Life In The Slower Lane

Here is the PICO analysis for the twenty-ninth uploaded article:

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✅ PICO Analysis

Full Article Title:

A Systematic Review of Staff Training Interventions to Reduce the Behavioural and Psychological Symptoms of Dementia

Type of Study:

Systematic review of randomised and non-randomised studies

Journal and Year:

Ageing Research Reviews (2013); 12:354–364

DOI: 10.1016/j.arr.2012.06.005

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P – Population

• Setting:
  • Residential aged care facilities (nursing homes, care homes, long-term care units)
• Participants:
  • Residents diagnosed with dementia who exhibit behavioural and psychological symptoms (BPSD)
  • Paid care staff (e.g., nurses, care assistants, support workers) receiving training

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I – Intervention

• Nature of Intervention:
  • Staff training programmes targeting the management of BPSD
  • Training types included:
    • Behavioural approaches (e.g., person-environment fit)
    • Communication-based training
    • Person-centred care
    • Emotion-oriented approaches
    • Combined or other models (e.g., restraint reduction, care planning, dementia care mapping)
  • Intensity of training varied:
    • Low (<10 hours): 4 studies
    • Medium (11–18 hours): 11 studies
    • High (>19 hours): 5 studies
  • Some included supervision, manuals, or follow-up support 

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C – Comparison

• Comparator:
  • Standard care or wait-list control groups in most randomised controlled trials (RCTs)
  • Some used non-randomised time-series or quasi-experimental comparisons

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O – Outcomes

1. 

Primary Resident Outcomes (BPSD):

• Symptom reduction:
  • 12 of 20 studies showed significant reductions in BPSD
  • 4 studies showed positive trends but not statistically significant
  • 4 studies showed no effect
• Depression and agitation were the most commonly targeted symptoms
• Several studies also measured anxiety, aggression, restraint use, and quality of life

2. 

Secondary Staff Outcomes:

• Positive impacts:
  • Improved self-efficacy and skills in managing BPSD (5 studies)
  • Higher observer-rated staff performance (3 studies)
  • Reductions in staff stress (2 studies)
  • Some improvement in staff attitudes and confidence
• Limited impact:
  • Job satisfaction, burnout, and general dementia knowledge often unchanged

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Outcome Classification

• Person-centred outcomes:
  • Direct improvement in resident symptoms (agitation, depression, anxiety, use of restraint)
• Process outcomes:
  • Changes in staff communication, care planning, attitudes, and behavioural support skills
• Health system outcomes:
  • Not directly measured; inferred through reduced need for pharmacological or crisis interventions

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Summary Conclusion

This systematic review found that staff training interventions can reduce behavioural and psychological symptoms of dementia (BPSD) in aged care settings. However, effectiveness varied, and the methodological quality of many studies was low. Training programmes based on behavioural or person-centred approaches, with medium intensity and ongoing support (e.g., supervision), were more likely to be successful. While some benefits were seen in staff skill and self-efficacy, changes in job satisfaction or burnout were inconsistent. The review highlights an urgent need for higher-quality trials, better-defined interventions, and more rigorous attention to cluster trial methodologies .

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