title: An RCT to evaluate the utility of a clinical protocol for staff in the management of behavioral and psychological symptoms of dementia in residential aged-care settings.
abstract: OBJECTIVE
  Behavioral and psychological symptoms of dementia (BPSD) cause significant stress and distress to both aged-care residents and staff. This study evaluated a training program to assist staff to manage BPSD in residential care.
  
  
  METHODS
  A randomised controlled trial (RCT) was employed. The study was included in the Australian and New Zealand Clinical Trial Register residential care facilities. Staff (n = 204) and residents (n = 187) were from 16 residential care facilities. Facilities were recruited and randomly assigned to four staff training conditions: (1) training in the use of a BPSD-structured clinical protocol, plus external clinical support, (2) a workshop on BPSD, plus external clinical support, (3) training in the use of the structured clinical protocol alone, and (4) care as usual. Staff and resident outcome measures were obtained pre-intervention, three months and six months post-intervention. The primary outcome was changes in BPSD, measured using the Cohen-Mansfield Agitation Inventory (CMAI) as well as frequency and duration of challenging behaviors. Secondary outcomes were changes in staff adjustment.
  
  
  RESULTS
  There were improvements in challenging behaviors for both intervention conditions that included training in the BPSD instrument, but these were not maintained in the condition without clinical support. The training/support condition resulted in sustained improvements in both staff and resident variables, whereas the other conditions only led to improvement in some of the measured variables.
  
  
  CONCLUSIONS
  These results demonstrate the effectiveness of the BPSD protocol in reducing BPSD and improving staff self-efficacy and stress.
authors.affiliation: a School of Psychology , Deakin University , Victoria , Australia.
authors.forename: Marita P
authors.initials: MP
authors.lastname: McCabe
authors.forename: Michael
authors.initials: M
authors.lastname: Bird
authors.forename: Tanya E
authors.initials: TE
authors.lastname: Davison
authors.forename: David
authors.initials: D
authors.lastname: Mellor
authors.forename: Sarah
authors.initials: S
authors.lastname: MacPherson
authors.forename: David
authors.initials: D
authors.lastname: Hallford
authors.forename: Melissa
authors.initials: M
authors.lastname: Seedy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002985:Clinical Protocols / Q000592:standards*; D003704:Dementia / Q000451:nursing*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D000066553:Problem Behavior; D016896:Treatment Outcome
keywords: BPSD; effectiveness of intervention; role of clinical support; staff training program