1 Centre for Dementia Research, Leeds Beckett University, Leeds, United Kingdom.
2 Clinical Trials Research Unit, University of Leeds, Leeds, United Kingdom.
Am J Alzheimers Dis Other Demen. 2019 Sep;34(6):390-398. doi: 10.1177/1533317519845725. Epub 2019 May 5.
This study explored intervention implementation within a pragmatic, cluster randomized controlled trial of Dementia Care Mapping™ (DCM) in UK care homes. DCM is a practice development tool comprised of a 5 component cycle (staff briefing, mapping observations, data analysis and reporting, staff feedback, and action planning) that supports delivery of person-centered care. Two staff from the 31 intervention care homes were trained in DCM and asked to deliver 3 cycles over a 15-month period, supported by a DCM expert during cycle 1. Implementation data were collected after each mapping cycle. There was considerable variability in DCM implementation fidelity, dose, and reach. Not all homes trained 2 mappers on schedule, and some found it difficult to retain mappers. Only 26% of homes completed more than 1 cycle. Future DCM trials in care home settings should consider additional methods to support intervention completion including intervention delivery being conducted with ongoing external support.
本研究探讨了在英国养老院中进行的实用、集群随机对照试验中痴呆症关爱映射（DCM）的干预实施情况。DCM 是一种实践发展工具，由 5 个组成部分循环（员工简介、映射观察、数据分析和报告、员工反馈和行动计划）组成，支持提供以患者为中心的护理。31 家干预养老院的两名员工接受了 DCM 的培训，并在 15 个月的时间内要求完成 3 个循环，在第 1 个循环期间由 DCM 专家提供支持。在每次映射循环后收集实施数据。DCM 的实施保真度、剂量和范围存在很大差异。并非所有的养老院都按计划培训了 2 名映射师，有些养老院发现很难留住映射师。只有 26%的养老院完成了超过 1 个循环。未来在养老院环境中进行的 DCM 试验应考虑额外的方法来支持干预的完成，包括在持续的外部支持下进行干预交付。
