Article type
Year
Abstract
Background: Person-centered care (PCC) is a holistic and integrative approach designed to maintain well-being and quality of life of people with dementia and to address the incidence of need-driven challenging behaviors as an alternative to conventional care.
Objectives: The aim of this review is to provide the most reliable summary of the effect of PCC targeted toward people with dementia.
Methods: Records from six databases were obtained. The search included randomized controlled trials (RCT) and non-RCT studies, published in English, providing PCC interventions for people with dementia living in long-term care facilities and in the community. To enhance applicability of study findings, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the evidence level of the included outcomes.
Results: This review included 19 intervention studies consisting of 15 RCTs and four non-RCTs. When PCC was compared to usual care in the RCTs, significant effects were found in favor of PCC for agitation (GRADE evidence: low), neuropsychiatric symptoms (GRADE evidence: low), quality of life (QoL) (GRADE evidence: low), and depression (GRADE evidence: very low). Greater effectiveness of PCC was identified, when it was implemented in people with less severe dementia and led by external experts. PCC was more effective in short-term interventions for agitation and long-term interventions for QoL.
Conclusions: PCC interventions can be considered especially for individuals who have a diagnosis of early-stage dementia. Short-term interventions with more frequent exposure to PCC activities ensured a higher engagement of the person with dementia in programs, and produced a better outcome in the reduction of agitation. For QoL and depression in particular, PCC interventions can prevent further deterioration caused by depression, leading to an improved level of QoL in individuals with dementia. More rigorous studies of this subject are warranted so that future interventions provide nurses with a clear understanding of the effectiveness of PCC.
Objectives: The aim of this review is to provide the most reliable summary of the effect of PCC targeted toward people with dementia.
Methods: Records from six databases were obtained. The search included randomized controlled trials (RCT) and non-RCT studies, published in English, providing PCC interventions for people with dementia living in long-term care facilities and in the community. To enhance applicability of study findings, we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the evidence level of the included outcomes.
Results: This review included 19 intervention studies consisting of 15 RCTs and four non-RCTs. When PCC was compared to usual care in the RCTs, significant effects were found in favor of PCC for agitation (GRADE evidence: low), neuropsychiatric symptoms (GRADE evidence: low), quality of life (QoL) (GRADE evidence: low), and depression (GRADE evidence: very low). Greater effectiveness of PCC was identified, when it was implemented in people with less severe dementia and led by external experts. PCC was more effective in short-term interventions for agitation and long-term interventions for QoL.
Conclusions: PCC interventions can be considered especially for individuals who have a diagnosis of early-stage dementia. Short-term interventions with more frequent exposure to PCC activities ensured a higher engagement of the person with dementia in programs, and produced a better outcome in the reduction of agitation. For QoL and depression in particular, PCC interventions can prevent further deterioration caused by depression, leading to an improved level of QoL in individuals with dementia. More rigorous studies of this subject are warranted so that future interventions provide nurses with a clear understanding of the effectiveness of PCC.