A Quasi-experimental study on prevention and reduction of involuntary treatment at home (PRITAH) in people with dementia

A.M.H.J. Mengelers*, Michel H. C. Bleijlevens, Hilde Verbeek, Elizabeth Capezuti, Jan P. H. Hamers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aim and objectives
To examine the implementation (reach, dose, fidelity, adaptations, satisfaction), mechanisms of impact (attitude, subjective norm, perceived behavioural control and intention) and context of the PRITAH intervention.

Background
Involuntary treatment, defined as care provided against one's will, is highly prevalent in home care. The PRITAH intervention comprises policy, workshops, coaching and alternative measures for professional caregivers to prevent and reduce involuntary treatment in home care.

Design
Quasi-experimental study.

Methods
Eight home care teams from two care organisations participated in this study. Guided by the Theory of Planned Behavior, the mechanisms of impact were evaluated with questionnaires. Implementation and context were assessed using attendance lists, evaluation questionnaires, focus groups and logbooks. The study adhered to the TREND checklist.

Results
124 of 133 eligible professional caregivers participated (93%). All four components were delivered with minor deviations from protocol. Participants' subjective norms and perceived behavioural control changed over time in favour of the intervention group. No effects were seen for attitude and intention. Barriers included an unclear policy and lack of communication between stakeholders. The multidisciplinary approach and possibility to discuss involuntary treatment with the specialised nurse were described as facilitators.

Conclusions
Prevention and reduction of involuntary treatment at home is feasible in home care practice and contributes to changing professional caregivers' subjective norms and perceived behavioural control, prerequisites for behavioural change in order to prevent and reduce involuntary treatment. A follow-up study on the effectiveness of PRITAH on actual use, prevention and reduction of involuntary treatment in home care is needed. Future studies should emphasise the role of family caregivers and GPs and actively involve them in the prevention and reduction of involuntary treatment.

Relevance to clinical practice
Involuntary treatment is commonly used in dementia home care and professional and family caregivers need to be supported in prevention and reduction of involuntary treatment in people with dementia.
Original languageEnglish
Number of pages13
JournalJournal of Clinical Nursing
Early online date7 Dec 2021
DOIs
Publication statusPublished - 7 Dec 2021

Keywords

  • Involuntary treatment
  • Home care
  • Dementia
  • Intervention
  • Professional and family caregiving
  • MANAGEMENT
  • OLDER-ADULTS
  • COGNITIVE IMPAIRMENT
  • PHYSICAL RESTRAINT
  • SYMPTOMS
  • CARE
  • RESIDENTS
  • INTERVENTIONS
  • home care
  • dementia
  • NURSING-HOMES
  • QUALITY-OF-LIFE
  • intervention
  • involuntary treatment

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