title: A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings.
abstract: BACKGROUND
  The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy.
  
  
  METHODS
  A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention.
  
  
  RESULTS
  Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care.
  
  
  CONCLUSIONS
  The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Register (ANZCTR): The Universal Trial Number (UTN) is U1111-1141-0109.
authors.affiliation: School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Melbourne 3125, Victoria, Australia. marita.mccabe@deakin.edu.au.
authors.forename: Marita P
authors.initials: MP
authors.lastname: McCabe
authors.forename: David
authors.initials: D
authors.lastname: Mellor
authors.forename: Tanya E
authors.initials: TE
authors.lastname: Davison
authors.forename: Gery
authors.initials: G
authors.lastname: Karantzas
authors.forename: Kathryn
authors.initials: K
authors.lastname: von Treuer
authors.forename: Daniel W
authors.initials: DW
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D019468:Disease Management; D005500:Follow-Up Studies; D006282:Health Personnel / Q000193:education* / Q000592:standards; D006707:Homes for the Aged / Q000592:standards; D006801:Humans
references.citation: Aging Ment Health. 2013;17(4):449-55
references.pmid: 23116088
references.citation: Aging Ment Health. 2007 Sep;11(5):505-19
references.pmid: 17882588
references.citation: Biol Psychiatry. 2002 Sep 15;52(6):543-58
references.pmid: 12361668
references.citation: Aust N Z J Public Health. 1998 Aug;22(5):589-97
references.pmid: 9744215
references.citation: J Am Med Dir Assoc. 2007 Sep;8(7):441-5
references.pmid: 17845946
references.citation: Int Psychogeriatr. 2010 Nov;22(7):1025-39
references.pmid: 20522279
references.citation: Int Psychogeriatr. 2007 Oct;19(5):859-73
references.pmid: 16973098
references.citation: J Pers Soc Psychol. 2001 Jul;81(1):57-64
references.pmid: 11474726
references.citation: Aging Ment Health. 2008 Mar;12(2):228-35
references.pmid: 18389403
references.citation: Biol Psychiatry. 1988 Feb 1;23(3):271-84
references.pmid: 3337862
references.citation: Aging Ment Health. 2009 Jul;13(4):577-86
references.pmid: 19629783
references.citation: Int Psychogeriatr. 2008 Aug;20(4):724-37
references.pmid: 18341752
references.citation: Int J Geriatr Psychiatry. 2006 Jul;21(7):633-44
references.pmid: 16906590
references.citation: J Gerontol Nurs. 1997 Oct;23(10):40-7
references.pmid: 9384095
references.citation: J Nurs Manag. 2003 Mar;11(2):73-9
references.pmid: 12581394