Background The implementation of clearly structured dementia-specific case conferences could be an important tool to enable nursing staff to properly analyse and manage challenging behaviour in nursing home residents with dementia. A process evaluation of the responses of nursing homes to the implementation of WELCOME-IdA (Wittener model of case conferences for people with dementia - the Innovative dementia-oriented Assessment tool) was carried out to gain insight into which key elements of the intervention were adopted by the nursing homes and which elements were adapted. Methods This study was part of a larger process evaluation using a qualitative design. Thirty-four semi-structured telephone interviews and 15 focus group interviews were conducted in four nursing homes. The interviews were analysed using deductive content analysis, although inductive categories have been developed. Results Nursing home staff adopted the roles of moderator, case reporter, keeper of the minutes and reflection partner in WELCOME-IdA, but the selection of the staff members who filled these roles differed across nursing homes. The recommended group size of 5-8 participants per case conference was sometimes adopted. The key element of having core nursing teams who participated continuously in all case conferences was not adopted at all. Instead, there was a high level of rotation among staff members. The pre-defined process structure of WELCOME-IdA was adapted in such a way that the assessment of the residents' behaviour and the selection of the relevant domain for the behaviour analysis were conducted in advance of the case conference. The evaluation of the interventions was also organized differently. Conclusion The scope of the response implies that WELCOME-IdA requires further adaptation to the requirements of nursing processes in nursing homes. The results provide important information on the selection of role keepers and offer insights into a) how knowledge of the structured training was circulated and transformed into self-organized case conferences and b) how knowledge was circulated throughout the entire processing of one case. Thus, these results can be used to optimize intervention and implementation. Overall, the intervention should allow more possibilities for tailored adaptation than it currently does.

中文翻译：

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疗养院对实施痴呆症特异性病例会议概念 WELCOME-IdA 的反应的过程评估：一项定性研究。

背景 实施结构清晰的痴呆症特定病例会议可能是使护理人员能够正确分析和管理患有痴呆症的疗养院居民的挑战性行为的重要工具。对疗养院对实施 WELCOME-IdA（痴呆症患者案例会议的 Wittener 模型 - 创新的痴呆导向评估工具）的反应进行了过程评估，以深入了解采用了哪些干预措施的关键要素由疗养院和哪些元素进行了调整。方法 本研究是使用定性设计进行的更大过程评估的一部分。在四个疗养院进行了 34 次半结构化电话访谈和 15 次焦点小组访谈。使用演绎内容分析对访谈进行分析，尽管已经开发了归纳类别。结果 疗养院工作人员在 WELCOME-IdA 中担任主持人、案例报告人、会议记录保管人和反思伙伴的角色，但担任这些角色的工作人员的选择在各个疗养院有所不同。有时会采用建议的每个案例会议 5-8 名参与者的小组规模。核心护理团队持续参与所有病例会议的关键要素根本没有被采纳。相反，工作人员之间的轮换程度很高。WELCOME-IdA 的预定义流程结构进行了调整，以便在案例会议之前进行居民行为的评估和行为分析的相关领域的选择。干预措施的评估也有不同的组织方式。结论 响应范围意味着 WELCOME-IdA 需要进一步适应疗养院护理流程的要求。结果提供了有关选择角色保持者的重要信息，并提供了以下方面的见解：a）结构化培训的知识如何传播并转化为自组织的案例会议，b）知识如何在一个案例的整个处理过程中传播。因此，这些结果可用于优化干预和实施。总体而言，与目前相比，干预措施应该为量身定制的适应提供更多可能性。结果提供了有关选择角色保持者的重要信息，并提供了以下方面的见解：a）结构化培训的知识如何传播并转化为自组织的案例会议，b）知识如何在一个案例的整个处理过程中传播。因此，这些结果可用于优化干预和实施。总体而言，与目前相比，干预措施应该为量身定制的适应提供更多可能性。结果提供了有关选择角色保持者的重要信息，并提供了以下方面的见解：a）结构化培训的知识如何传播并转化为自组织的案例会议，b）知识如何在一个案例的整个处理过程中传播。因此，这些结果可用于优化干预和实施。总体而言，与目前相比，干预措施应该为量身定制的适应提供更多可能性。