4.3 Article

Adapting a Dementia Care Management Intervention for Regional Implementation: A Theory-Based Participatory Barrier Analysis

出版社

MDPI
DOI: 10.3390/ijerph19095478

关键词

dementia care; care management; participatory research; barrier analysis; implementation research; consolidated framework for implementation research

资金

  1. Ministry of Culture and Science of the german federal State of North Rhine-Westphalia [NRW: AZ 224-1.08.01.04]
  2. German Federal Ministery of Health (Bundesministerium fur Gesundheit, BMG) [ZMI1-2521FSB907]

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Dementia is a major cause of disability and dependency in older people worldwide, requiring innovative care models. This study aims to investigate the influencing factors and critical pathways for implementing DCM standards in the existing primary care structures in the German region. The study found that insufficient involvement of relevant stakeholders and comprehensive consideration of patient needs through dementia care managers are the main barriers and facilitators for DCM implementation.
Dementia is a leading cause of disability and dependency in older people worldwide. As the number of people affected increases, so does the need for innovative care models. Dementia care management (DCM) is an empirically validated approach for improving the care and quality of life for people with dementia (PwD) and caregivers. The aim of this study is to investigate the influencing factors and critical pathways for the implementation of a regionally adapted DCM standard in the existing primary care structures in the German region of Siegen-Wittgenstein (SW). Utilizing participatory research methods, five local health care experts as co-researchers conducted N = 13 semi-structured interviews with 22 local professionals and one caregiver as peer reviewers. Data collection and analysis were based on the Consolidated Framework for Implementation Research (CFIR). Our results show that among the most mentioned influencing factors, three CFIR constructs can be identified as both barriers and facilitators: Patients' needs and resources, Relative advantage, and Cosmopolitanism. The insufficient involvement of relevant stakeholders is the major barrier and the comprehensive consideration of patient needs through dementia care managers is the strongest facilitating factor. The study underlines the vital role of barrier analysis in site-specific DCM implementation.

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