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. 2022 Nov;31(21-22):3250-3262.
doi: 10.1111/jocn.16163. Epub 2021 Dec 7.

A Quasi-experimental study on prevention and reduction of involuntary treatment at home (PRITAH) in people with dementia

Angela M H J Mengelers  1   2 , Michel H C Bleijlevens  1   2 , Hilde Verbeek  1   2 , Elizabeth Capezuti  3 , Jan P H Hamers  1   2
Affiliations

A Quasi-experimental study on prevention and reduction of involuntary treatment at home (PRITAH) in people with dementia

Angela M H J Mengelers et al. J Clin Nurs. 2022 Nov.

Abstract

Aim and objectives: To examine the implementation (reach, dose, fidelity, adaptations, satisfaction), mechanisms of impact (attitude, subjective norm, perceived behavioural control and intention) and context of the PRITAH intervention.

Background: Involuntary treatment, defined as care provided against one's will, is highly prevalent in home care. The PRITAH intervention comprises policy, workshops, coaching and alternative measures for professional caregivers to prevent and reduce involuntary treatment in home care.

Design: Quasi-experimental study.

Methods: Eight home care teams from two care organisations participated in this study. Guided by the Theory of Planned Behavior, the mechanisms of impact were evaluated with questionnaires. Implementation and context were assessed using attendance lists, evaluation questionnaires, focus groups and logbooks. The study adhered to the TREND checklist.

Results: 124 of 133 eligible professional caregivers participated (93%). All four components were delivered with minor deviations from protocol. Participants' subjective norms and perceived behavioural control changed over time in favour of the intervention group. No effects were seen for attitude and intention. Barriers included an unclear policy and lack of communication between stakeholders. The multidisciplinary approach and possibility to discuss involuntary treatment with the specialised nurse were described as facilitators.

Conclusions: Prevention and reduction of involuntary treatment at home is feasible in home care practice and contributes to changing professional caregivers' subjective norms and perceived behavioural control, prerequisites for behavioural change in order to prevent and reduce involuntary treatment. A follow-up study on the effectiveness of PRITAH on actual use, prevention and reduction of involuntary treatment in home care is needed. Future studies should emphasise the role of family caregivers and GPs and actively involve them in the prevention and reduction of involuntary treatment.

Relevance to clinical practice: Involuntary treatment is commonly used in dementia home care and professional and family caregivers need to be supported in prevention and reduction of involuntary treatment in people with dementia.

Keywords: dementia; home care; intervention; involuntary treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

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