Abstract
Objectives
A process evaluation was performed for an intervention aimed at improvement of the
management of neuropsychiatric symptoms in young-onset dementia. Data about sample
quality and intervention quality was evaluated to better understand internal and external
validity. In addition, data about the implementation strategy and factors affecting
implementation were evaluated to improve further implementation of the intervention.
Design
A model proposed by Leontjevas and colleagues consisting of first-order (validity)
and second-order (implementation) data was used.
Setting and Participants
Care units delivering specialized treatment and support for residents with young-onset
dementia.
Measures
A description of the recruitment, randomization procedure, and intervention reach
was carried out to determine sample quality. To determine intervention quality, data
on satisfaction, relevance, feasibility, and fidelity were collected through a questionnaire
and reports logged on the server of the web-based intervention. A description of the
implementation strategy was provided. Barriers and facilitators for implementation
were collected by a questionnaire and analyzed by deductive content analysis.
Results
Care units varied in size and were recruited from different geographical regions in
the Netherlands. The informed consent rate of the residents was 87.7%. The majority
of the nursing home staff were satisfied with the intervention. However, parts of
the intervention were perceived as less relevant for their own organization. The feasibility
of the intervention was considered low. The fidelity differed between care units.
The implementation strategy did not overcome all barriers. Factors affecting implementation
covered 3 themes: organizational aspects, culture of the organization, and aspects
of the intervention.
Conclusions
In general, our results showed sufficient internal and external validity, warranting
further effect analyses. Adaptations to specific steps of the care program should
be considered to increase feasibility and sustainability. In addition, integration
of the care program into the electronic health records is expected to further improve
implementation.
Keywords
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Article info
Publication history
Published online: April 10, 2018
Footnotes
The authors declare no conflicts of interest.
This study was funded by the Netherlands Organization for Health Research and Development (ZonMW, nr: 733050402), the Archipel Care Group in the Netherlands, the Florence Care Group in the Netherlands, the Dutch YOD Knowledge Center, and the Dutch Alzheimer Society.
Identification
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© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
