TY - JOUR
T1 - Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan
T2 - a secondary analysis of qualitative and quantitative data
AU - Nakanishi, Miharu
AU - Ziylan, Canan
AU - Bakker, Ton
AU - Granvik, Eva
AU - Nägga, Katarina
AU - Nishida, Atsushi
N1 - Funding Information:
This study was funded by the Tokyo Metropolitan Government under Project Number 29‐Fukushi‐Hoken‐Kourei‐Zaitaku 1397. This work was also partly supported by the Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science. None of these funding sources were involved in the design or conduct of this study. They had no input into data collection, management, analysis or interpretation and were not able to monitor the manuscript for presentation, review or approval.
Publisher Copyright:
© 2020 Nordic College of Caring Science
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - dementia
KW - home care services
KW - implementation science
KW - international cooperation
KW - psychosocial interventions
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U2 - 10.1111/scs.12854
DO - 10.1111/scs.12854
M3 - Article
C2 - 32285513
AN - SCOPUS:85083323169
SN - 0283-9318
VL - 35
SP - 430
EP - 441
JO - Scandinavian Journal of Caring Sciences
JF - Scandinavian Journal of Caring Sciences
IS - 2
ER -
