title: Dementia care mapping: effects on residents' quality of life and challenging behavior in German nursing homes. A quasi-experimental trial.
abstract: BACKGROUND
  Person-centered care (PCC) is a widely recognized concept in dementia research and care. Dementia Care Mapping (DCM) is a method for implementing PCC. Prior studies have yielded heterogeneous results regarding the effectiveness of DCM for people with dementia (PwD). We aimed to investigate the effectiveness of DCM with regard to quality of life (QoL) and challenging behavior in PwD in nursing homes (NHs).
  
  
  METHODS
  Leben-QD II is an 18-month, three-armed, pragmatic quasi-experimental trial. The sample of PwD was divided into three groups with three living units per group: (A) DCM applied since 2009, (B) DCM newly introduced during the study, and (C) a control intervention based on a regular and standardized QoL rating. The primary outcome was QoL measured with the Quality of Life-Alzheimer's Disease (QoL-AD) proxy, and the secondary outcomes were QoL (measured with QUALIDEM) and challenging behavior (measured with the Neuropsychiatric Inventory Nursing Home version, NPI-NH).
  
  
  RESULTS
  There were no significant differences either between the DCM intervention groups and the control group or between the two DCM intervention groups regarding changes in the primary or secondary outcomes. At baseline, the estimated least square means of the QoL-AD proxy for groups A, B, and C were 32.54 (confidence interval, hereafter CI: 29.36-35.72), 33.62 (CI: 30.55-36.68), and 30.50 (CI: 27.47-33.52), respectively. The DCM groups A (31.32; CI: 28.15-34.48) and B (27.60; CI: 24.51-30.69) exhibited a reduction in QoL values, whereas group C exhibited an increase (32.54; CI: 29.44-35.64) after T2.
  
  
  CONCLUSIONS
  DCM exhibited no statistically significant effect in terms of QoL and challenging behavior of PwD in NHs. To increase the likelihood of a positive effect for PwD, it is necessary to ensure successful implementation of the intervention.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Martin Nikolaus
authors.initials: MN
authors.lastname: Dichter
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Quasdorf
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Christian Günter Georg
authors.initials: CG
authors.lastname: Schwab
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Trutschel
authors.affiliation: mediStatistica,Neuenrade,Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Haastert
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Riesner
authors.affiliation: School of Nursing Science,Faculty of Health,Witten/Herdecke University,Witten,Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Bartholomeyczik
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE),Witten,Germany.
authors.forename: Margareta
authors.initials: M
authors.lastname: Halek
mesh_terms: D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009629:Person-Centered Psychotherapy / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome
keywords: challenging behavior; dementia; dementia care mapping; nursing homes; person-centered care; psychosocial intervention; quality of life