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Exploring dementia care dyads' person transfer situations from a behavioral medicine perspective in physiotherapy: development of an assessment scale
Örebro universitet, Institutionen för hälsovetenskap och medicin.
2015 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Individuals who suffer from severe dementia require assistance when performing activities of daily living. The highly important person transfer situation is influenced by complex, intertwined biopsychosocial factors that are related to the expression of personal, environmental and behavioral variables, which can interfere with the performance of dementia-care dyads' transfer situations.

The overall aim of this study was to leverage a behavioral medicine perspective in physiotherapy to explore, intervene in, and develop an assessment scale for problematic person transfer situations including persons with dementia and the interaction with the caregiver in these transfer situations.

Interviews were performed with ten caregivers who were recruited to two focus groups and worked in a special care unit for persons with dementia; interviewees described their experiences pursuant to assisting persons with dementia in transfer situations (I).

Literature review and video recordings elicited 93 possible items for the new scale. Expert opinions and item-content validity index reduced the number of items to 17 that spanned two areas. Eight items related to the actions of persons with dementias, whereas nine related to caregiver actions. The feasibility testing of the scale in eight person transfer situations showed that the scale was ready for inter- and intra-rated reliability testing (II). Inter- and intra- rater reliability was good (III). In two single-case experimental design studies, the new scale was shown to contribute to a substantial gathering of data on behaviors in care dyads' person transfer situations (IV). In summary, the results of the thesis show that person transfer situations in dementia special care units are influenced by different biopsychosocial factors and that the new assessment scale can support decision-making about treatment strategies. These findings are important in promoting evidence-based behavior change strategies that can facilitate both sets of individuals—i.e., both persons with dementia and caregivers—in transfer situations. The results highlight important research issues that merit attention in future studies.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro university , 2015. , s. 97
Serie
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 126
Nyckelord [en]
Behavioral medicine in physiotherapy, Care dyad, Dementia, Intervention, Scale development, Transfer problems
Nationell ämneskategori
Geriatrik
Forskningsämne
Vårdvetenskap; Geriatrik
Identifikatorer
URN: urn:nbn:se:oru:diva-45277ISBN: 978-91-7529-090-4 (tryckt)OAI: oai:DiVA.org:oru-45277DiVA, id: diva2:842386
Disputation
2015-10-02, Prismahuset, Hörsal 2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2015-07-20 Skapad: 2015-07-20 Senast uppdaterad: 2020-01-30Bibliografiskt granskad
Delarbeten
1. Reciprocal struggling in person transfer tasks - Caregivers’ experiences in dementia care
Öppna denna publikation i ny flik eller fönster >>Reciprocal struggling in person transfer tasks - Caregivers’ experiences in dementia care
2012 (Engelska)Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 14, nr 4, s. 175-182Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: This study describes caregivers’ experiences of person transfer situations involving people with dementia.

Method: Qualitative focus group interviews were conducted with a total of 10 caregivers; two groups with five persons each, including two men and eight women. The resulting data were extracted and condensed into meaning units and codes using content analysis.

Findings: One main theme was formulated that represents the caregivers’ experiences of person transfer situations involving people with dementia: "Reciprocal struggle in person transfer tasks". Five categories were formulated: "Becoming familiar and making contact", "Risking one’s own body to protect the resident from injury", "Focused yet aware of the surroundings", "Identifying needs to facilitate the person transfer" and "Struggling to be understood".

Conclusion: Person transfer situations involving people with dementia are subject to sudden changes. The ongoing challenge is to ensure a dynamic approach that can be adapted to the needs of the person with dementia at any given time. There is a need for more studies within the field about care and rehabilitation among people with dementia. We suggest that assessment of person transfer situations involving people with dementia and their caregivers is an important issue for further investigation and physiotherapeutic interventions.

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2012
Nyckelord
article; caregiver; caregiver support; cognition; dementia; health care quality; human; nonverbal communication; patient care; patient mobility; physiotherapist; physiotherapy; verbal communication
Nationell ämneskategori
Geriatrik
Identifikatorer
urn:nbn:se:oru:diva-45733 (URN)10.3109/14038196.2012.725184 (DOI)2-s2.0-84870533043 (Scopus ID)
Tillgänglig från: 2015-09-08 Skapad: 2015-09-08 Senast uppdaterad: 2020-01-30Bibliografiskt granskad
2. Development of a new assessment scale for measuring interaction during staff-assisted transfer of residents in dementia special care units
Öppna denna publikation i ny flik eller fönster >>Development of a new assessment scale for measuring interaction during staff-assisted transfer of residents in dementia special care units
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2015 (Engelska)Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, artikel-id 6Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Mobility problems and cognitive deficits related to transferring or moving persons suffering from dementia are associated with dependency. Physical assistance provided by staff is an important component of residents' maintenance of mobility in dementia care facilities. Unfortunately, hands-on assistance during transfers is also a source of confusion in persons with dementia, as well as a source of strain in the caregiver. The bidirectional effect of actions in a dementia care dyad involved in transfer is complicated to evaluate. This study aimed to develop an assessment scale for measuring actions related to transferring persons with dementia by dementia care dyads.

