Implementing reablement for community dwelling people with dementia: A formative evaluation using single-case experimental design.

Alexis Campbell, Christopher J Poulos, Caroline Takla, Joy Allen, Kylie Lemsing, Claire Mc O'Connor
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Abstract

Background: Reablement is recommended to maximise functioning in people with dementia, yet in Australia, is not routinely available. This study aimed to provide insight into the implementation and program outcomes of reablement in real-world practice for a person living with dementia.

Methods: Reablement was implemented for a client with dementia. In parallel, a formative mixed-methods pilot evaluation was performed, using single-case experimental A-B-A design (n = 1), supplemented by routinely collected pre-post program clinical measures. Implementation was evaluated qualitatively via clinical notes for fidelity, feasibility and client engagement.

Results: Single-case experimental design outcomes indicated the program positively impacted the participant's physical functioning. Additionally, most routinely collected pre-post clinical measures demonstrated improvement. Intervention fidelity varied, with differences in length and client engagement.

Conclusion: Implementation of evidence-informed reablement has been shown to be feasible in real-world practice for a community-dwelling person living with dementia. Larger implementation trials are needed to build on preliminary outcomes to ultimately improve access to these important programs.

背景:为最大限度地发挥痴呆症患者的功能,我们建议进行康复治疗,但在澳大利亚,康复治疗并不是一项常规措施。本研究旨在深入探讨在现实世界中为痴呆症患者实施的康复治疗的实施情况和计划成果:方法:为一名痴呆症患者实施了康复训练。与此同时,还采用单例实验 A-B-A 设计(n = 1)进行了形成性混合方法试点评估,并辅以日常收集的项目实施前-实施后临床测量结果。通过临床笔记对实施的忠实度、可行性和客户参与度进行了定性评估:结果:单一案例实验设计结果表明,该计划对参与者的身体机能产生了积极影响。此外,大多数常规收集的事后前临床测量结果表明,参与者的身体机能得到了改善。干预的保真度各不相同,在时间长度和客户参与度方面也存在差异:结论:对居住在社区的痴呆症患者而言,在现实世界的实践中实施循证再适应疗法是可行的。需要在初步成果的基础上进行更大规模的实施试验,以最终提高这些重要计划的可及性。
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