Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

Sun Kyung Kim, Myonghwa Park Education and Research Center for Evidence Based Nursing Knowledge, College of Nursing, Chungnam National University, Daejeon, Republic of Korea Background: Person-centered care is a holistic and integrative approach designed to maintain well-being and quality...

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Autores principales:	Kim SK, Park M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	dementia person-centered care neuropsychiatric symptoms behavior quality of life Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/400107a4cbaa44e6b7c0e3531bb4abac
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spelling	oai:doaj.org-article:400107a4cbaa44e6b7c0e3531bb4abac2021-12-02T00:21:57ZEffectiveness of person-centered care on people with dementia: a systematic review and meta-analysis1178-1998https://doaj.org/article/400107a4cbaa44e6b7c0e3531bb4abac2017-02-01T00:00:00Zhttps://www.dovepress.com/effectiveness-of-person-centered-care-on-people-with-dementia-a-system-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Sun Kyung Kim, Myonghwa Park Education and Research Center for Evidence Based Nursing Knowledge, College of Nursing, Chungnam National University, Daejeon, Republic of Korea Background: Person-centered care is a holistic and integrative approach designed to maintain well-being and quality of life for people with dementia, and it includes the elements of care, the individual, the carers, and the family.Aim: A systematic literature review and meta-analysis were undertaken to investigate the effectiveness of person-centered care for people with dementia.Methods: Literature searches were undertaken using six databases including Medline, EMBASE, CINAHL, PsycINFO, Cochrane Database, and KoreaMed using the following keywords: cognition disorder, dementia, person-centered care, patient-centered care, client-centered care, relationship-centered care, and dementia care. The searches were limited to interventional studies written in English and Korean and included randomized controlled studies and noncontrolled studies for people with dementia living in any setting.Results: Nineteen interventional studies, including 3,985 participants, were identified. Of these, 17 studies were from long-term care facilities and two studies were from homecare settings. The pooled data from randomized controlled studies favored person-centered care in reducing agitation, neuropsychiatric symptoms, and depression and improving the quality of life. Subgroup analysis identified greater effectiveness of person-centered care when implemented for people with less severe dementia. For agitation, short-term interventions had a greater effect (standardized mean difference [SMD]: -0.434; 95% conference interval [CI]: -0.701 to -0.166) than long-term interventions (SMD: -0.098; 95% CI: -0.190 to 0.007). Individualized activities resulted in a significantly greater beneficial effect than standard care (SMD: 0.513; 95% CI: -0.994 to -0.032). However, long-term, staff education, and cultural change interventions had a greater effect on improving the quality of life for people with dementia (SMD: 0.191; 95% CI: 0.079 to 0.302).Conclusion: This systematic review and meta-analysis provided evidence for person-centered care in clinical practice for people with dementia. Person-centered care interventions were shown to reduce agitation, neuropsychiatric symptoms, and depression and to improve the quality of life. Person-centered care interventions can effectively reduce agitation for a short term using intensive and activity-based intervention. However, an educational strategy that promotes learning and skill development of internal care staff is needed to enhance patient’s quality of life and to ensure the sustainability of the effects of behavioral problems. The feasibility and effectiveness of the intervention, the severity of patient disease, and intervention type and duration should be considered as part of an intervention design. Keywords: dementia, meta-analysis, patient-centered care, person-centered care, neuropsychiatric symptoms, systematic reviewKim SKPark MDove Medical Pressarticledementiaperson-centered careneuropsychiatric symptomsbehaviorquality of lifeGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 381-397 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	dementia person-centered care neuropsychiatric symptoms behavior quality of life Geriatrics RC952-954.6
spellingShingle	dementia person-centered care neuropsychiatric symptoms behavior quality of life Geriatrics RC952-954.6 Kim SK Park M Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
description	Sun Kyung Kim, Myonghwa Park Education and Research Center for Evidence Based Nursing Knowledge, College of Nursing, Chungnam National University, Daejeon, Republic of Korea Background: Person-centered care is a holistic and integrative approach designed to maintain well-being and quality of life for people with dementia, and it includes the elements of care, the individual, the carers, and the family.Aim: A systematic literature review and meta-analysis were undertaken to investigate the effectiveness of person-centered care for people with dementia.Methods: Literature searches were undertaken using six databases including Medline, EMBASE, CINAHL, PsycINFO, Cochrane Database, and KoreaMed using the following keywords: cognition disorder, dementia, person-centered care, patient-centered care, client-centered care, relationship-centered care, and dementia care. The searches were limited to interventional studies written in English and Korean and included randomized controlled studies and noncontrolled studies for people with dementia living in any setting.Results: Nineteen interventional studies, including 3,985 participants, were identified. Of these, 17 studies were from long-term care facilities and two studies were from homecare settings. The pooled data from randomized controlled studies favored person-centered care in reducing agitation, neuropsychiatric symptoms, and depression and improving the quality of life. Subgroup analysis identified greater effectiveness of person-centered care when implemented for people with less severe dementia. For agitation, short-term interventions had a greater effect (standardized mean difference [SMD]: -0.434; 95% conference interval [CI]: -0.701 to -0.166) than long-term interventions (SMD: -0.098; 95% CI: -0.190 to 0.007). Individualized activities resulted in a significantly greater beneficial effect than standard care (SMD: 0.513; 95% CI: -0.994 to -0.032). However, long-term, staff education, and cultural change interventions had a greater effect on improving the quality of life for people with dementia (SMD: 0.191; 95% CI: 0.079 to 0.302).Conclusion: This systematic review and meta-analysis provided evidence for person-centered care in clinical practice for people with dementia. Person-centered care interventions were shown to reduce agitation, neuropsychiatric symptoms, and depression and to improve the quality of life. Person-centered care interventions can effectively reduce agitation for a short term using intensive and activity-based intervention. However, an educational strategy that promotes learning and skill development of internal care staff is needed to enhance patient’s quality of life and to ensure the sustainability of the effects of behavioral problems. The feasibility and effectiveness of the intervention, the severity of patient disease, and intervention type and duration should be considered as part of an intervention design. Keywords: dementia, meta-analysis, patient-centered care, person-centered care, neuropsychiatric symptoms, systematic review
format	article
author	Kim SK Park M
author_facet	Kim SK Park M
author_sort	Kim SK
title	Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
title_short	Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
title_full	Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
title_fullStr	Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
title_full_unstemmed	Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
title_sort	effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/400107a4cbaa44e6b7c0e3531bb4abac
work_keys_str_mv	AT kimsk effectivenessofpersoncenteredcareonpeoplewithdementiaasystematicreviewandmetaanalysis AT parkm effectivenessofpersoncenteredcareonpeoplewithdementiaasystematicreviewandmetaanalysis
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Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis

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