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      Towards capturing meaningful outcomes for people with dementia in psychosocial intervention research: A pan‐European consultation

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          Abstract

          Background

          People with dementia are often marginalized and excluded from influence, also in relation to dementia research. There is, however, a growing requirement for inclusion through Patient and Public Involvement ( PPI), but there is still limited knowledge on how researchers can fully benefit from the involvement of people with dementia in the development and testing of psychosocial interventions. This paper describes the results of a pan‐European consultation with people with dementia, synthesizing their views on outcomes of psychosocial interventions.

          Objective

          To involve people with dementia in establishing what are meaningful outcomes when participating in psychosocial interventions.

          Setting and participants

          Consultations took place at four divergent sites across Europe, involving twenty‐five people with dementia from nine European countries.

          Methods

          The methods used for the consultation were developed through an iterative process involving people with dementia. Data from the consultation were analysed from a thematic analysis approach.

          Results

          The results suggested that people with dementia wish to participate in interventions that enhance their well‐being, confidence, health, social participation and human rights. This highlights a need for improvements in psychosocial research to capture these outcomes.

          Discussion and conclusions

          Involving people with dementia in discussions of psychosocial interventions has enhanced our understanding about meaningful outcome measures in research and methods of data collection. This study suggests that new outcome measures in psychosocial research are needed where concepts of positive psychology and social health can guide innovation and outcome measurement.

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          Most cited references18

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          Nonpharmacological Therapies in Alzheimer’s Disease: A Systematic Review of Efficacy

          Introduction: Nonpharmacological therapies (NPTs) can improve the quality of life (QoL) of people with Alzheimer’s disease (AD) and their carers. The objective of this study was to evaluate the best evidence on the effects of NPTs in AD and related disorders (ADRD) by performing a systematic review and meta-analysis of the entire field. Methods: Existing reviews and major electronic databases were searched for randomized controlled trials (RCTs). The deadline for study inclusion was September 15, 2008. Intervention categories and outcome domains were predefined by consensus. Two researchers working together detected 1,313 candidate studies of which 179 RCTs belonging to 26 intervention categories were selected. Cognitive deterioration had to be documented in all participants, and degenerative etiology (indicating dementia) had to be present or presumed in at least 80% of the subjects. Evidence tables, meta-analysis and summaries of results were elaborated by the first author and reviewed by author subgroups. Methods for rating level of evidence and grading practice recommendations were adapted from the Oxford Center for Evidence-Based Medicine. Results: Grade A treatment recommendation was achieved for institutionalization delay (multicomponent interventions for the caregiver, CG). Grade B recommendation was reached for the person with dementia (PWD) for: improvement in cognition (cognitive training, cognitive stimulation, multicomponent interventions for the PWD); activities of daily living (ADL) (ADL training, multicomponent interventions for the PWD); behavior (cognitive stimulation, multicomponent interventions for the PWD, behavioral interventions, professional CG training); mood (multicomponent interventions for the PWD); QoL (multicomponent interventions for PWD and CG) and restraint prevention (professional CG training); for the CG, grade B was also reached for: CG mood (CG education, CG support, multicomponent interventions for the CG); CG psychological well-being (cognitive stimulation, multicomponent interventions for the CG); CG QoL (multicomponent interventions for PWD and CG). Conclusion: NPTs emerge as a useful, versatile and potentially cost-effective approach to improve outcomes and QoL in ADRD for both the PWD and CG.
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            How should we define health?

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              Positive Health

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                Author and article information

                Contributors
                laila.oeksnebjerg.02@regionh.dk
                Role: Project Officer
                Role: Director for Projects
                Role: Professor
                Role: Professor
                Role: Associate Professor
                Role: Professor
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                19 June 2018
                December 2018
                : 21
                : 6 ( doiID: 10.1111/hex.2018.21.issue-6 )
                : 1056-1065
                Affiliations
                [ 1 ] Department of Neurology Danish Dementia Research Centre Rigshospitalet University of Copenhagen Copenhagen Denmark
                [ 2 ] Alzheimer Europe Luxembourg Luxembourg
                [ 3 ] School of Health and Social Work Faculty of Health Sciences University of Hull Hull UK
                [ 4 ] Centre for Applied Dementia Studies University of Bradford Bradford UK
                [ 5 ] Dipartimento di Psicologia University of Bologna Bologna Italy
                [ 6 ] Dementia Services Development Centre Wales Bangor University Bangor UK
                Author notes
                [*] [* ] Correspondence

                Laila Øksnebjerg, Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

                Email: laila.oeksnebjerg.02@ 123456regionh.dk

                Author information
                http://orcid.org/0000-0003-2322-8000
                Article
                HEX12799
                10.1111/hex.12799
                6250864
                29920881
                6cdf9cec-655b-4da6-bc85-e45dadbbb6bd
                © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 April 2018
                Page count
                Figures: 0, Tables: 1, Pages: 10, Words: 6752
                Funding
                Funded by: EU Joint Programme—Neurodegenerative Disease Research (JPND) Working Group on Longitudinal Cohorts
                Funded by: Innovation Fund Denmark
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12799
                December 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.3 mode:remove_FC converted:23.11.2018

                Health & Social care
                consultation,dementia,methods,outcome measures,patient and public involvement,positive psychology,psychosocial,quality of life,social health

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