Till Örebro universitet

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.

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.

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.