Wyman, Danielle;
Butler, Laurie T;
Morgan-Trimmer, Sarah;
Bright, Peter;
Barber, Julie;
Budgett, Jessica;
Walters, Kate;
... Cooper, Claudia; + view all
(2024)
Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family).
Age and Ageing
, 53
(8)
, Article afae181. 10.1093/ageing/afae181.
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Walters_NIDUS-professional process evaluation MANUSCRIPT _REVISED_v5.pdf Access restricted to UCL open access staff until 23 August 2025. Download (1MB) |
Abstract
Introduction: We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year.// Methods: In 2021–2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data.// Results: 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) ‘Someone to talk to helps dyads feel supported’; (B) ‘NIDUS-Family helps carers change their perspective’; (C) ‘Personalisation helps people living with dementia maintain their identity’ and (D) ‘Small steps help dyads move forward’.// Conclusion: Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities.//
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