Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study
BackgroundNeuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-06-01
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| Series: | JMIR Research Protocols |
| Online Access: | https://www.researchprotocols.org/2022/6/e34550 |
| _version_ | 1797735005541105664 |
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| author | Helma M F Verstraeten Canan Ziylan Debby L Gerritsen Robbert Huijsman Miharu Nakanishi Martin Smalbrugge Jenny T van der Steen Sytse U Zuidema Wilco P Achterberg Ton J E M Bakker |
| author_facet | Helma M F Verstraeten Canan Ziylan Debby L Gerritsen Robbert Huijsman Miharu Nakanishi Martin Smalbrugge Jenny T van der Steen Sytse U Zuidema Wilco P Achterberg Ton J E M Bakker |
| author_sort | Helma M F Verstraeten |
| collection | DOAJ |
| description |
BackgroundNeuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Method, a personalized integrated stepped-care method to prevent and treat neuropsychiatric symptoms. The STIP-Method comprises 5 phases of clinical reasoning to neuropsychiatric symptoms and 4 stepped-care interventions and is supported with a web application.
ObjectiveThis study aims to identify the facilitators and barriers in the implementation of the STIP-Method in nursing homes.
MethodsA mixed methods design within a participatory action research was used to implement the STIP-Method in 4 facilities of 2 Dutch nursing home organizations. In total, we aimed at participation of 160-200 persons with dementia and expected an intervention fidelity of 50% or more, based on earlier studies regarding implementation of effective psychosocial interventions to manage neuropsychiatric symptoms. All involved managers and professionals were trained in the principles of the STIP-Method and in using the web application. An advisory board of professionals, managers, and informal caregivers in each facility supported the implementation during 21 months, including an intermission of 6 months due to the COVID-19 pandemic. In these 6-weekly advisory board meetings, 2 researchers stimulated the members to reflect on progress of the implementation by making use of available data from patient records and the web application. Additionally, the 2 researchers invited the members to suggest how to improve the implementation. Data analysis will involve (1) analysis of facilitators and barriers to the implementation derived from verbatim text reports of advisory board meetings to better understand the implementation process; (2) analysis of patient records in accordance with multidisciplinary guidelines to neuropsychiatric symptoms: personalized, interdisciplinary, and proactive management of neuropsychiatric symptoms; (3) evaluation of the web application in terms of usability scores; (4) pre- and postimplementation analysis of patient records and the web application to evaluate the impact of the STIP-Method, such as changes in neuropsychiatric symptoms and informal caregiver burden.
ResultsWe enrolled 328 persons with dementia. Data collection started in July 2019 and ended in December 2021. The first version of this manuscript was submitted in October 2021. The first results of data analysis are expected to be published in December 2022 and final results in June 2023.
ConclusionsOur study may increase understanding of facilitators and barriers to the prevention and treatment of neuropsychiatric symptoms in nursing home residents with dementia by implementing the integrated STIP-Method. The need for well-designed implementation studies is of importance to provide nursing homes with optimal tools to prevent and treat neuropsychiatric symptoms.
