PMID- 34433600
OWN - NLM
STAT- MEDLINE
DCOM- 20210914
LR  - 20210915
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 8
DP  - 2021 Aug 25
TI  - Exploring dementia family carers' self-initiated strategies in managing 
      behavioural and psychological symptoms in dementia: a qualitative study.
PG  - e048761
LID - 10.1136/bmjopen-2021-048761 [doi]
LID - e048761
AB  - OBJECTIVES: Carer's self-initiated management strategies of behavioural and 
      psychological symptoms of dementia (BPSD) can inform intervention development. 
      These strategies are affected by cultural values. Little is known about 
      non-Western dementia carers' BPSD management strategies. This study aimed to 
      explore self-initiated strategies in managing BPSD adopted by Chinese carers. 
      DESIGN: Qualitative study using thematic framework method. SETTING: Community 
      setting in Hong Kong. PARTICIPANTS: 16 dementia carers with purposive sampling to 
      include carers of different relationships to the people living with dementia 
      (PLwD), education level and living arrangement. RESULTS: Six overarching themes 
      emerged from the data: (1) maintaining personhood in PLwD, (2) responding 
      positively to BPSD, (3) explanation and bargaining, (4) responding negatively to 
      BPSD, (5) controlling upsetting thoughts, and (6) getting respite care. Chinese 
      carers treasured warm and supportive family relationships. They identified and 
      minimised triggers to alleviate BPSD. Some carers struggled with care tasks and 
      reacted with confrontation and avoidance. Changing attitudes and getting social 
      and emotional support were described to manage carers' distress. Few self-care 
      strategies including getting respite care were reported. CONCLUSIONS: Carers' 
      self-initiated strategies largely aligned with existing theoretical frameworks in 
      BPSD management, such as person-centred approach, and echoed Asian culture, which 
      advocates filial piety and supportive family relationships. While these cultural 
      values encourage the engagement of people living with dementia in the normal 
      process of family life, they may also prevent carers from taking time away from 
      care. Interventions could support carers by enhancing their knowledge and skills 
      in managing BPSD, providing social and emotional support, and providing guidance 
      in self-care. Future cross-cultural research could explore factors contributing 
      to how carers manage BPSD and how interventions could be culturally adapted to 
      facilitate carers to apply learnt skills in daily practice and hence benefit the 
      people living with dementia and carer population.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Leung, Dara K Y
AU  - Leung DKY
AUID- ORCID: 0000-0002-7255-2790
AD  - Social Work and Social Administration, Hong Kong University, Hong Kong.
FAU - Wong, Kayla K Y
AU  - Wong KKY
AD  - Social Work and Social Administration, Hong Kong University, Hong Kong.
FAU - Spector, Aimee
AU  - Spector A
AD  - Department of Clinical, Educational and Health Psychology, UCL, London, UK.
FAU - Wong, Gloria H Y
AU  - Wong GHY
AUID- ORCID: 0000-0002-1331-942X
AD  - Social Work and Social Administration, Hong Kong University, Hong Kong 
      ghywong@hku.hk.
LA  - eng
PT  - Journal Article
DEP - 20210825
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Behavioral Symptoms
MH  - *Caregivers
MH  - *Dementia
MH  - Family Relations
MH  - Humans
MH  - Qualitative Research
PMC - PMC8388289
OTO - NOTNLM
OT  - dementia
OT  - depression & mood disorders
OT  - qualitative research
OT  - schizophrenia & psychotic disorders
COIS- Competing interests: None declared.
EDAT- 2021/08/27 06:00
MHDA- 2021/09/15 06:00
PMCR- 2021/08/25
CRDT- 2021/08/26 05:36
PHST- 2021/08/26 05:36 [entrez]
PHST- 2021/08/27 06:00 [pubmed]
PHST- 2021/09/15 06:00 [medline]
PHST- 2021/08/25 00:00 [pmc-release]
AID - bmjopen-2021-048761 [pii]
AID - 10.1136/bmjopen-2021-048761 [doi]
PST - epublish
SO  - BMJ Open. 2021 Aug 25;11(8):e048761. doi: 10.1136/bmjopen-2021-048761.