Healthcare professionals' experiences of using a biopsychosocial approach to understand behavioural and psychological symptoms of dementia: A qualitative interview study

Abstract

Background: Biopsychosocial approaches to understanding behavioural and psychological (otherwise known as "non-cognitive" or "neuropsychiatric") symptoms of dementia tend to be conducted by specialist psychology professionals. To increase service users' access to these approaches, healthcare professionals from nursing and allied health disciplines are being trained to use them. However, little is known about healthcare professionals' experiences of implementing biopsychosocial approaches in everyday practice.

Objectives: To explore nursing and allied healthcare professionals' views of using the "Newcastle Model," which is a biopsychosocial approach to understanding behavioural and psychological symptoms of dementia.

Method: Thirteen community mental healthcare professionals from nursing, social work and occupational therapy backgrounds were interviewed about their views and experiences of using the Newcastle Model to understand and work with behavioural and psychological symptoms of dementia. Data were analysed using thematic analysis.

Results: Five themes were identified. The first theme reflected the perceived positive value of taking a more psychosocial approach to understanding behavioural and psychological symptoms of dementia. The second theme reported participants' expressions of low confidence in using the approach, as well as their reported difficulties in prioritising it. The third theme highlighted the perceived time-consuming nature of the approach, and the adaptations that some staff made to increase its practicality. The fourth theme highlighted the importance of working in collaboration with those who provided direct care and support to the person with dementia. The final theme reflected participants' positive view of the effectiveness of the approach for delivering person-centred care CONCLUSION: Community healthcare professionals valued the integration of a biopsychosocial approach into their practice, although identified key implementation barriers.

Implications for practice: Formalising this approach within professional role descriptions; increasing collaborative working within multidisciplinary teams; and increasing carers' psychological understanding of dementia, are key ways in which this biopsychosocial approach could be implemented more effectively.

Keywords: clinical psychology; community healthcare; dementia; staff development.