A coaching tele-consultation service to improve care for behavioral and psychological symptoms of dementia: A pilot study.
Background Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in major neurocognitive disorders and have considerable impacts. Many clinical settings struggle with insufficient knowledge, suboptimal management and excessive use of psychotropic medications. Research aim Giv...
| Publicado en: | Gerontechnology Vol. 19; no. 1; pp. 42 - 54 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
International Society for Gerontechnology
2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144595820&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 144595820 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15691101 904R jtl: Gerontechnology issn: 15691101 maglogo: N pubinfo: dt: 2020 vid: 19 iid: 1 pid: 54298 pub: International Society for Gerontechnology artinfo: ui: 144595820 144595820 144595820 10.4017/gt.2020.19.1.005.00 144595820 ppf: 42 ppct: 12 formats: tig: atl: A coaching tele-consultation service to improve care for behavioral and psychological symptoms of dementia: A pilot study. aug: au: Bruneau, Marie-Andrée Bier, Nathalie Daneau, Stéphanie Dubé, Catherine Villeneuve, Laurence Ménard, Caroline Bourbonnais, Anne affil: Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada sug: subj: Dementia Therapy Behavioral Symptoms Therapy Remote Consultation Education Geriatricians Education Program Evaluation Human Quebec Pilot Studies Interviews Open-Ended Questionnaires Descriptive Statistics Gerontologic Care Neuropsychology Education Skill Acquisition Clinical Competence Patient Satisfaction Quality of Health Care Clinical Assessment Tools ab: Background Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in major neurocognitive disorders and have considerable impacts. Many clinical settings struggle with insufficient knowledge, suboptimal management and excessive use of psychotropic medications. Research aim Given the low availability of specialized staff and the remoteness of some healthcare locations, our aim was to document the effects and the implementation process of a telehealth coaching service on BPSD care. Methods Geriatric specialists at the Institut universitaire de gériatrie de Montréal (IUGM) offered a structured training program to distant community care teams through tele-consultation. It involved setting up a BPSD team in each participating community to ensure acquired skills would be sustained. The program proposed a 2-day formal training followed by a monthly complex BPSD case tele-consultation. One of these clinical projects with the Magdalen Islands health centre (MIHC) included a mixed methods research component. We evaluated clinical benefits by comparing Neuropsychiatric Inventory (NPI-Q), Clinical Global Impression (CGI-I) and psychotropic intake at baseline and three months post tele-consultation, on clinical chart review with non-parametric Wilcoxon analysis. The implementation process was evaluated by open-ended interviews and satisfaction questionnaires. The qualitative data were analyzed using Miles and Huberman's approach. Results Twelve patients were evaluated by tele-consultation. Results showed clinical benefits (decrease of 35% NPI-Q (p=0.024), an improvement on CGI, as well as high satisfaction levels (caregivers and remote team). Eleven open interviews were completed (2 nurses, 3 psychosocial staff, 2 managers, 4 doctors). The project helped to define a better care trajectory for BPSD. Professionals felt a sense of competency and relief from helplessness and isolation. They also described improved patient care (systematic evaluations, individualized interventions integrating non-pharmacological aspects, more appropriate prescriptions). Conclusion These results suggest that tele-consultation is a good way to disseminate expertise concerning BPSD. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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