1. Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family).
- Author
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Wyman, Danielle, Butler, Laurie T, Morgan-Trimmer, Sarah, Bright, Peter, Barber, Julie, Budgett, Jessica, Walters, Kate, Lang, Iain, Rapaport, Penny, Banks, Sara, Palomo, Marina, Orgeta, Vasiliki, Livingston, Gill, Rockwood, Kenneth, Lord, Kathryn, Manthorpe, Jill, Dow, Briony, Hoe, Juanita, and Cooper, Claudia
- Subjects
TREATMENT of dementia ,PSYCHOTHERAPY ,RESEARCH funding ,QUALITATIVE research ,EVALUATION of human services programs ,QUESTIONNAIRES ,INTERVIEWING ,GOAL (Psychology) ,SERVICES for caregivers ,JUDGMENT sampling ,DESCRIPTIVE statistics ,TREATMENT effectiveness ,FAMILIES ,THEMATIC analysis ,MATHEMATICAL models ,RESEARCH methodology ,PATIENT-professional relations ,SOCIAL support ,THEORY ,DEMENTIA ,CHANGE theory ,WELL-being ,CAREGIVER attitudes - Abstract
Introduction We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year. Methods In 2021–2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data. Results 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) 'Someone to talk to helps dyads feel supported'; (B) 'NIDUS-Family helps carers change their perspective'; (C) 'Personalisation helps people living with dementia maintain their identity' and (D) 'Small steps help dyads move forward'. Conclusion Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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