ArticlePloS one2018
How can a measure improve assessment and management of symptoms and concerns for people with dementia in care homes? A mixed-methods feasibility and process evaluation of IPOS-Dem.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Implementing patient-centred outcome measures in palliative care clinical practice. An updated systematic review of facilitators and barriers.BMC palliative care · 2026Pooled it
- Needs-based triggers for timely referral to palliative care for older adults severely affected by noncancer conditions: a systematic review and narrative synthesis.BMC palliative care · 2023Pooled it
- Interventions promoting family involvement with care homes following placement of a relative with dementia: A systematic review.Dementia (London, England) · 2022Pooled it
- Managing clinical uncertainty in older people towards the end of life: a systematic review of person-centred tools.BMC palliative care · 2021Pooled it
- Pooled it
- The effect of community-based palliative supportive care integrated with primary health care (PHC) on the outcomes of terminally ill cancer patients.BMC primary care · 2025Trial
- A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT.Health technology assessment (Winchester, England) · 2020Trial
- Palliative Home Care Based on Clinically Relevant Scientific Measures: A Cross-Sectional Study.The American journal of hospice & palliative care · 2025Article
- Internal consistency and structural validity of the Swiss easy-read Integrated Palliative Care Outcome Scale for People with dementia: a secondary exploratory factor analysis.BMC palliative care · 2025Article
- Article
- Co-Designing a Palliative Dementia Care Framework to Support Holistic Assessment and Decision Making: The EMBED-Care Framework.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Co-design of the EMBED-Care Framework as an intervention to enhance shared decision-making for people affected by dementia and practitioners, comprising holistic assessment, linked with clinical decision support tools: A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Understanding the extent to which PROMs and PREMs used with older people with severe frailty capture their multidimensional needs: A scoping review.Palliative medicine · 2024Article
- Inter-rating reliability of the Swiss easy-read integrated palliative care outcome scale for people with dementia.PloS one · 2023Article
- Primary care contacts, continuity, identification of palliative care needs, and hospital use: a population-based cohort study in people dying with dementia.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Translation and cultural adaptation of the Integrated Palliative care Outcome Scale for Dementia (IPOS-Dem) to Swedish.BMC nursing · 2022Article
- Integrated Palliative Outcome Scale for People with Dementia: easy language adaption and translation.Journal of patient-reported outcomes · 2022Article
- How do person-centered outcome measures enable shared decision-making for people with dementia and family carers?-A systematic review.Alzheimer's & dementia (New York, N. Y.) · 2022Review
- A cross-sectional assessment of symptom burden among patients with advanced cervical cancer.BMC palliative care · 2021Article
- Improving caring quality for people with dementia in nursing homes using IPOS-Dem: A stepped-wedge cluster randomized controlled trial protocol.Journal of advanced nursing · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessment of people with dementia is challenging; with undetected and under treated symptoms and concerns resulting in avoidable distress, and few evidence-based interventions to support this. We aimed to understand the mechanisms of action of a measure to support comprehensive assessment of people with dementia in care homes; and its acceptability, feasibility, and implementation requirements.
methodsA qualitative study with an embedded quantitative component in three residential care homes, underpinned by an initial theoretical model of mechanisms of action. The measure, the Integrated Palliative care Outcome Scale for Dementia (IPOS-Dem), was introduced into the care of residents with dementia for 12 weeks. Qualitative data comprised focus groups and semi-structured interviews with family, care home staff, general practitioners and district nurses; and non-participant observations. Quantitative data comprised IPOS-Dem data. Directed content analysis for qualitative data, and descriptive statistics were used for quantitative data.
findingsKey mechanisms of action were: improved observation and awareness of residents, collaborative assessment, comprehensive 'picture of the person', systematic record keeping, improved review and monitoring, care planning and changes to care provision, and facilitated multi-agency communication. Potential benefit included improved symptom management, improved comprehensive care, and increased family empowerment and engagement. IPOS-Dem was found to be acceptable and feasible. It was perceived as quick and easy to use, with proportion of overall missing data decreasing from 2.1% to 1.1% from baseline to final time points. 'Trust' in the measure was important; and leadership essential to ensure integration into care processes.
conclusionsIn a population with complex care needs, with challenges to assessment and barriers to multi-agency working, a measure introduced into routine care is feasible and acceptable, and supports assessment and management of symptoms and concerns. A refined theoretical model demonstrating the likely mechanisms of action was developed. Further evaluation is required to test its effectiveness.
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