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The impact of using measurements of electrodermal activity in the assessment of problematic behaviour in dementia
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.ORCID-id: 0000-0003-0313-6002
Faculty of Health and Sport Sciences, Centre for EHEALTH, University of Agder, Grimstad, Norway.
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
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2018 (Engelska)Ingår i: Dementia and geriatric cognitive disorders extra, E-ISSN 1664-5464, Vol. 8, nr 3, s. 333-347Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: A major and complex challenge when trying to support individuals with dementia is meeting the needs of those who experience changes in behaviour and mood. Aim: To explore how a sensor measuring electrodermal activity (EDA) impacts assistant nurses' structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions. Methods: Fourteen individuals with dementia wore a sensor that measured EDA. The information from the sensor was presented to assistant nurses during structured assessments of problematic behaviours. The evaluation process included scorings with the instrument NPI-NH (Neuropsychiatric Inventory-Nursing Home version), the care interventions suggested by assistant nurses to decrease problematic behaviours, and the assistant nurses' experiences obtained by focus group interviews. Results: The information from the sensor measuring EDA was perceived to make behavioural patterns more visual and clear, which enhanced assistant nurses' understanding of time-related patterns of behaviours. In turn, this enhancement facilitated timely care interventions to prevent the patterns and decrease the levels of problematic behaviour. Conclusion: With the addition of information from the sensor, nursing staff could target causes and triggers in a better way, making care interventions more specific and directed towards certain times throughout the day to prevent patterns of problematic behaviours.

Ort, förlag, år, upplaga, sidor
Basel: S. Karger, 2018. Vol. 8, nr 3, s. 333-347
Nationell ämneskategori
Hälsovetenskaper Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
URN: urn:nbn:se:ltu:diva-70846DOI: 10.1159/000493339ISI: 000465207700004PubMedID: 30386370Scopus ID: 2-s2.0-85054876403OAI: oai:DiVA.org:ltu-70846DiVA, id: diva2:1247565
Anmärkning

Validerad;2018;Nivå 2;2018-11-07 (johcin) 

Tillgänglig från: 2018-09-12 Skapad: 2018-09-12 Senast uppdaterad: 2019-05-02Bibliografiskt granskad
Ingår i avhandling
1. Piecing together a fragmented world: Structures to promote the understanding of people with advanced dementia
Öppna denna publikation i ny flik eller fönster >>Piecing together a fragmented world: Structures to promote the understanding of people with advanced dementia
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Föra samman fragment till en helhet : Strukturer för att öka förståelsen för personer med avancerad demens
Abstract [en]

Understanding people with dementia whose verbal ability has been impaired is a complex and challenging task, even for professional nursing staff. The aim of this PhD thesis was to explore structures that may promote the understanding of people with advanced dementia living in nursing homes. It focusses specifically on (I) the clinical reasoning employed by assistant nurses when utilizing the NPI-NH (Neuropsychiatric Inventory Nursing Home version) as a tool to assess frequency and severity of BPSD (behavioural and psychological symptoms in dementia, i.e. problematic behaviours) in people with advanced dementia, (II) whether a sensor measuring electrodermal activity (EDA) can improve the identification of agitation in individuals with dementia, (III) how an EDA sensor impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions, and (IV) how Martha Nussbaum’s approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes. Study I used a method of discourse analysis that focussed on clinical reasoning utilized by assistant nurses when assessing problematic behaviours. In study II, a nonexperimental and correlational observation of the relationship between a sensor measuring EDA and assistant nurses’ structured observations of agitation in people with advanced dementia was applied. Study III used both quantitative and qualitative approaches; data were collected during structured assessments of problematic behaviours conducted by assistant nurses, as well as by focus group interviews with assistant nurses. Study IV took an ethnographic approach with participatory observations that were analyzed with a recursive analysis using a theoretical framework for the conditions necessary for a dignified human life. The structure of the NPI-NH provided a supportive framework that encouraged assistant nurses to discuss and broaden their understanding of the person with dementia (I). The EDA sensor provided continuous information regardless of staff presence and the potential to identify EDA prior to observing these behaviours (II, III), which supported the understanding of the person and when to introduce timely interventions to prevent the onset of problematic behaviours (III). The structure of Nussbaum’s approach to human capabilities illuminated that people with advanced dementia were at risk of living a life in which their opportunities for human capabilities were limited, and hence, the possibility to live a dignified life (IV). An overview of the findings in this thesis indicates that the studied structures were used to piece together fragments of information to create a comprehensive understanding of the needs of the person with dementia. For the structures to support the understanding of the person with dementia, it was crucial that nursing staff were present, attentive and engaged in each person’s situation in order for them to figure out how to piece together and integrate the structures into the overall understanding of the person and, based on that, formulate caring actions in daily life that are meaningful from the perspective of the person with advanced dementia.

Ort, förlag, år, upplaga, sidor
Luleå: Luleå University of Technology, 2018
Serie
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Nyckelord
dementia, nursing home, electrodermal activity, capability approach, clinical reasoning, assessment, behaviour
Nationell ämneskategori
Omvårdnad
Forskningsämne
Omvårdnad
Identifikatorer
urn:nbn:se:ltu:diva-70847 (URN)978-91-7790-199-0 (ISBN)978-91-7790-200-3 (ISBN)
Disputation
2018-10-26, Deltasalen, D770, Luleå, 10:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-09-13 Skapad: 2018-09-12 Senast uppdaterad: 2018-09-27Bibliografiskt granskad

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Melander, CatharinaOlsson, MalinWälivaara, Britt-MarieSävenstedt, Stefan

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