Insight into dementia care management using social-behavioral theory and mixed methods

Area of Science:

• Gerontology
• Health Services Research
• Psychology

Background:

• Effective care management is crucial for health organizations to improve patient outcomes and resource efficiency.
• Identifying and quantifying care-management activities and their overarching domains is essential for program advancement.

Purpose of the Study:

• To apply mixed methods, including qualitative statistical techniques and factor analysis, to identify domains of dementia care management.
• To construct variables for exploratory factor analysis based on a theoretical framework.

Main Methods:

• Extracted care-management activity data from 181 dementia care plans.
• Utilized card-sorting methods and theoretical constructs (self-efficacy, general strain theory) to categorize activities.
• Employed principal components extraction and varimax/promax rotations for factor analysis, assessing reliability with Cronbach's alpha.

Main Results:

• A two-phase card-sorting technique identified 45 activity types from 450 unique activities.
• Exploratory factor analysis revealed four distinct care-management domains: behavior management, clinical strategies and caregiver support, community agency, and safety.
• Internal consistency reliability (Cronbach's alpha) for the identified domains ranged from 0.63 to 0.89.

Conclusions:

• A systematic methodology can identify a concise set of higher-order domains for understanding dementia care management.
• These identified domains can guide the understanding and optimization of dementia care-management processes.
• Further research is needed to test the methodology's practicality in outcome analyses and diverse datasets.