Author/Authors :
Ryan, Nicholas P Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , Scott, Laura Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , McPhee, Maryanne Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , Mathers, Susan Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , Davis, Marie-Claire Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , Maule, Roxanne Calvary Health Care Bethlehem - South Caulfield, VIC, Australia , Fisher, Fiona Calvary Health Care Bethlehem - South Caulfield, VIC, Australia
Abstract :
Objectives. Behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both aged care residents and
staff. Despite the high prevalence of BPSD in progressive neurological diseases (PNDs) such as multiple sclerosis, Huntington’s
disease, and Parkinson’s disease, the utility of a structured clinical protocol for reducing BPSD has not been systematically
evaluated in PND populations. Method. Staff (n = 51) and individuals with a diagnosis of PND (n = 13) were recruited into the
study, which aimed to evaluate the efficacy of a PND-specific structured clinical protocol for reducing the impact of BPSD in
residential aged care (RAC) and specialist disability accommodation (SDA) facilities. Staff were trained in the clinical protocol
through face-to-face workshops, which were followed by 9 weeks of intensive clinical supervision to a subset of staff (“behaviour
champions”). Staff and resident outcome measures were administered preintervention and immediately following the
intervention. The primary outcome was frequency and severity of BPSD, measured using the Neuropsychiatric InventoryNursing Home Version (NPI-NH). The secondary outcome was staff coping assessed using the Strain in Dementia Care Scale
(SDCS). Results. In SDA, significant reductions in staff ratings of job-related stress were observed alongside a statistically
significant decrease in BPSD from T1 to T2. In RAC, there was no significant time effect for BPSD or staff coping; however, a
medium effect size was observed for staff job stress. Conclusions. Staff training and clinical support in the use of a structured
clinical protocol for managing BPSD were linked to reductions in staff job stress, which may in turn increase staff capacity to
identify indicators of resident distress and respond accordingly. Site variation in outcomes may relate to organisational and
workforce-level barriers that may be unique to the RAC context and should be systematically addressed in future RCT studies of
larger PND samples.
