Exploring conditions for implementing daily monitoring of Behavioral and Psychological Symptoms of Dementia (BPSD) in dementia care: insights from a participatory design study

探索在痴呆症护理中实施痴呆症行为和心理症状(BPSD)日常监测的条件:一项参与式设计研究的启示

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Abstract

BACKGROUND: Behavioral and Psychological Symptoms of Dementia (BPSD) affect up to 90% of people living with dementia and present significant challenges for individuals, relatives, and care staff, often impacting quality of life and care provision. Despite the high prevalence and fluctuating nature, BPSD are often monitored infrequently in routine care, limiting opportunities for timely, person-centered interventions. Digital tools that support frequent and individualized symptom monitoring may help bridge this gap. METHODS: This study explored contextual factors, including barriers, facilitators, needs, and expectations, relevant to the potential implementation of Daily-BPSD, a digital tool designed to support individualized and frequent monitoring of BPSD in Swedish nursing homes. This participatory design study was conducted in two stages. Preparatory semi-structured interviews with disability care staff guided the initial design of the Daily-BPSD prototype, followed by research circles with nursing home staff and relatives. Data were analyzed thematically. RESULTS: The analysis generated six themes: (1) implementation and adoption, (2) usability and accessibility, (3) communication and collaboration, (4) value for care and people with dementia, (5) training and support, and (6) the selection and interpretation of relevant variables to monitor. The findings were interpreted in relation to established determinants of technology acceptance, providing a structured understanding of factors shaping the anticipated adoption of Daily-BPSD. CONCLUSION: Findings emphasize the need to align digital tools with everyday work routines, ensure adequate training, and address infrastructural conditions for reliable use. By outlining conditions that may enable or hinder daily monitoring of BPSD, this study contributes to the development phase of complex intervention design. It provides a foundation for further refinement and feasibility testing of Daily-BPSD in dementia care.

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