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Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan : a secondary analysis of qualitative and quantitative data

Nakanishi, Miharu ; Ziylan, Canan ; Bakker, Ton ; Granvik, Eva ; Nägga, Katarina LU and Nishida, Atsushi (2021) In Scandinavian Journal of Caring Sciences 35(2). p.430-441
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.... (More)

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.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dementia, home care services, implementation science, international cooperation, psychosocial interventions
in
Scandinavian Journal of Caring Sciences
volume
35
issue
2
pages
12 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85083323169
  • pmid:32285513
ISSN
0283-9318
DOI
10.1111/scs.12854
language
English
LU publication?
yes
id
0210b798-15ca-49a9-8a92-b37a0787fea6
date added to LUP
2020-05-06 15:20:26
date last changed
2024-07-10 14:37:54
@article{0210b798-15ca-49a9-8a92-b37a0787fea6,
  abstract     = {{<p>Background: A psychosocial dementia care programme for challenging behaviour (DEMBASE<sup>®</sup>) 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.</p>}},
  author       = {{Nakanishi, Miharu and Ziylan, Canan and Bakker, Ton and Granvik, Eva and Nägga, Katarina and Nishida, Atsushi}},
  issn         = {{0283-9318}},
  keywords     = {{dementia; home care services; implementation science; international cooperation; psychosocial interventions}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{2}},
  pages        = {{430--441}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Scandinavian Journal of Caring Sciences}},
  title        = {{Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan : a secondary analysis of qualitative and quantitative data}},
  url          = {{http://dx.doi.org/10.1111/scs.12854}},
  doi          = {{10.1111/scs.12854}},
  volume       = {{35}},
  year         = {{2021}},
}