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Development of a new assessment scale for measuring interaction during staff-assisted transfer of residents in dementia special care units
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden .ORCID iD: 0000-0003-0964-1747
School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden .
School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden .
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
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2015 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 6Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
BioMed Central, 2015. Vol. 15, article id 6
Keywords [en]
Caregiver, Dementia, Dyadic interaction, Observation scale, Scale construction, Special care unit
National Category
Geriatrics
Research subject
Geriatrics
Identifiers
URN: urn:nbn:se:oru:diva-43938DOI: 10.1186/s12877-015-0003-6ISI: 000349862200001Scopus ID: 2-s2.0-84923859656OAI: oai:DiVA.org:oru-43938DiVA, id: diva2:799178
Available from: 2015-03-30 Created: 2015-03-30 Last updated: 2020-01-30Bibliographically approved
In thesis
1. Exploring dementia care dyads' person transfer situations from a behavioral medicine perspective in physiotherapy: development of an assessment scale
Open this publication in new window or tab >>Exploring dementia care dyads' person transfer situations from a behavioral medicine perspective in physiotherapy: development of an assessment scale
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2015. p. 97
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 126
Keywords
Behavioral medicine in physiotherapy, Care dyad, Dementia, Intervention, Scale development, Transfer problems
National Category
Geriatrics
Research subject
Nursing Science; Geriatrics
Identifiers
urn:nbn:se:oru:diva-45277 (URN)978-91-7529-090-4 (ISBN)
Public defence
2015-10-02, Prismahuset, Hörsal 2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:00 (Swedish)
Opponent
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Available from: 2015-07-20 Created: 2015-07-20 Last updated: 2020-01-30Bibliographically approved

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Thunborg, CharlottaIvarsson, Ann-Britt

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