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In this person-centered study, we identified different profiles of resilience and vulnerability in emerging adulthood in response to previously experienced stressful life events. Additionally, we examined whether mothers’ and fathers’ parenting and participants’ personality traits in adolescence predicted these profiles. Data from the Flemish Study on Parenting, Personality, and Development (N = 346 families) were used. At T1 (2004; Mage = 11 years), T2 (2007), and T3 (2009), mothers and fathers reported on their parenting and their child’s personality. At T4 (2018; Mage = 25 years), emerging adults retrospectively self-reported the occurrence and impact of 22 stressful life events and rated current behavior problems and subjective well-being. Latent profile analysis revealed three profiles: Competent (71%; low stress, low behavior problems, high subjective well-being), Vulnerable (21%; average stress, high behavior problems, low subjective well-being), and Resilient (9%; high stress, average behavior problems, average subjective well-being). Emerging adults in the Resilient profile had experienced higher levels of maternal positive parenting and were less emotionally stable and conscientious than those in the Competent profile. Furthermore, emerging adults in the Vulnerable profile were less emotionally stable than their peers in the Competent profile. These findings reveal new insights into the heterogeneous patterns of emerging adults’ adaptation following stressful life events.
For feeling empowered, a sense of identity, usefulness, control, and self-worth is important for people living with dementia. We developed an empowerment intervention called the SPAN+ program to promote empowerment for nursing home residents with dementia. The aim of this study is to evaluate the feasibility of the SPAN+ program for these residents.
Healthcare professionals of two dementia special care units of one care organization worked with the SPAN+ intervention, which lasted for four months (September 2020 – December 2020). During the intervention, they reflected together on the four themes of empowerment for each resident, and set specific goals. Subsequently, they discussed and adjusted these goals with family caregivers and the person living with dementia (when possible). Furthermore, their personal professional development was targeted by specific exercises around the themes of empowerment.
We used the method of Bowen and colleagues (2009) to evaluate the feasibility of the SPAN+program in terms of acceptability, demand, implementation, practicality, integration, and possible efficacy.
Qualitative data was collected through interviews and a focus group discussion with participating healthcare professionals. Quantitative data was collected through standardized questionnaires filled in by healthcare professionals and family caregivers at baseline and at four- month follow-up.
Preliminary results show that the SPAN+ program supports healthcare professionals to increase attention for empowerment of residents living with dementia, by reflecting together with other healthcare professionals on what matters for each individual resident. Difficulties were reported in engaging family caregivers in the SPAN+ program.
The SPAN+ program seems valuable to increase the focus of healthcare professionals on a sense of identity, usefulness, control, and self-worth of people living with dementia in a nursing home, and to promote their empowerment.
Although the concept of empowerment seems useful for good care and support for people living with dementia, there is a lack of understanding as to how to define this concept. Therefore, insight is needed in what empowerment means for people living with dementia.
We performed an integrative literature review (PubMed, CINAHL, PsychINFO), including articles that addressed empowerment for people living with dementia in their title or abstract. Using qualitative data analysis software ATLAS.ti, we applied open codes to describe all relevant aspects of included articles. Common themes and categories were identified using inductive reasoning and constant comparison.
Sixty-nine articles were included. We identified four themes: (1) description of the state of being empowered, (2) the process of empowerment, (3) contribution of the environment to the empowerment process, and (4) effects on other variables. We combined these results with the conceptual framework of our previous qualitative study on the definition of empowerment for people living with dementia based on stakeholders’ perspectives into a revised conceptual framework. Subsequently, the combined information of both studies was visualized in a revised conceptual framework.
This literature review provides more details as to the role of the environment for empowerment of people living with dementia and suggests that empowerment can be considered a dynamic process, taking place through interaction between the person living with dementia and their environment. Our revised conceptual framework of empowerment can serve as a basis for future studies on empowerment for people living with dementia, and to support (in)formal caregivers in the empowerment process.
Neuropsychiatric symptoms (NPS) often occur in patients with dementia. Understanding the course of NPS in dementia is important for healthcare professionals for psycho-educational purposes and adequate and timely interventions to prevent or diminish NPS as much as possible.
We conducted a systematic literature search in several electronic databases. We combined search strings for the terms dementia, community-dwelling, cohort studies and NPS. Screening titles and abstracts, assessing the methodological quality and data-extraction were independently conducted by at least two authors.
This literature search revealed 6605 unique records of which 23 studies were included in data synthesis. In total 7184 patients participated in the included studies with a mean number of 312. Sixty percent of the participants were female and the mean age of all participants was 74.8 years. Follow-up varied between 1 and 6 years; in 17 studies loss to follow-up was less than 20% per year. NPS are highly prevalent, incident and persistent although frequency parameters vary considerably across studies. Delusions/delusional misidentification, wandering/agitation, aberrant motor behavior/motor hyperactivity and apathy are the most common NPS. For hallucinations, delusions/delusional misidentification, paranoia, aggression, wandering/agitation, aberrant motor behavior/motor hyperactivity, disinhibition, apathy, and sleep disturbance increasing trends in point prevalence rates have been found.
NPS in community-dwelling patients are frequent and persistent. The increasing trends of several NPS in the course of dementia require a preventive approach of professional caretakers. For such an approach, a timely diagnosis and adequate professional support to prevent or diminish these problems is necessary.
Currently only about half of the people who have major depressive disorder are detected during regular health care. Screening in high-risk groups might be a possible solution.
To evaluate the effectiveness of selective screening for major depressive disorder in three high-risk groups in primary care: people with mental health problems, people with unexplained somatic complaints and people who frequently attend their general practitioner.
Prospective cohort study among 2005 people in high-risk groups in three health centres in The Netherlands.
Of the 2005 people identified, 1687 were invited for screening and of these 780 participated. Screening disclosed 71 people with major depressive disorder: 36 (50.7%) already received treatment, 14 (19.7%) refused treatment and 4 individuals did not show up for an appointment. As a final result of the screening, 17 individuals (1% of 1687) started treatment for major depressive disorder.
Screening for depression in high-risk populations does not seem to be effective, mainly because of the low rates of treatment initiation, even if treatment is freely and easily accessible.