Details

Autor(en) / Beteiligte

• Eccles, Martin P.
• Francis, Jill
• Foy, Robbie
• Johnston, Marie
• Bamford, Claire
• Grimshaw, Jeremy M.
• Hughes, Julian
• Lecouturier, Jan
• Steen, Nick
• Whitty, Paula M.

Titel

Improving Professional Practice in the Disclosure of a Diagnosis of Dementia: A Modeling Experiment to Evaluate a Theory-Based Intervention

Ist Teil von

• International journal of behavioral medicine, 2009-12, Vol.16 (4), p.377-387

Ort / Verlag

Boston: Springer US

Erscheinungsjahr

2009

Quelle

SpringerLink

Beschreibungen/Notizen

• Background Among health professionals, there is wide variation in the practice of disclosing a diagnosis of dementia to patients. Purpose The purpose of this study was to evaluate the effect of one theory-based and two pragmatic interventions on intention to perform three behaviors, namely (1) finding out what the patient already knows or suspects about their diagnosis; (2) using the actual words “dementia” or “Alzheimer’s disease” when talking to the patient (i.e., the use of explicit terminology); (3) exploring what the diagnosis means to the patient. Method Within an intervention-modeling process, members of old-age mental health teams in England were sent postal questionnaires measuring psychological variables. Respondents were randomized by team to one of four groups to receive: theory-based intervention; evidence-based communication; patient-based intervention; or no intervention (control). Interventions were delivered as pen-and-paper exercises at the start of a second postal questionnaire that remeasured the same psychological variables. The outcome measures were intention and scenario-based behavioral simulation. Results Responses were received from 644 of 1,103 (58%) individuals from 179 of 205 (87%) mental health teams. There were no significant differences in terms of intention or simulated behavior between the trial groups. The theory-based intervention significantly increased scores for attitudes to ( p = 0.03) and perceived behavioral control ( p = 0.001) for the behavior of “finding out what the patient already knows or suspects about their diagnosis.” Conclusions The intervention had a limited effect. This may be partly explained by clinical or methodological factors. The use of a systematic intervention modeling process allows clearer understanding of the next appropriate steps which should involve further evaluation of the interventions using an interactive delivery method in a less selected group of study participants.