People with dementia represent a large group of residents in nursing homes. As a result, person-centred dementia care, in which the person comes first, is highly relevant for long-term care. This approach is increasingly replacing traditional models of care and is considered a quality indicator for dementia-specific long-term care. Various guidelines or national standards in Germany, such as the expert standard for relationship management in the care of people with dementia, demand the implementation of this approach. Administrators of nursing homes are encouraged to operationalize person-centred dementia care for their nursing homes and to implement this approach in daily practice. International studies show that internal policies and guidelines for person-centred dementia care can provide orientation and support for nursing staff in their daily practice. At the same time, they can facilitate the implementation of this approach in dementia-specific long-term care. Internal policies and guidelines are often used synonymously with the terms guidelines, standards or written procedural instructions.
In order to measure and describe the existence of internal policies and facility-specific guidelines for person-centred behavior management of people with dementia, Barbara Resnick and colleagues developed the American "Assessment of Policies for Person-Centred Management of BPSD". Since no comparable assessment exists for the German context, the "Assessment of Policies for Person-Centred Management of BPSD" was used by the DZNE to develop the Dementia Policy Questionnaire (DemPol-Q). This instrument aims to record person-centred care approaches in nursing homes in Germany.
The Dementia Policy Questionnaire (DemPol-Q) is an instrument (questionnaire) that aims to assess the existence of internal policies and guidelines for person-centred dementia care in nursing homes in Germany. The instrument contains 19 dichotomous items. We translated and cross-cultural adapted 14 items from the "Assessment of Policies for Person-Centred Management of BPSD" by Barbara Resnick and colleagues. In addition, we developed five items of the DemPol-Q based on literature recommendations, focusing on the assessment of internal policies for the implementation of non-pharmacological interventions. The DemPol-Q is a measurement to apply to organizational level in nursing homes that provide dementia-specific care and to track progress in the implementation process of person-centred dementia care.
We first used the instrument from June to December 2020 in a national survey study with a randomized sample of 134 nursing homes. Subsequently, we conducted an exploratory secondary data analysis to determine whether the DemPol-Q represents the intended construct of person-centred dementia care in nursing homes.
The aim of the project is to further develop and specify the DemPol-Q in order to be able to use it as a valid and reliable instrument in German nursing homes that provide dementia care. This is necessary to enable nursing homes to deal with internal policies and guidelines for person-centred dementia care.
We use the data set of the national survey study to investigate to which extent and why the existence of internal policies on person-centred dementia care in dementia-specific care unit types in nursing homes in Germany differs. Furthermore, we will investigate how differences between dementia-specific care unit types correspond to the respective concepts of the care units. We will use these results to prepare focus group discussions with experts on person-centred dementia care from practice and research for further development of the DemPol-Q. Together with these experts, we will examine and discuss the significance of person-centred dementia care in nursing homes in Germany, its operationalization, and its translation in internal policies. With the results of the focus group discussions it is possible to specify existing items of the DemPol-Q and to generate new items. We want to investigate, how experts assign the specified and newly generated items to aspects of person-centred dementia care. Therefore, the items will subsequently be sorted and grouped by participants of the focus group discussions using concept mapping. We will examine the further developed DemPol-Q with regard to content validity. In a final step, we will examine the DemPol-Q with regard to reliability.
The DemPol-Q allows solid statements about (1) the degree of implementation of person-centred dementia care and (2) the relevance of internal policies for the implementation of person-centred dementia care in nursing homes in Germany. The further developed DemPol-Q can be applied in the internal quality management of nursing homes as well as in the development of new dementia-specific care concepts in nursing homes in Germany. Therefore, the DemPol-Q contributes to the sustainable implementation of person-centred care.