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Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
Rehabilitation Unit, Nyköping Municipality, Nyköping, 611 83, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Neurobiology, Care Sciences and Society Division of Clinical Geriatrics, Karolinska Institute, Karolinska vägen 37A, SE, Stockholm, 171 76, Sweden. (BeMe)ORCID iD: 0000-0003-0964-1747
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (BEME)ORCID iD: 0000-0002-1912-3110
2022 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, no 1, article id 261Article in journal (Refereed) Published
Abstract [en]

Background: Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads. Methods: This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection. Results: Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved. Conclusions: The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study. 

Place, publisher, year, edition, pages
BioMed Central Ltd , 2022. Vol. 22, no 1, article id 261
Keywords [en]
Dementia, Functional behaviour analysis, Person transfer situation, Physiotherapy, Single-case design, Special care unit
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-58031DOI: 10.1186/s12877-022-02952-5ISI: 000774866300002PubMedID: 35351026Scopus ID: 2-s2.0-85127250990OAI: oai:DiVA.org:mdh-58031DiVA, id: diva2:1651812
Available from: 2022-04-13 Created: 2022-04-13 Last updated: 2024-07-04Bibliographically approved

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Thunborg, CharlottaSandborgh, Maria

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