Collaborative Consulting, Mill Valley, California, USA.
Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA.
Gerontologist. 2024 Oct 1;64(10). doi: 10.1093/geront/gnae122.
The Individualized Positive Psychosocial Interaction (IPPI) program is an adaptable, evidence-based intervention. IPPI trains nursing home care partners to engage residents living with moderate to severe dementia in preference-based, one-to-one interactions using emotion-focused communication. We sought to understand provider-driven adaptations made to the IPPI program and whether the adaptations made were fidelity-consistent.
Data were collected from n = 78 interviews with n = 23 nursing home provider champions who led a quality improvement project to implement the IPPI program with 3-5 residents per care community. Using content analysis, we report quantitative data on the adaptation characteristics according to the Framework for Reporting Adaptations and Modifications-Expanded core modules and participant quotes to illustrate adaptations.
Champions reported 34 adaptations, with an average of 2.6 adaptations per nursing home. The majority of IPPI adaptations pertained to implementation (65%; n = 22), whereas 17% (n = 6) were content and 17% (n = 6) were context. Some adaptations were motivated by the organization (e.g., time constraints), while others were motivated by the recipient (e.g., cognitive capacity). Most adaptations made to the IPPI protocol by care partners were fidelity-consistent (92%; n = 33).
Care partners' adaptations to the IPPI made the intervention more resident-centric. Future healthcare intervention providers must consider the user perspective and encourage adaptations that further tailor to the user, as long as the adaptations are fidelity-consistent.
个体化积极心理社会干预（IPPI）计划是一种适应性强、基于证据的干预措施。IPPI 培训养老院护理伙伴，采用以情绪为中心的沟通方式，与患有中度至重度痴呆症的居民进行偏好导向的一对一互动。我们旨在了解护理伙伴对 IPPI 计划进行的自主调整，以及所做的调整是否与保真度一致。
数据来自对 23 名护理院提供者冠军的 n = 78 次访谈，他们领导了一项质量改进项目，以便在每个护理社区使用 3-5 名居民实施 IPPI 计划。我们使用内容分析法，根据改编和修改框架报告改编特征，根据扩展核心模块报告定量数据，并引用参与者的引述来说明改编。
冠军们报告了 34 项改编措施，每个养老院平均有 2.6 项改编措施。大多数 IPPI 改编措施涉及实施（65%；n = 22），而 17%（n = 6）是内容方面的改编，17%（n = 6）是背景方面的改编。一些改编措施是由组织驱动的（例如，时间限制），而另一些则是由接受者驱动的（例如，认知能力）。护理伙伴对 IPPI 协议的大多数调整都是保真一致的（92%；n = 33）。
护理伙伴对 IPPI 的调整使干预措施更加以居民为中心。未来的医疗保健干预措施提供者必须考虑用户的角度，并鼓励进一步针对用户进行调整，只要调整与保真度一致。
