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Dementia care mapping: effects on residents’ quality of life and challenging behavior in German nursing homes. A quasi-experimental trial

Published online by Cambridge University Press:  03 July 2015

Martin Nikolaus Dichter ,
Tina Quasdorf ,
Christian Günter Georg Schwab ,
Diana Trutschel ,
Burkhard Haastert ,
Christine Riesner ,
Sabine Bartholomeyczik  and
Margareta Halek
Martin Nikolaus Dichter*
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Tina Quasdorf
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Christian Günter Georg Schwab
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Diana Trutschel
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany Institute of Computer Science, Martin-Luther-University Halle-Wittenberg, Halle, Germany
Burkhard Haastert
Affiliation:
mediStatistica, Neuenrade, Germany
Christine Riesner
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany Division “Nursing Science and Pedagogics” Ministry of Health, Equalities, Care and Ageing of the State of North Rhine-Westphalia, Düsseldorf, Germany
Sabine Bartholomeyczik
Affiliation:
School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
Margareta Halek
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Witten, Germany School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
*
Correspondence should be addressed to: Martin Nikolaus Dichter, German Center for Neurodegenerative Diseases (DZNE), Witten, Germany. Phone: +49 2302 926 253; Fax: +49 2302 926 239. Email: Martin.Dichter@dzne.de.
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Abstract

Background:

Person-centered care (PCC) is a widely recognized concept in dementia research and care. Dementia Care Mapping (DCM) is a method for implementing PCC. Prior studies have yielded heterogeneous results regarding the effectiveness of DCM for people with dementia (PwD). We aimed to investigate the effectiveness of DCM with regard to quality of life (QoL) and challenging behavior in PwD in nursing homes (NHs).

Methods:

Leben-QD II is an 18-month, three-armed, pragmatic quasi-experimental trial. The sample of PwD was divided into three groups with three living units per group: (A) DCM applied since 2009, (B) DCM newly introduced during the study, and (C) a control intervention based on a regular and standardized QoL rating. The primary outcome was QoL measured with the Quality of Life-Alzheimer's Disease (QoL-AD) proxy, and the secondary outcomes were QoL (measured with QUALIDEM) and challenging behavior (measured with the Neuropsychiatric Inventory Nursing Home version, NPI-NH).

Results:

There were no significant differences either between the DCM intervention groups and the control group or between the two DCM intervention groups regarding changes in the primary or secondary outcomes. At baseline, the estimated least square means of the QoL-AD proxy for groups A, B, and C were 32.54 (confidence interval, hereafter CI: 29.36–35.72), 33.62 (CI: 30.55–36.68), and 30.50 (CI: 27.47–33.52), respectively. The DCM groups A (31.32; CI: 28.15–34.48) and B (27.60; CI: 24.51–30.69) exhibited a reduction in QoL values, whereas group C exhibited an increase (32.54; CI: 29.44–35.64) after T2.

Conclusions:

DCM exhibited no statistically significant effect in terms of QoL and challenging behavior of PwD in NHs. To increase the likelihood of a positive effect for PwD, it is necessary to ensure successful implementation of the intervention.

Keywords

nursing homesdementiaquality of lifeperson-centered caredementia care mappingchallenging behaviorpsychosocial intervention
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 11 , November 2015 , pp. 1875 - 1892
Copyright
Copyright © International Psychogeriatric Association 2015 

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