title: Factors to make the VIPS practice model more effective in the treatment of neuropsychiatric symptoms in nursing home residents with dementia.
abstract: OBJECTIVE
  A recent cluster-randomized controlled study showed that the VIPS practice model (VPM) for person-centred care had a significant effect on neuropsychiatric symptoms in nursing home residents with dementia. The randomized controlled trial (RCT) indicated that a substantial proportion of the total variance of the effects was related to conditions in the particular unit (ward). We have explored which factors explain the variance of the effect of the VPM.
  
  
  METHODS
  The VPM subset of data from the RCT was explored using multilevel linear regression. The dependent variables were the change in scores on the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Cornell Scale for Depression in Dementia (CSDD).
  
  
  RESULTS
  The unit in which the resident was living explained 22% of the VPM's total variance of the effect on the NPI-Q and 13% of that on the CSDD. The intraclass correlation coefficient at the unit level was explained mainly by unit size on both scales and was considerably higher than at the institutional level.
  
  
  CONCLUSIONS
  The unit is the most influential level when implementing person-centred dementia care by use of the VPM. The unit size explains most of the variance of the effect of the VPM, and the effects were best in the small units.
authors: Ageing and Health, Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway.
authors: Janne
authors: J
authors: Rosvik
authors: Knut
authors: K
authors: Engedal
authors: Oyvind
authors: O
authors: Kirkevold
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000451:nursing* / Q000523:psychology; D057565:Apathy; D003702:Delusions / Q000451:nursing* / Q000523:psychology; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D003863:Depression / Q000451:nursing* / Q000523:psychology; D005260:Female; D006212:Hallucinations / Q000451:nursing* / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D055361:Multilevel Analysis; D009735:Nursing Homes; D018802:Patient-Centered Care / Q000379:methods*