title: Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience.
abstract: BACKGROUND
  Person-centeredness has had substantial uptake in the academic literature on care of older people and people with dementia. However, challenges exist in interpreting and synthesizing the evidence on effects of providing person-centered care, as the person-centered components of some intervention studies are unclear - targeting very different and highly specific aspects of person-centeredness, as well as not providing empirical data to indicate the extent to which care practice was actually perceived to become more person-centered post-intervention.
  
  
  METHODS
  The study employed a quasi-experimental, one-group pre-test-post-test design with a 12-month follow-up to explore intervention effects on person-centeredness of care and the environment (primary endpoints), and on staff strain and stress of conscience (secondary endpoints).
  
  
  RESULTS
  The intervention resulted in significantly higher scores on person-centeredness of care at follow-up, and the facility was rated as being significantly more hospitable at follow-up. A significant reduction of staff stress of conscience was also found at follow-up, which suggests that, to a larger extent, staff could provide the care and activities they wanted to provide after the intervention.
  
  
  CONCLUSIONS
  The results indicated that an interactive and step-wise action-research intervention consisting of knowledge translation, generation, and dissemination, based on national guidelines for care of people with dementia, increased the staff self-reported person-centeredness of care practice, perceived hospitality of the setting, and reduced staff stress of conscience by enabling staff to provide the care and activities they want to provide.
authors.affiliation: School of Nursing and Midwifery,La Trobe University,Melbourne,Australia.
authors.forename: David
authors.initials: D
authors.lastname: Edvardsson
authors.affiliation: Department of Neurobiology,Care Sciences and Society (NVS),Division of Nursing,Karolinska Institutet,Stockholm,Sweden.
authors.forename: P O
authors.initials: PO
authors.lastname: Sandman
authors.affiliation: Department of Neurobiology,Care Sciences and Society (NVS),Division of Occupational Therapy,Karolinska Institutet,Stockholm,Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Borell
mesh_terms: D000368:Aged; D003704:Dementia / Q000628:therapy*; D005260:Female; D006282:Health Personnel / Q000193:education / Q000523:psychology; D006707:Homes for the Aged / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009936:Organizational Innovation; D017410:Practice Guidelines as Topic; D057285:Precision Medicine / Q000379:methods / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards; D013315:Stress, Psychological / Q000209:etiology; D013548:Sweden; D000078329:Workforce