Mediative therapy as a treatment of challenging behavior in people with dementia living in nursing homes: a mixed methods systematic review

Introduction Behavioural and psychological symptoms of dementia (BPSD) occur in most people with dementia living in nursing homes, which comprises the well-being of the person with dementia. This forms a great burden for the person with dementia, as well as the healthcare professionals, relatives, and fellow residents of the nursing home. Since individual treatment is not always possible in dementia, psychologists often implement mediative therapy in which members of the healthcare team or relatives function as mediators. However, there are multiple variations of this behavioral therapy, and its’ effectiveness is unknown. Therefore, there is an urgent need for clarification and optimalization of the added value of mediative therapy for people with dementia in nursing homes who show BPSD. Objectives The objective of this systematic review is to explore the elements, underlying working mechanisms, and effects of mediative therapy for BPSD in people with dementia living in nursing homes. Method This review is being performed using the JBI mixed methods review approach. The concepts Dementia, Mediative therapy: intervention, Mediative therapy: outcomes, and Nursing homes were searched in PubMed, Web of Science, PsychINFO (Ovid), and CINAHL (EBSCO) were searched with no date limit. Additionally, an advisory panel of psychologists provided additional peer reviewed articles and grey literature. Two reviewers screened all references according to the inclusion criteria and critically appraised for methodological quality using the Mixed Methods Appraisal Tool (MMAT). Currently, fulltext screening is ongoing. Data extraction will follow the standardized JBI tool for mixed methods systematic reviews. For data synthesis and integration, a convergent integrated approach will be used. Results At the time of the conference, results and conclusions will be available. Findings will be available at the time of the conference. The preliminary PRISMA flowchart is shown in Figure 1.