Interventions to improve attitudes towards people with neurological conditions

Abstract

The aim of this thesis was to develop understanding of staff interventions to improve attitudes towards neurological conditions. It is presented to the reader as three separate papers: 1) a systematic review exploring the effects of training interventions on healthcare professionals’ attitudes to dementia; 2) an empirical research paper investigating the feasibility of using Dementia Care Mapping-Neurorehabilitation (DCM-NR) to improve staff attitudes and self-efficacy and 3) a critical appraisal paper reviewing and reflecting upon the processes involved in conducting the research. Paper one, the systematic review, aimed to outline the different types of intervention that have been carried out to improve healthcare professionals’ attitudes towards people with dementia and to explore the effectiveness of these interventions. A systematic search of the databases using a predefined search strategy and inclusion/exclusion criteria revealed 8,298 potentially relevant studies. Following review, 24 studies were included and appraised using a quality rating tool. Studies were found to be of variable quality. Ten out of the 24 studies found a significant change in attitude following an intervention. The variability of interventions made it somewhat difficult to draw a specific conclusion about the effectiveness of these interventions to improving attitudes. Paper two, the empirical research, aimed to assess the feasibility of DCM-NR as an intervention to improve staff attitudes towards people with neurological conditions and self-efficacy to undertake person-centred care (PCC). A cluster-randomised controlled trial was undertaken and feasibility data was collected on the: recruitment and retention rates; fidelity of the intervention and the acceptability and usability of DCM-NR as an intervention. Measures for the outcomes of attitudes and self-efficacy were developed and trialled and deemed appropriate. The study demonstrated the successes of the intervention feasibility but also the challenges presented. Paper three is a critical appraisal of the systematic review paper and the empirical research paper. Both papers are closely considered and pertinent strengths, issues and limitations are discussed. Implications for clinical practice and directions for future research are also considered.

Date of Award	31 Dec 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Katherine Berry (Supervisor) & Laura Brown (Supervisor)