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Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial

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Geertje van de Ven



The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention. Methods Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI). The secondary outcomes included residents’ neuropsychiatric symptoms (NPSs) and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects. Results 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI −2·7 to 7·6; p = 0·34). More NPSs were reported in the intervention group than in usual care (p = 0·02). Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02). There were no other significant effects. Conclusions Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect


van de Ven, G., Draskovic, I., Adang, E. M., Donders, R., Zuidema, S. U., Koopmans, R. T., & Vernooij-Dassen, M. J. (2013). Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial. PloS one, 8(7), e67325.





Conent Area

Geertje van de Ven

EWB-Related Construct

(4) quality of life
(2)Life Satisfaction
(3) Positive Affect

Study Design

Species or Study Population

(5) RCT

Sex (%Female)

residents: 75.1%
staff: 98.$%

Age (Mean, SD)

residents: 84.7, 6.3
staff: 43.0, 10.9

Younger Controls?


Longitudinal Data?


Sample Size



dementia-care mapping intervention

Ethnicity (%white)

not stated (Brazil)

Inclusion Criteria

The inclusion criteria for the residents required dementia diagnosed by an elderly-care physician according to the Diagnostic and statistical manual of mental disorders-IV criteria for dementia, approval of the elderly-care physician for inclusion, age of 65 years or more, at least one NPS, informed consent from the family of the resident, and the ability of the resident to use the common areas, such as the shared living room, for at least 4 h a day.

Exclusion Criteria

Residents with an estimated life expectancy of 6 weeks or less and those who were physically unable to spend time in common areas of the unit were not included in the study

EWB Measures

dementia-specific Quality of life: Qualidem
EuroQol 5D
General Health Questionnaire

Non-EWB Behavioral

Cohen-Mansfield Agitation Inventory,
Neuropsychiatric Inventory - Nursing Home version
Maastricht Job Satisfaction Scale for Healthcare
Questionnaire about Experience and Assessment of Work

Physiological Measures


Brain IMaging Modality

Brain IMaging Paradigm


Brain Region/Circuit


Biological Measures


Other Neural Measures

Data Availability?


Data Avalability Details


Diagnostic Measures

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