Key components of person‐centered care for people with dementia: A systematic review of interventions to design a patient preference study
Bibliographic record
Abstract
Abstract Background To provide Person‐Centered Care (PCC) for People with Dementia (PwD), patient’s stated preferences must be known. Data about stated care‐preferences among PwD are limited. This study aimed to identify key components of PCC for PwD by a systematic review of PCC‐interventions, to inform the construction of a decision model for PwD‐preference elicitation. Method A protocol was registered with PROSPERO (CRD42021225084). A search of the concepts Dementia, Person‐Centered Care, and Intervention was performed in PubMed, EMBASE, and Web of Science in Nov2020. Study selection was based on 2‐stage screening against eligibility criteria, limited to randomized controlled trials (RCT) and nonrandomized controlled study (NRS) designs. Risk of bias was assessed with version 2 of the Cochrane risk‐of‐bias tool for randomized trials (RoB2) and the Newcastle‐Ottawa Scale (NOS) for nonrandomized studies. Information about authors, interventions, and outcomes were extracted and entered into an “Effects Table”. The identified PCC‐interventions were thus synthesized into intervention categories to form key components of PCC. Result Searches identified 1781 records. 19 studies (15 RCT, 4 NRS) were included after screening. The quality of the studies varied between low to moderate. The individual interventions covered a wide range of non‐pharmacological, psychosocial offers, oftentimes bundled in multi‐component intervention‐sets. Nine intervention categories, i.e. key components of PCC to inform the construction of a decision model for PwD‐preference elicitation, emerged from data synthesis: sensory enhancement/relaxation, social contact, cognitive training, validation and reminiscence, physical activities, environmental adjustments, caregiver training and support, care organization and daily living assistance. Effect measures included i.a. agitation, quality of life, antipsychotic use, depression, neuropsychiatric symptoms and behavior, with mixed results concerning the effect of the PCC interventions. All studies were conducted in nursery home or hospital settings. Conclusion Nine intervention categories as key components of PCC to inform the construction of a decision model for PwD‐preference elicitation could be identified. As the findings were limited to nursery home and hospital settings, community‐dwelling PwD and the primary care‐setting should find greater consideration for future investigations on PCC interventions and patient preference studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.076 | 0.185 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.014 |
| Bibliometrics | 0.011 | 0.012 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".