homes; however, many trial results are limited. Synthesis of qualitative findings highlight core components of interventions that staff value and feel improve care. These findings provide useful evidence to inform the development of sustainable, effective psychosocial interventions in care homes. CRD42015017621.