Actions seen as demanding in patients with severe dementia during one year of intervention. Comparison with controls

Behaviours, viewed by nurses as demanding, performed by patients with severe dementia were investigated during one year of intervention. Supervised implementation of individually planned care and systematic clinical supervision were implemented on one experimental ward (EW) while another ward (CW) served as control. Each ward had 11 patients. At baseline and after 6 and 12 months of intervention structured interviews with the patients' assigned nurses were conducted based on the Demanding Behaviour Assessment Scale and Multi Dimensional Dementia Assessment Scale. At the EW there was a decreased frequency (p = 0.000) and a reduced occurrence of physical behaviours (p = 0.008), a decreased frequency (p = 0.029) and a reduced occurrence of vocal behaviours (p = 0.002). No significant changes were seen at the CW. Bearing the small sample size in mind, the findings indicate that individually planned care and systematic clinical supervision could be a means of reducing the frequency, and/or effect the nurses' attitude and interpretation of the patients' behaviour as demanding. The findings, however, can only be seen as indications for further research, but point to the importance of including effect variables related to patients when intervening in nursing care. (C) 2001 Elsevier Science Ltd. All rights reserved.