关键词: Best practice Consensus Crisis resolution team Dementia Fidelity

Mesh : Caregivers Crisis Intervention Dementia / therapy Humans Psychometrics Surveys and Questionnaires

来  源:   DOI:10.1186/s12888-020-02899-0   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia.
The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing).
One hundred sixty-five candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48 to 92/100. The median score for the crisis teams was 74.5 (range 67-92), and the median score for non-crisis teams was 60 (range 48-72).
With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.
摘要:
为痴呆症患者及其护理人员提供危机解决服务的团队提供短期干预措施,以防止进入急性护理环境。英国各地的这些服务差异很大。本文报告了为设计最佳实践模型和评估工具而进行的共识过程,以与管理痴呆症危机的团队一起使用。
最佳实践模型和工具是通过三个阶段开发的:(i)证据收集和候选标准的生成(系统审查和范围调查,访谈和焦点小组);(ii)标准的优先排序和选择(咨询小组,共识会议和修改后的Delphi流程);(iii)完善和实施标准(咨询小组和现场测试)。
证据收集阶段产生了一百六十五项候选标准;通过咨询小组的练习进行了改进并减少到90项;然后在共识会议期间减少到50项,并使用修改后的Delphi程序进行加权。然后通过临床咨询小组实施标准,并与11个危机小组和5个非危机小组进行现场测试。分数从48到92/100不等。危机小组的中位数为74.5(范围为67-92),非危机组的中位数为60分(范围48-72分).
通过进一步的心理测试,这个最佳实践模型和工具将是规划的理想选择,未来管理痴呆症危机的团队的改进和国家基准。
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