Virtual Reality-Based Education Program for Managing Behavioral and Psychological Symptoms of Dementia: Development and Feasibility Test.

This study aims to develop a virtual reality-based education program for managing behavioral and psychological symptoms of dementia for family carers of persons living with dementia and investigate the feasibility for users. The program was developed through literature review, interviews with family carers, surveys, and expert content validity assessment. User feasibility was evaluated quantitatively through a questionnaire on usefulness, ease of use, and satisfaction, and qualitatively through participant interviews. The program was produced in two parts, Type 1 and Type 2, consisting of three and six episodes, respectively. Participants showed a high level of satisfaction with overall program scores of 4.28 ± 0.66 and 4.34 ± 0.41 for the two evaluations. Participants also expressed that both programs were helpful, Type 1 for achieving changes in attitude associated with more understanding of persons living with dementia and Type 2 for acquiring coping methods through communication training. Use of the virtual reality device was not inconvenient and was identified as helpful due to the high immersion experience. Results of this study confirmed that family carers had no resistance to education using new technologies such as virtual reality devices and that virtual reality-based education could be effective for training family carers.

Korean Family Caregivers' Experiences With Managing Behavioral and Psychological Symptoms of Dementia: Keeping Harmony in Daily Life.

Behavioral and psychological symptoms of dementia (BPSD) are symptoms of dementia that family caregivers find difficult to manage. Competence in managing BPSD differs according to individual family caregiver. The current study investigated the competence in managing BPSD, focusing on family caregivers who were recognized as managing them well. Twenty-four Korean family caregivers (83% female, mean age = 67 years) living with persons with dementia (PWD) were interviewed. Four themes were derived from the content analysis: Entering and Looking into the World of PWD, Keeping Daily Life in Harmony With BPSD, Becoming an Expert in BPSD, and Balancing Between Caregiving and Myself. Family caregivers minimized the impact of BPSD and maintained life balance. As a result, they were able to continue a harmonious life with PWD. [Research in Gerontological Nursing, 15(3), 141-150.].

The Competence Scale in Managing Behavioral and Psychological Symptoms of Dementia (CS-MBPSD) for family caregivers: Instrument development and cross-sectional validation study.

BACKGROUND: Families' caring competence plays a key role in caring for the elderly with dementia. In particular, the management of the behavioural and psychological symptoms of dementia is different from the management of other symptoms of dementia. However, there is no tool for evaluating family caregiver competence for managing the behavioural and psychological symptoms of dementia. OBJECTIVE: This study aimed to develop a competence scale in managing the behavioural and psychological symptoms of dementia for family caregivers and to evaluate its psychometric properties. DESIGN: An instrument development and cross-sectional validation study was conducted. SETTINGS: Twenty-one local dementia centres in Seoul, Korea. PARTICIPANTS: A total of 460 community-dwelling family caregivers of people living with dementia (mean age = 69.82 ± 11.08, female = 78.7%, spouse = 65.7%) participated in the study. METHODS: This study was conducted in two steps: (1) instrument development and (2) psychometric tests (N = 460). After item generation and the evaluation of content validity and face validity, a total of 39 preliminary items were tested. For the psychometric tests, item analysis using the corrected item-to-total correlations and construct validity with exploratory and confirmatory factor analysis were performed. Using measurement tools of the Behaviour Management Skill, a Visual Analogue Scale, and a general question of the scale developed in this study, the concurrent validity was examined by calculating Pearson's correlation coefficient. Reliability was evaluated with Cronbach's α, test reliability with the standard error of measurement, and test-retest reliability with the intraclass correlation coefficient. RESULTS: The exploratory and confirmatory factor analyses yielded a six-factor solution with 28 items. The six factors were 'person-centred attitude', 'introspection for improvement', 'symptom occurrence analysis', 'application of various strategies', 'awareness of symptoms' and 'caring for one's own mind and body'. The concurrent validity was established. The reliability was demonstrated to be acceptable (Cronbach's α = 0.922, ICC = 0.781). CONCLUSIONS: The competence scale in managing the behavioural and psychological symptoms of dementia for family caregivers was found to be a valid and reliable instrument. The scale is potentially useful for promoting better dementia care in both research and clinical practice settings by enabling the identification of needs to be improved for family caregivers in coping with dementia symptoms.

Family caregiver competence in managing behavioral and psychological symptoms of dementia: A concept synthesis.

AIM: This study aimed to identify the attributes of "family caregiver competence in managing behavioral psychological symptoms of dementia". METHODS: Six electronic databases were searched for studies published between January 1990 and June 2017 with the key words "dementia", "behavioral psychological symptoms of dementia", "caregiver", "coping (managing)", and "competence". From the final fully reviewed 26 articles, descriptions related to family caregiver's dealing with behavioral psychological symptoms of dementia were extracted first. Then, based on Walker and Avant's concept synthesis, the concept of "family caregiver competence in managing behavioral psychological symptoms of dementia" was explored. RESULTS: Four attributes, namely "Judging", "Empathizing", "Adjusting", and "Reflecting", comprised of ten categories were identified as constituting the concept of family caregiver competence in managing the behavioral psychological symptoms of dementia. As a meta competence, "reflecting" may play a significant role in improving family caregiver competence by interacting with the other dimensions of competence in managing symptoms. CONCLUSIONS: Based on the suggested conceptual model, education or training programs could be developed to improve family caregiver competence in managing behavioral psychological symptoms of dementia. To refine the attributes found in this study, field studies including observations of and interviews with family caregivers need to be conducted. Studies exploring the associations between these attributes are also of value.

Comparison of different impression techniques for edentulous jaws using three-dimensional analysis.

PURPOSE: The purpose of this study was to compare two novel impression methods and a conventional impression method for edentulous jaws using 3-dimensional (3D) analysis software. MATERIALS AND METHODS: Five edentulous patients (four men and one woman; mean age: 62.7 years) were included. Three impression techniques were used: conventional impression method (CI; control), simple modified closed-mouth impression method with a novel tray (SI), and digital impression method using an intraoral scanner (DI). Subsequently, a gypsum model was made, scanned, and superimposed using 3D analysis software. Mean area displacement was measured using CI method to evaluate differences in the impression surfaces as compared to those values obtained using SI and DI methods. The values were confirmed at two to five areas to determine the differences. CI and SI were compared at all areas, while CI and DI were compared at the supporting areas. Kruskal-Wallis test was performed for all data. Statistical significance was considered at P value <.05. RESULTS: In the comparison of the CI and SI methods, the greatest difference was observed in the mandibular vestibule without statistical significance (P>.05); the difference was < 0.14 mm in the maxilla. The difference in the edentulous supporting areas between the CI and DI methods was not significant (P>.05). CONCLUSION: The CI, SI, and DI methods were effective in making impressions of the supporting areas in edentulous patients. The SI method showed clinically applicability.