International Registered Report Identifier (IRRID)DERR1-10.2196/34550 |
| first_indexed | 2024-03-12T12:51:52Z |
| format | Article |
| id | doaj.art-98123234466846da96f9dbc8647bd3f2 |
| institution | Directory Open Access Journal |
| issn | 1929-0748 |
| language | English |
| last_indexed | 2024-03-12T12:51:52Z |
| publishDate | 2022-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj.art-98123234466846da96f9dbc8647bd3f22023-08-28T22:20:47ZengJMIR PublicationsJMIR Research Protocols1929-07482022-06-01116e3455010.2196/34550Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods StudyHelma M F Verstraetenhttps://orcid.org/0000-0002-4119-5102Canan Ziylanhttps://orcid.org/0000-0002-7158-9508Debby L Gerritsenhttps://orcid.org/0000-0002-3356-0237Robbert Huijsmanhttps://orcid.org/0000-0002-9776-129XMiharu Nakanishihttps://orcid.org/0000-0001-6200-9279Martin Smalbruggehttps://orcid.org/0000-0003-0538-4843Jenny T van der Steenhttps://orcid.org/0000-0002-9063-7501Sytse U Zuidemahttps://orcid.org/0000-0002-4991-9507Wilco P Achterberghttps://orcid.org/0000-0001-9227-7135Ton J E M Bakkerhttps://orcid.org/0000-0002-3773-5436 BackgroundNeuropsychiatric symptoms occur frequently in many nursing home residents with dementia. Despite the availability of multidisciplinary guidelines, neuropsychiatric symptoms are often inadequately managed. Three proven effective methods for managing neuropsychiatric symptoms were integrated into a single intervention method: the STIP-Method, a personalized integrated stepped-care method to prevent and treat neuropsychiatric symptoms. The STIP-Method comprises 5 phases of clinical reasoning to neuropsychiatric symptoms and 4 stepped-care interventions and is supported with a web application. ObjectiveThis study aims to identify the facilitators and barriers in the implementation of the STIP-Method in nursing homes. MethodsA mixed methods design within a participatory action research was used to implement the STIP-Method in 4 facilities of 2 Dutch nursing home organizations. In total, we aimed at participation of 160-200 persons with dementia and expected an intervention fidelity of 50% or more, based on earlier studies regarding implementation of effective psychosocial interventions to manage neuropsychiatric symptoms. All involved managers and professionals were trained in the principles of the STIP-Method and in using the web application. An advisory board of professionals, managers, and informal caregivers in each facility supported the implementation during 21 months, including an intermission of 6 months due to the COVID-19 pandemic. In these 6-weekly advisory board meetings, 2 researchers stimulated the members to reflect on progress of the implementation by making use of available data from patient records and the web application. Additionally, the 2 researchers invited the members to suggest how to improve the implementation. Data analysis will involve (1) analysis of facilitators and barriers to the implementation derived from verbatim text reports of advisory board meetings to better understand the implementation process; (2) analysis of patient records in accordance with multidisciplinary guidelines to neuropsychiatric symptoms: personalized, interdisciplinary, and proactive management of neuropsychiatric symptoms; (3) evaluation of the web application in terms of usability scores; (4) pre- and postimplementation analysis of patient records and the web application to evaluate the impact of the STIP-Method, such as changes in neuropsychiatric symptoms and informal caregiver burden. ResultsWe enrolled 328 persons with dementia. Data collection started in July 2019 and ended in December 2021. The first version of this manuscript was submitted in October 2021. The first results of data analysis are expected to be published in December 2022 and final results in June 2023. ConclusionsOur study may increase understanding of facilitators and barriers to the prevention and treatment of neuropsychiatric symptoms in nursing home residents with dementia by implementing the integrated STIP-Method. The need for well-designed implementation studies is of importance to provide nursing homes with optimal tools to prevent and treat neuropsychiatric symptoms. International Registered Report Identifier (IRRID)DERR1-10.2196/34550https://www.researchprotocols.org/2022/6/e34550 |
| spellingShingle | Helma M F Verstraeten Canan Ziylan Debby L Gerritsen Robbert Huijsman Miharu Nakanishi Martin Smalbrugge Jenny T van der Steen Sytse U Zuidema Wilco P Achterberg Ton J E M Bakker Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study JMIR Research Protocols |
| title | Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study |
| title_full | Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study |
| title_fullStr | Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study |
| title_full_unstemmed | Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study |
| title_short | Implementing a Personalized Integrated Stepped-Care Method (STIP-Method) to Prevent and Treat Neuropsychiatric Symptoms in Persons With Dementia in Nursing Homes: Protocol for a Mixed Methods Study |
| title_sort | implementing a personalized integrated stepped care method stip method to prevent and treat neuropsychiatric symptoms in persons with dementia in nursing homes protocol for a mixed methods study |
| url | https://www.researchprotocols.org/2022/6/e34550 |
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