International Psychogeriatrics

Research Article

Improving patient-centered care for people with dementia in medical encounters: an educational intervention for old age psychiatrists

Louise Robinsona1 c1, Claire Bamforda1, Ruth Briela2, John Spencera3 and Paula Whittya1

a1 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, U.K.

a2 Tees, Esk & Wear Valley NHS Trust, Bowes Lyon Unit, Earls House Hospital, Durham, U.K.

a3 School of Medical Education, Newcastle University, Newcastle upon Tyne, U.K.

ABSTRACT

Background: Health care professionals are recommended to deliver patient-centered care in dementia; however, guidance and training on how to do this in practice is currently lacking. The aim of this study was to develop and evaluate pragmatically an educational intervention for old age psychiatrists to promote patient-centered care in their consultations with people with dementia and their carers.

Methods: We used a range of methods to (i) identify the theoretical components of patient-centered care (literature review) and (ii) observe actual practice (video recording of 53 consultations between old age psychiatrists and people with dementia and their family carers). We also interviewed participants from (ii) including 7 old age psychiatrists, 25 people with dementia and 44 carers. From this we developed a workshop for old age psychiatrists and piloted and evaluated it. Pre- and post-workshop questionnaires were completed; the latter included an assessment of planned and subsequent behavior change by participants.

Results: The educational workshop, attended by 41 old age psychiatrists, focused on how best to structure the consultation and the most effective communication skills to use in consultation with people with dementia. Three months after the workshop, 59% had made one or more changes to the structure of their consultations, 71% had used new communication skills and 56% had reflected further on their practice.

Conclusions: We developed an educational intervention with both a theoretical and empirical basis. The workshops resulted in many changes to self-reported practice; whether this was noticeable to patients and carers requires further study.

(Received January 22 2009)

(Revised March 19 2009)

(Revised May 18 2009)

(Accepted May 20 2009)

(Online publication July 17 2009)

Correspondence:

c1 Correspondence should be addressed to: Dr. Louise Robinson, Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA, U.K. Phone: +44 (0)191 222 7013; Fax: +44 (0)191 222 6043. Email: a.l.robinson@ncl.ac.uk.

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