Promoting independence in dementia: protocol for a feasibility trial of the PRIDE intervention for living well with dementia

Background:Dementia can lead to social exclusion, loss of identity and independence, due to deterioration in cognition and activities of daily living. The aim of the study is to investigate the feasibility of the Promoting Independence in Dementia (PRIDE) intervention, designed to facilitate independence in people with mild dementia.Methods:This is a mixed-methods feasibility trial of the PRIDE, in preparation for a future randomised controlled trial. Up to 50 people with dementia will be recruited. Demetia advisors will deliver the three session intervention. Quantitative outcomes will be taken at baseline and up to three months post baseline. Fidelity checklists will assess fidelity to the intervention. Qualitative implementation data will be gathered in a series of post-intervention semi-structured interviews with staff and participants. This will include data to examine participant experiences of and engagement with the intervention, and other aspects of delivery such as recruitment of DAWs, fidelity and experiences of receiving and delivering the intervention. This studyaims to establish and field test the PRIDE intervention; determine the recruitment rate of sites, providers and participants; assess fidelity in delivery of the intervention and engagement with people with dementia; assess the feasibility and acceptability of outcome measure data and assess the acceptability of the intervention by stakeholders.Conclusions: There has been increased need for non-pharmacological interventions for mild dementia. The results of this feasibility study will allow us to plan fora definitive RCT of a three session dementia advisor led intervention for mild dementia.

Administration of Medical Decision-making in Market-oriented Mechanism---in the View of Medical Ethical Boundary and Stratification / 中国医学伦理学

In the circumstance of that the medical system reform follows to the principle of combination of government leading and market mechanism and in view of medical ethics boundary and stratification, this paper pointed out that whether the discussion and introspection of society or the doctors,medical decision-making should focus on the relationship between medical behavior and the patients′health interests, which is ensured by reasona-ble system. Decided by the current situation of medical decision -making stratification, layered construction of medical ethics is beneficial to that the medical behaviors gradually regress to the ethical value, while establishment of diagnosis and treatment norms is the ethical choice of current medical decision-making.