The development of the Promoting Independence in Dementia (PRIDE) intervention to enhance independence in dementia
2019
Objective: Support after a diagnosis of dementia may facilitate better adjustment and
ongoing management of symptoms. The aim of the Promoting Independence in Dementia
(PRIDE) study was to develop a postdiagnostic social intervention to help people live as well
and as independently as possible. The intervention facilitates engagement in evidence-based
stimulating cognitive, physical and social activities.
Methods: Theories to promote adjustment to a dementia diagnosis, including theories of
social learning and self-efficacy, were reviewed alongside self-management and the selective
optimization model, to form the basis of the intervention. Analyses of two longitudinal
databases of older adults, and qualitative analyses of interviews of older people, people with
dementia, and their carers about their experiences of dementia, informed the content and
focus of the intervention. Consensus expert review involving stakeholders was conducted to
synthesize key components. Participants were sourced from the British NHS, voluntary
services, and patient and public involvement groups. A tailored manual-based intervention
was developed with the aim for this to be delivered by an intervention provider.
Results: Evidence-based stimulating cognitive, physical, and social activities that have been
shown to benefit people were key components of the proposed PRIDE intervention. Thirty-two
participants including people with dementia (n=4), carers (n=11), dementia advisers (n=14), and
older people (n=3) provided feedback on the drafts of the intervention and manual. Seven topics
for activities were included (eg, “making decisions” and “getting your message across”). The
manual outlines delivery of the intervention over three sessions where personalized profiles and
plans for up to three activities are developed, implemented, and reviewed.
Conclusion: A manualized intervention was constructed based on robust methodology and
found to be acceptable to participants. Consultations with stakeholders played a key role in
shaping the manualized PRIDE intervention and its delivery. Unlike most social interventions for
dementia, the target audience for our intervention is the people with dementia themselves.
Keywords: self-management, public patient involvement, behavior change, manual,
cognitive impairment
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