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Journeying through Dementia Randomised Controlled Trial of a Psychosocial Intervention for People Living with Early Dementia: Embedded Qualitative Study with Participants, Carers and Interventionists

Authors Sprange K, Beresford-Dent J, Mountain G, Thomas B, Wright J, Mason C, Cooper CL

Received 25 November 2020

Accepted for publication 9 January 2021

Published 4 February 2021 Volume 2021:16 Pages 231—244

DOI https://doi.org/10.2147/CIA.S293921

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Kirsty Sprange,1 Jules Beresford-Dent,2 Gail Mountain,2 Ben Thomas,3 Jessica Wright,3 Clare Mason,2 Cindy L Cooper3

1Nottingham Clinical Trials Unit, Faculty of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK; 2University of Bradford, Bradford West Yorkshire, BD7 1DP, UK; 3Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, S1 4DP, UK

Correspondence: Kirsty Sprange
Nottingham Clinical Trials Unit, Building 42, Room A05, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
Tel +44 0115 82 31574
Email Kirsty.sprange@nottingham.ac.uk

Objective: To identify the barriers and facilitators to the implementation of a complex psychosocial intervention though a study exploring the experiences of participants, carers and interventionists during a trial.
Methods: Individual semi-structured interviews were conducted with participants, their carers, and interventionists from a sample of recruiting sites that took part in the Journeying through Dementia randomized controlled trial (RCT). Interview data were transcribed and analysed using framework analysis. Co-researcher data analysis workshops were also conducted to explore researcher interpretations of the data through the lens of those with lived experience of dementia. Triangulation enabled comparison of findings from the interviews with findings from the co-researcher workshops.
Results: Three main themes emerged from the interview data: being prepared; intervention engagement; and participation and outcomes from engagement. From these themes, a number of factors that can moderate delivery and receipt of the intervention as intended were identified. These were context and environment; readiness, training, skills and competencies of the workforce; identifying meaningful participation and relationships.
Conclusion: This study highlighted that the observed benefit of the intervention was nuanced for each individual. Mechanisms of change were influenced by a range of individual, social and contextual factors. Future research should therefore consider how best to identify and measure the multifaceted interplay of mechanisms of change in complex interventions.
Trial Registration: ISRCTN17993825.

Keywords: psychosocial, self-management, dementia, wellbeing, occupational therapy, qualitative

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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