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The disconnect between evidence and practice: a systematic review of person‐centred interventions and training manuals for care home staff working with people with dementia
Author(s) -
Fossey Jane,
Masson Sarah,
Stafford Jane,
Lawrence Vanessa,
Corbett Anne,
Ballard Clive
Publication year - 2014
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4072
Subject(s) - psychological intervention , dementia , intervention (counseling) , medicine , nursing , evidence based practice , randomized controlled trial , training manual , medline , mental health , psychology , alternative medicine , psychiatry , disease , surgery , pathology , political science , law , economics , economic growth
Objective The overall objective is to determine the availability of person‐centred intervention and training manuals for dementia care staff with clinical trial evidence of efficacy. Design Interventions were identified using a search of electronic databases, augmented by mainstream search engines, reference lists, hand searching for resources and consultation with an expert panel. The specific search for published manuals was complemented by a search for randomised control trials focussing on training and activity‐based interventions for people with dementia in care homes. Manuals were screened for eligibility and rated to assess their quality, relevance and feasibility. Results A meta‐analysis of randomised control trials indicated that person‐centred training interventions conferred significant benefit in improving agitation and reducing the use of antipsychotics. Each of the efficacious packages included a sustained period of joint working and supervision with a trained mental health professional in addition to an educational element. However, of the 170 manuals that were identified, 30 met the quality criteria and only four had been evaluated in clinical trials. Conclusions Despite the availability of a small number of evidence‐based training manuals, there is a widespread use of person‐centred intervention and training manuals that are not evidence‐based. Clearer guidance is needed to ensure that commissioned training and interventions are based on robust evidence. Copyright © 2014 John Wiley & Sons, Ltd.