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  • 1.
    Cabrera, Esther
    et al.
    School of Health Sciences TecnoCampus, University Pompeu Fabra, Barcelona, Spain.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Verbeek, Hilde
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Soto-Martin, Maria
    Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France.
    Meyer, Gabriele
    Medical Faculty, Institute for Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Germany.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland/Turku University Hospital, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Zabalegui, Adelaida
    Nursing Hospital Clinic of Barcelona, Spain.
    Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes: A systematic review2015Inngår i: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, nr 2, s. 134-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Two-thirds of nursing home residents suffer from dementia and there is a need for effective and efficient interventions with meaningful outcomes for these individuals. This study aims to identify current best practices in non-pharmacological interventions in nursing homes.

    Methods: A systematic literature review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guideline. Studies and Randomized Controlled Trials (RCT) evaluating non-pharmacological interventions focused on improving the Quality of Care (QoC) and/or Quality of Life (QoL) of people with dementia (PwD) living in nursing homes were included. For individual study evaluation, the Cochrane Collaboration risk of bias assessment tool was used.

    Results: A total of 31 articles were included and five main categories emerged: psychosocial and educational, physical activity, sensorial therapies, staff-focused interventions and complex interventions. Psychosocial interventions were the most exhaustively studied and evaluated interventions. Few studies related to physical therapy were identified and they did not provide enough evidence of their effectiveness. Therapeutic touch was revealed to have positive effects on residents with dementia.

    Conclusion: Psychosocial interventions have been shown to have the potential to improve the QoL and QoC of people with dementia in nursing homes. Before implementation of the intervention, it is recommended that activities are adjusted according to residents' characteristics and external factors controlled to achieve effectiveness and to structure a well-designed intervention. However, there is not enough evidence to support the effectiveness of non-pharmacological interventions in general. Further well-designed research is needed on non-pharmacological interventions in nursing facilities. (C) 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.

  • 2.
    Hallberg, Ingalill Rahm
    et al.
    Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland & Hospital District of Southwest Finland, Turku, Finland.
    Meyer, Gabriele
    Witten/Herdecke University, Witten, Germany.
    Raamat, Katrin
    University of Tartu, Tartu, Estonia.
    Martin Soto, Maria
    Gerontopôle, Alzheimer's disease Research and Clinical Center, Toulouse University Hospital, Toulouse, France.
    Sutcliffe, Caroline
    University of Manchester, Manchester, United Kingdom.
    Zabalegui,, Adelaida
    Hospital Clinic of Barcelona, Barcelona, Spain.
    Zwakhalen, Sandra
    Maastricht University, Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht, Netherlands.
    Karlsson, Staffan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad. Lund University, Lund, Sweden.
    Dementia care in eight European Countries: developing a mapping system to explore systems2013Inngår i: Image - the Journal of Nursing Scholarship, ISSN 0743-5150, Vol. 45, nr 4, s. 412-424Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: There is a knowledge gap with regard to the structure of the care and service system available to persons with dementia. This is very much a concern for nurses who are the main providers in the care of dementia. The study, a part of the "RightTimePlaceCare" project, describes the development and content of a mapping system aimed at exploring the content of care and service for persons with dementia and their informal caregiver throughout the disease trajectory. The usefulness of the mapping system is illustrated in describing the availability of care and service at the diagnostic stage, and at the institutional and palliative stages.

    Design: A descriptive cross-country design concerning eight European countries differing in demographic composition and terms of long-term care provided is employed.

    Methods: A modified consensus strategy was used to develop the mapping system and define the terminology. Thereafter, each country ' s mapping systemwas completed by its research group collecting country-specific information and using expert groups either as consultants or for completing the system.

    Findings: The consensus procedure worked satisfactorily with regard to content and definitions, whereas assessing the availability and utilization of care and service was problematic. Some 50 types care and service activities were identified and defined and were categorized as follows: (a) screening, diagnostic procedures, and treatment of dementia; (b) outpatient care facilities; (c) care at home; (d) institutional care; (e) palliative care; (f) informal caregiving and supportive actions; and (g) civic activities. Care at home included the broadest range of activities; palliative care, informal caregiving, and supportive actions were the smallest range.

    Conclusions: The dementia care systems were found to be comprehensive and to emphasize home care. Activities aimed at transferring knowledge to informal caregivers, though highly important for home care, seemed less extensive. The mapping system appears useful from a nurse manager's standpoint for exploring the dementia care pathway. Comparisons between countries appear useful for developing the care system and for sharing information of how toperfect it. Further testing and development are needed regarding information on the availability and utilization of care and service activities.

