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Article: Exploring dementia family carers’ self-initiated strategies in managing behavioural and psychological symptoms in dementia: a qualitative study

TitleExploring dementia family carers’ self-initiated strategies in managing behavioural and psychological symptoms in dementia: a qualitative study
Authors
Keywordsdementia
depression & mood disorders
qualitative research
schizophrenia & psychotic disorders
Issue Date2021
PublisherBMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com
Citation
BMJ Open, 2021, v. 11 n. 8, p. article no. e048761 How to Cite?
AbstractObjectives: Carer’s self-initiated management strategies of behavioural and psychological symptoms of dementia (BPSD) can inform intervention development. These strategies are affected by cultural values. Little is known about non-Western dementia carers’ BPSD management strategies. This study aimed to explore self-initiated strategies in managing BPSD adopted by Chinese carers. Design: Qualitative study using thematic framework method. Setting: Community setting in Hong Kong. Participants: 16 dementia carers with purposive sampling to include carers of different relationships to the people living with dementia (PLwD), education level and living arrangement. Results: Six overarching themes emerged from the data: (1) maintaining personhood in PLwD, (2) responding positively to BPSD, (3) explanation and bargaining, (4) responding negatively to BPSD, (5) controlling upsetting thoughts, and (6) getting respite care. Chinese carers treasured warm and supportive family relationships. They identified and minimised triggers to alleviate BPSD. Some carers struggled with care tasks and reacted with confrontation and avoidance. Changing attitudes and getting social and emotional support were described to manage carers’ distress. Few self-care strategies including getting respite care were reported. Conclusions: Carers’ self-initiated strategies largely aligned with existing theoretical frameworks in BPSD management, such as person-centred approach, and echoed Asian culture, which advocates filial piety and supportive family relationships. While these cultural values encourage the engagement of people living with dementia in the normal process of family life, they may also prevent carers from taking time away from care. Interventions could support carers by enhancing their knowledge and skills in managing BPSD, providing social and emotional support, and providing guidance in self-care. Future cross-cultural research could explore factors contributing to how carers manage BPSD and how interventions could be culturally adapted to facilitate carers to apply learnt skills in daily practice and hence benefit the people living with dementia and carer population.
Persistent Identifierhttp://hdl.handle.net/10722/305887
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 0.971
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, DKY-
dc.contributor.authorWong, KKY-
dc.contributor.authorSpector, A-
dc.contributor.authorWong, GHY-
dc.date.accessioned2021-10-20T10:15:44Z-
dc.date.available2021-10-20T10:15:44Z-
dc.date.issued2021-
dc.identifier.citationBMJ Open, 2021, v. 11 n. 8, p. article no. e048761-
dc.identifier.issn2044-6055-
dc.identifier.urihttp://hdl.handle.net/10722/305887-
dc.description.abstractObjectives: Carer’s self-initiated management strategies of behavioural and psychological symptoms of dementia (BPSD) can inform intervention development. These strategies are affected by cultural values. Little is known about non-Western dementia carers’ BPSD management strategies. This study aimed to explore self-initiated strategies in managing BPSD adopted by Chinese carers. Design: Qualitative study using thematic framework method. Setting: Community setting in Hong Kong. Participants: 16 dementia carers with purposive sampling to include carers of different relationships to the people living with dementia (PLwD), education level and living arrangement. Results: Six overarching themes emerged from the data: (1) maintaining personhood in PLwD, (2) responding positively to BPSD, (3) explanation and bargaining, (4) responding negatively to BPSD, (5) controlling upsetting thoughts, and (6) getting respite care. Chinese carers treasured warm and supportive family relationships. They identified and minimised triggers to alleviate BPSD. Some carers struggled with care tasks and reacted with confrontation and avoidance. Changing attitudes and getting social and emotional support were described to manage carers’ distress. Few self-care strategies including getting respite care were reported. Conclusions: Carers’ self-initiated strategies largely aligned with existing theoretical frameworks in BPSD management, such as person-centred approach, and echoed Asian culture, which advocates filial piety and supportive family relationships. While these cultural values encourage the engagement of people living with dementia in the normal process of family life, they may also prevent carers from taking time away from care. Interventions could support carers by enhancing their knowledge and skills in managing BPSD, providing social and emotional support, and providing guidance in self-care. Future cross-cultural research could explore factors contributing to how carers manage BPSD and how interventions could be culturally adapted to facilitate carers to apply learnt skills in daily practice and hence benefit the people living with dementia and carer population.-
dc.languageeng-
dc.publisherBMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com-
dc.relation.ispartofBMJ Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectdementia-
dc.subjectdepression & mood disorders-
dc.subjectqualitative research-
dc.subjectschizophrenia & psychotic disorders-
dc.titleExploring dementia family carers’ self-initiated strategies in managing behavioural and psychological symptoms in dementia: a qualitative study-
dc.typeArticle-
dc.identifier.emailLeung, DKY: daralky@hku.hk-
dc.identifier.emailWong, KKY: kaylawky@hku.hk-
dc.identifier.emailWong, GHY: ghywong@hku.hk-
dc.identifier.authorityWong, GHY=rp01850-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1136/bmjopen-2021-048761-
dc.identifier.pmid34433600-
dc.identifier.pmcidPMC8388289-
dc.identifier.scopuseid_2-s2.0-85113958125-
dc.identifier.hkuros326952-
dc.identifier.volume11-
dc.identifier.issue8-
dc.identifier.spagearticle no. e048761-
dc.identifier.epagearticle no. e048761-
dc.identifier.isiWOS:000689747400010-
dc.publisher.placeUnited Kingdom-

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