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Developing a Decision Tree to Address Behavioral and Psychological Symptoms of Dementia in the Primary Care Setting
Developing a Decision Tree to Address Behavioral and Psychological Symptoms of Dementia in...
Developing a Decision Tree to Address Behavioral and Psychological Symptoms of Dementia in the Primary Care Setting

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202103547
ISBN  
9798288807060
DDC  
610.73
저자명  
Tramel, Lolita.
서명/저자  
Developing a Decision Tree to Address Behavioral and Psychological Symptoms of Dementia in the Primary Care Setting
발행사항  
[Sl] : Yale University, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
88 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-01, Section: A.
주기사항  
Advisor: Tufano, Carissa;Iennaco, Joanne.
학위논문주기  
Thesis (D.N.P.)--Yale University, 2025.
초록/해제  
요약There are 55 million people living with dementia worldwide. In the United States, there are approximately 7.2 million people living with Alzheimer's dementia and these numbers are expected to rise. The U.S. Department of Health and Human Services (2022) identified there is a shortage of behavioral health clinicians nationwide. As the population ages, demand for behavioral health clinicians will be high and supply will remain low. Primary care providers (PCPs) will be required to see an influx of dementia patients despite finding it challenging to manage behavioral and psychological symptoms of dementia (BPSD). This DNP quality improvement project addressed this concern by developing a decision tree to manage complex and challenging behaviors in two geriatric primary care practice settings in Arizona. After a comprehensive review of the literature, the decision tree content was developed. A panel of six experts reviewed the decision tree for relevance, useability, and best practice. Five PCPs participated in the DNP project over a 10-week period. Nine patient participants were enrolled in the DNP project and four out of nine participants had pre-and-post follow-up visits and were urgent cases. Patients received an initial visit and a follow up visit within 2-8 weeks. The CGI scale was used with each use of the decision tree. Paired samples t-test examined if there was a significant change in CGI score between initial visit and follow-up visit. No statistically significant change was found, (t(3) = 1.36, p = .252), likely due to a small sample size. However, the effect size was large (Cohen's d = 1.00), suggesting with a larger power sample the change could reach statistical significance.  This DNP project identified that PCPs find the decision tree beneficial to guide their practice. The decision tree also has the potential to improve best practice among PCPs in the management of BPSD. In addition, there is a strong need for a decision tree to manage BPSD in clinical practice.  
일반주제명  
Nursing
일반주제명  
Gerontology
일반주제명  
Behavioral psychology
키워드  
Alzheimer's dementia
키워드  
Challenging behaviors
키워드  
Primary care providers
키워드  
DNP project
키워드  
Behavioral health clinicians
기타저자  
Yale University Yale University School of Nursing
기본자료저록  
Dissertations Abstracts International. 87-01A.
전자적 위치 및 접속  
로그인 후 원문을 볼 수 있습니다.

MARC

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■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a610.73
■1001  ▼aTramel,  Lolita.
■24510▼aDeveloping  a  Decision  Tree  to  Address  Behavioral  and  Psychological  Symptoms  of  Dementia  in  the  Primary  Care  Setting
■260    ▼a[Sl]▼bYale  University▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a88  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-01,  Section:  A.
■500    ▼aAdvisor:  Tufano,  Carissa;Iennaco,  Joanne.
■5021  ▼aThesis  (D.N.P.)--Yale  University,  2025.
■520    ▼aThere  are  55  million  people  living  with  dementia  worldwide.  In  the  United  States,  there  are  approximately  7.2  million  people  living  with  Alzheimer's  dementia  and  these  numbers  are  expected  to  rise.  The  U.S.  Department  of  Health  and  Human  Services  (2022)  identified  there  is  a  shortage  of  behavioral  health  clinicians  nationwide.  As  the  population  ages,  demand  for  behavioral  health  clinicians  will  be  high  and  supply  will  remain  low.  Primary  care  providers  (PCPs)  will  be  required  to  see  an  influx  of  dementia  patients  despite  finding  it  challenging  to  manage  behavioral  and  psychological  symptoms  of  dementia  (BPSD).  This  DNP  quality  improvement  project  addressed  this  concern  by  developing  a  decision  tree  to  manage  complex  and  challenging  behaviors  in  two  geriatric  primary  care  practice  settings  in  Arizona.  After  a  comprehensive  review  of  the  literature,  the  decision  tree  content  was  developed.  A  panel  of  six  experts  reviewed  the  decision  tree  for  relevance,  useability,  and  best  practice.  Five  PCPs  participated  in  the  DNP  project  over  a  10-week  period.  Nine  patient  participants  were  enrolled  in  the  DNP  project  and  four  out  of  nine  participants  had  pre-and-post  follow-up  visits  and  were  urgent  cases.  Patients  received  an  initial  visit  and  a  follow  up  visit  within  2-8  weeks.  The  CGI  scale  was  used  with  each  use  of  the  decision  tree.  Paired  samples  t-test  examined  if  there  was  a  significant  change  in  CGI  score  between  initial  visit  and  follow-up  visit.  No  statistically  significant  change  was  found,  (t(3)  =  1.36,  p  =  .252),  likely  due  to  a  small  sample  size.  However,  the  effect  size  was  large  (Cohen's  d  =  1.00),  suggesting  with  a  larger  power  sample  the  change  could  reach  statistical  significance.  This  DNP  project  identified  that  PCPs  find  the  decision  tree  beneficial  to  guide  their  practice.  The  decision  tree  also  has  the  potential  to  improve  best  practice  among  PCPs  in  the management  of  BPSD.  In  addition,  there  is  a  strong  need  for  a  decision  tree  to  manage  BPSD  in  clinical  practice.  
■590    ▼aSchool  code:  0265.
■650  4▼aNursing
■650  4▼aGerontology
■650  4▼aBehavioral  psychology
■653    ▼aAlzheimer's  dementia
■653    ▼aChallenging  behaviors
■653    ▼aPrimary  care  providers
■653    ▼aDNP  project  
■653    ▼aBehavioral  health  clinicians
■690    ▼a0569
■690    ▼a0769
■690    ▼a0384
■690    ▼a0351
■71020▼aYale  University▼bYale  University  School  of  Nursing.
■7730  ▼tDissertations  Abstracts  International▼g87-01A.
■790    ▼a0265
■791    ▼aD.N.P.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357689▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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