Methods: This study was performed in four phases and guided by the framework of the biopsychosocial model and the approach presented by Social Cognitive Theory. These frameworks provided a starting point for understanding reciprocal effects in dyadic interaction. The four phases were 1) a literature review identifying existing assessment scales; 2) analyses of video-recorded transfer of persons with dementia for further generation of items, 3) computing the item content validity index of the 93 proposed items by 15 experts; and 4) expert opinion on the response scale and feasibility testing of the new assessment scale by video observation of the transfer situations.

Results: The development process resulted in a 17-item scale with a seven-point response scale. The scale consists of two sections. One section is related to transfer-related actions (e.g., capability of communication, motor skills performance, and cognitive functioning) of the person with dementia. The other section addresses the caregivers' facilitative actions (e.g., preparedness of transfer aids, interactional skills, and means of communication and interaction). The literature review and video recordings provided ideas for the item pool. Expert opinion decreased the number of items by relevance ratings and qualitative feedback. No further development of items was performed after feasibility testing of the scale.

Conclusions: To enable assessment of transfer-related actions in dementia care dyads, our new scale shows potential for bridging the gap in this area. Results from this study could provide health care professionals working in dementia care facilities with a useful tool for assessing transfer-related actions.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2015
Nyckelord
Caregiver, Dementia, Dyadic interaction, Observation scale, Scale construction, Special care unit
Nationell ämneskategori
Geriatrik
Forskningsämne
Geriatrik
Identifikatorer
urn:nbn:se:oru:diva-43938 (URN)10.1186/s12877-015-0003-6 (DOI)000349862200001 ()2-s2.0-84923859656 (Scopus ID)
Tillgänglig från: 2015-03-30 Skapad: 2015-03-30 Senast uppdaterad: 2020-01-30Bibliografiskt granskad
3. Inter- and intra-rater reliability of a newly developed assessment scale: the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS)
Öppna denna publikation i ny flik eller fönster >>Inter- and intra-rater reliability of a newly developed assessment scale: the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS)
2015 (Engelska)Ingår i: Physical & Occupational Therapy in Geriatrics, ISSN 0270-3181, E-ISSN 1541-3152, Vol. 33, nr 4, s. 279-293Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim: To study the inter- and intra-rater reliability of a newly developed assessment scale, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS).

Methods: Two physiotherapists completed the observational form of the DIDTAS while watching 20 video-films of sit-to-stand-transfers or bedside transfers (i.e., caregiver-assisted transfers), videotaped in a dementia special care unit. Two-way analyses of variance (ANOVAs) were used for calculating ICC values of each item.

Results: The results supported the overall reliability of the DIDTAS items with variations in inter- and intra-rater reliability, with ICC values from 0.35 to 0.92.

Conclusion: On the basis of the transfer-related actions of dementia care dyads, the DIDTAS was shown to be sufficiently reliable. This in turn can provide healthcare professionals seeing and treating individuals suffering from dementia with a new method for assessing actions related to person transfer situations in dementia care facilities.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2015
Nyckelord
Assessment tool, behavioral medicine, dementia, physical therapy, reliability test
Nationell ämneskategori
Geriatrik
Identifikatorer
urn:nbn:se:oru:diva-45734 (URN)10.3109/02703181.2015.1065939 (DOI)2-s2.0-84947913276 (Scopus ID)
Tillgänglig från: 2015-09-08 Skapad: 2015-09-08 Senast uppdaterad: 2022-06-17Bibliografiskt granskad
4. Functional Behavior Analysis-Guided Interventions for Improving Transfer-Related Behavior in Dementia Care Dyads: Two Experimental Single Cases
Öppna denna publikation i ny flik eller fönster >>Functional Behavior Analysis-Guided Interventions for Improving Transfer-Related Behavior in Dementia Care Dyads: Two Experimental Single Cases
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Geriatrik
Identifikatorer
urn:nbn:se:oru:diva-45735 (URN)
Tillgänglig från: 2015-09-08 Skapad: 2015-09-08 Senast uppdaterad: 2020-01-30Bibliografiskt granskad

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