    Clinical Relevance: The mapping system can be useful in clarifying the dementia care system for those concerned, in helping nurse researchers and managers review and initiate evaluation and communicate with policy makers, as well as to ensure that providers use appropriate parts of the system. It can also be useful in national and international comparative studies. © 2013 Sigma Theta Tau International.

  • 3.
    Lethin, Connie
    et al.
    Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland & University Hospital of Turku, Turku, Finland.
    Bleijlevens, Michel HC
    Maastricht University, Maastricht, The Netherlands.
    Stephan, Astrid
    Witten/Herdecke University, Witten, Germany & Martin Luther University Halle-Wittenberg, Halle, Germany.
    Soto Martin, Maria
    University of Toulouse, Toulouse, France.
    Zabalegui, Adelaida
    Hospital Clínic de Barcelona, Barcelona, Spain.
    Karlsson, Staffan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Lund University, Lund, Sweden.
    Nilsson, Christer ()
    Skåne University Hospital, Malmö, Sweden & Lund University, Lund, Sweden.
    Predicting caregiver burden in informal caregivers caring for persons with dementia living at home – A follow-up cohort study2018Inngår i: Dementia, ISSN 1471-3012, E-ISSN 1741-2684Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Longitudinal studies of caregiver burden when caring for persons with dementia living at home are sparse. The aim of the study was to identify factors associated with caregiver burden and predicting increased burden related to caregivers, persons with dementia and formal care. Data were collected through interviews with 1223 caregivers in eight European countries. Bivariate and multivariate regression analyses were performed. Factors associated with caregiver burden included extensive informal care provision, decreased well-being and reduced quality of life for the caregiver and reduced cognition, decreased quality of life, severe neuropsychiatric symptoms and depression in the person with dementia and caregivers’ negative experience of quality of care. Factors predicting an increased burden were diminished caregiver well-being, severe neuropsychiatric symptoms of the person with dementia and caregivers’ negative perception of quality of care. The knowledge gained in this study may be useful in developing more adequate service systems and interventions to improve dementia care. © 2018, The Author(s) 2018.

  • 4.
    Lethin, Connie
    et al.
    Lund University, Lund, Sweden.
    Renom-Guiteras, Anna
    University of Witten/Herdecke, Witten, Germany.
    Zwakhalen, Sandra
    Maastricht University, Maastricht, The Netherlands.
    Soto-Martin, Maria
    University of Witten/Herdecke, Witten, Germany.
    Saks, Kai
    University of Tartu, Tartu, Estonia.
    Zabalegui, Adelaida
    Hospital Clínic de Barcelona, Barcelona, Spain.
    Challis, David J
    University of Manchester, Manchester, United Kingdom.
    Nilsson, Christer
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Lund University, Lund, Sweden.
    Psychological well-being over time among informal caregivers caring for persons with dementia living at home2017Inngår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 21, nr 11, s. 1138-1146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate informal caregivers’ psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors.

    Method: A cohort study at baseline and 3 months’ follow-up in eight European countries. Caregivers included (n = 1223) were caring for PwDs aged ≥ 65 years at home. Data on caregivers, PwDs and FC were collected using standardized instruments. Regression analysis of factors associated with caregiver psychological well-being at baseline and 3 months later was performed.

    Results: Factors associated with caregiver psychological well-being at baseline were positive experience of caregiving, low caregiver burden, high quality of life (QoL) for caregivers, male gender of PwD, high QoL of PwD, few neuropsychiatric symptoms and depressive symptoms for the PwD. At follow-up, caregivers with increased psychological well-being experienced of quality of care (QoC) higher and were more often using dementia specific service. Predicting factors for caregivers’ increased psychological well-being were less caregiver burden, positive experience of caregiving, less supervision of the PwD and higher caregiver QoL, if PwD were male, had higher QoL and less neuropsychiatric symptoms. Furthermore, higher QoC predicted increased caregivers’ psychological well-being.

    Conclusion: Informal caregiving for PwDs living at home is a complex task. Our study shows that caregivers’ psychological well-being was associated with, among other things, less caregiver burden and higher QoL. Professionals should be aware of PwD neuropsychiatric symptoms that might affect caregivers’ psychological well-being, and provide proper care and treatment for caregivers and PwDs. © 2016 Informa UK Limited, trading as Taylor & Francis Group

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