Dalarna University's logo and link to the university's website

du.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Healthcare and community stakeholders’ perceptions of barriers and facilitators to implementing a behavioral activation intervention for people with dementia and depression: a qualitative study using Normalization Process Theory
Uppsala University, Uppsala.
Uppsala University, Uppsala.
Uppsala University, Uppsala.
University of Exeter, Devon, UK.
Show others and affiliations
2023 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 23, article id 814Article in journal (Refereed) Published
Abstract [en]

Background Depression is commonly experienced by people with dementia, and associated with lower quality of life and functional decline. However, access to evidence-based psychological interventions for people with dementia and depression is limited. One potential solution is guided low-intensity behavioral activation. Following the new Medical Research Council Framework, considering factors such as potential barriers and facilitators to implementation is recommended during the development of new interventions. Aims of this study were to: (1) develop an understanding of existing healthcare and community support in the Swedish context for people with dementia and their informal caregivers; and (2) identify barriers and facilitators to intervention uptake informed by Normalization Process Theory. Methods Semi-structured interviews and focus groups were held with healthcare (n = 18) and community (n = 7) stakeholders working with people with dementia and/or informal caregivers. Interview questions were informed by Normalization Process Theory. Data was analysed utilizing a two-step deductive analysis approach using the Normalization Process Theory coding manual, with inductive categories applied to data related to the main mechanisms of the theory, but not captured by its sub-constructs. Results Twelve deductive and three inductive categories related to three Normalization Process Theory primary mechanisms (Coherence, Cognitive Participation, and Collective Action) were identified. Identified barriers to intervention uptake included: (1) additional burden for informal caregivers; (2) lack of appropriate workforce to provide guidance; (3) lack of time and financial resources; (4) people with dementia not recognising their diagnosis of dementia and/or a need for support; and (5) stigma. Identified facilitators to intervention uptake included: (1) intervention has potential to fill a large psychological treatment gap in Sweden; (2) objectives and potential benefits understood and agreed by most stakeholders; and (3) some healthcare professionals recognized their potential role in providing intervention guidance. Conclusions Several barriers and facilitators for future implementation, specific to the intervention, individuals and families, as well as professionals, were identified during intervention development. Barriers were mapped into evidence-based implementation strategies, which will be adopted to overcome identified barriers. A feasibility study further examining implementation potential, acceptability and feasibility, alongside clinical, methodological, and procedural uncertainties associated with the intervention will be conducted. 

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 23, article id 814
Keywords [en]
Dementia, Depression, Mental Health, Behavioral Activation, Normalization Process Theory, Intervention Development
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:du-47450DOI: 10.1186/s12877-023-04522-9ISI: 001116849300004PubMedID: 38062362Scopus ID: 2-s2.0-85178946701OAI: oai:DiVA.org:du-47450DiVA, id: diva2:1818006
Funder
Swedish Research Council, Dnr: 2018-02691Available from: 2023-12-08 Created: 2023-12-08 Last updated: 2024-07-04Bibliographically approved

Open Access in DiVA

fulltext(2473 kB)114 downloads
File information
File name FULLTEXT01.pdfFile size 2473 kBChecksum SHA-512
c23ae63d9b5beeb74ff7daba9b53e6dfeaa44977de43ff6ac7c84934868b57972bbfbd5d41e837c0cd071ae05ce87a5d41167c9a8ce5a02866134e4600b20c1b
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Åberg, Anna Cristina

Search in DiVA

By author/editor
Åberg, Anna Cristina
By organisation
Medical Science
In the same journal
BMC Geriatrics
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 114 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 142 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf