Improving patient-centered care for people with dementia in medical encounters: an educational intervention for old age psychiatrists.
BACKGROUND
Health care professionals are recommended to deliver patient-centered care in dementia; however, guidance and training on how to do this in practice is currently lacking. The aim of this study was to develop and evaluate pragmatically an educational intervention for old age psychiatrists to promote patient-centered care in their consultations with people with dementia and their carers.


METHODS
We used a range of methods to (i) identify the theoretical components of patient-centered care (literature review) and (ii) observe actual practice (video recording of 53 consultations between old age psychiatrists and people with dementia and their family carers). We also interviewed participants from (ii) including 7 old age psychiatrists, 25 people with dementia and 44 carers. From this we developed a workshop for old age psychiatrists and piloted and evaluated it. Pre- and post-workshop questionnaires were completed; the latter included an assessment of planned and subsequent behavior change by participants.


RESULTS
The educational workshop, attended by 41 old age psychiatrists, focused on how best to structure the consultation and the most effective communication skills to use in consultation with people with dementia. Three months after the workshop, 59% had made one or more changes to the structure of their consultations, 71% had used new communication skills and 56% had reflected further on their practice.


CONCLUSIONS
We developed an educational intervention with both a theoretical and empirical basis. The workshops resulted in many changes to self-reported practice; whether this was noticeable to patients and carers requires further study.
Robinson
Louise
L
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. a.l.robinson@ncl.ac.uk
Bamford
Claire
C
Briel
Ruth
R
Spencer
John
J
Whitty
Paula
P
D000367:Age Factors; D000369:Aged, 80 and over; D000374:Aggression; D003693:Delirium / Q000453:epidemiology / Q000628:therapy; D003704:Dementia / Q000453:epidemiology* / Q000534:rehabilitation / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006282:Health Personnel; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards*; D010353:Patient Education as Topic; D010865:Pilot Projects; D011570:Psychiatry; D011595:Psychomotor Agitation / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology