PerCEN: A cluster randomized controlled trial of person-centered residential care and environment for people with dementia

Chenoweth, L; Forbes, I; Fleming, R; King, MT; Stein-Parbury, J; Luscombe, G; Kenny, P; Jeon, YH; Haas, M; Brodaty, H

PerCEN: A cluster randomized controlled trial of person-centered residential care and environment for people with dementia

Chenoweth, L

Forbes, I Fleming, R King, MT Stein-Parbury, J

Luscombe, G Kenny, P

Jeon, YH

Haas, M

Brodaty, H

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Publication Type:: Journal Article
Citation:: International Psychogeriatrics, 2014, 26 (7), pp. 1147 - 1160
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Chenoweth, L https://orcid.org/0000-0002-1783-9289	en_US
dc.contributor.author	Forbes, I	en_US
dc.contributor.author	Fleming, R	en_US
dc.contributor.author	King, MT	en_US
dc.contributor.author	Stein-Parbury, J https://orcid.org/0000-0002-0018-3236	en_US
dc.contributor.author	Luscombe, G	en_US
dc.contributor.author	Kenny, P https://orcid.org/0000-0002-5021-4758	en_US
dc.contributor.author	Jeon, YH https://orcid.org/0000-0003-2031-9134	en_US
dc.contributor.author	Haas, M https://orcid.org/0000-0002-9726-3063	en_US
dc.contributor.author	Brodaty, H	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	International Psychogeriatrics, 2014, 26 (7), pp. 1147 - 1160	en_US
dc.identifier.issn	1041-6102	en_US
dc.identifier.uri	http://hdl.handle.net/10453/35383
dc.description.abstract	Background: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. Methods: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. Results: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%. Conclusion: The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369. Copyright © International Psychogeriatric Association 2014.	en_US
dc.relation.ispartof	International Psychogeriatrics	en_US
dc.relation.isbasedon	10.1017/S1041610214000398	en_US
dc.subject.classification	Geriatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Dementia	en_US
dc.subject.mesh	Psychomotor Agitation	en_US
dc.subject.mesh	Depression	en_US
dc.subject.mesh	Residential Treatment	en_US
dc.subject.mesh	Environment	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Precision Medicine	en_US
dc.title	PerCEN: A cluster randomized controlled trial of person-centered residential care and environment for people with dementia	en_US
dc.type	Journal Article
utslib.citation.volume	7	en_US
utslib.citation.volume	26	en_US
utslib.for	111001 Aged Care Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Faculty of Design, Architecture and Building
pubs.organisational-group	/University of Technology Sydney/Faculty of Design, Architecture and Building/School of Built Environment
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	7	en_US
pubs.publication-status	Published	en_US
pubs.volume	26	en_US

Abstract:

Background: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. Methods: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. Results: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%. Conclusion: The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369. Copyright © International Psychogeriatric Association 2014.

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http://hdl.handle.net/10453/35383