Becoming a person again: A classic grounded theory of psychosocial intervention use with residents with dementia in long-stay care.
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This study set out to develop a theoretical understanding of staff's psychosocial intervention use with residents with dementia in long-stay care. This study applied classic grounded theory procedures. Data was collected from interviews with participants based in or associated with 9 long-term care settings: 14 residents with dementia, 19 staff nurses, 1 clinical facilitator, 7 nurse managers, 21 nursing assistants and 5 relatives. Researcher memos and applicable extant literature were also included as data. There were four phases of data collection with participant recruitment directed by theoretical sampling based upon the ongoing data analysis. All of the data was analysed through open coding, selective coding and theoretical coding to develop the core category and its properties. Constant comparative analysis produced the core category 'becoming a person again'. This core category accounts for a conceptual process comprising a cycle with four phases: balancing the influences, which accounts for the interaction of institutional and personal factors; individualising status, which accounts for individuals' capacity and inclination towards psychosocial intervention utilisation; striving to make the most of time, which accounts for staff's main concern and actual psychosocial intervention care delivery; interpreting care, which accounts for how staff reflect on and react to the psychosocial interventions delivered. Analysis showed that while participants aspired towards psychosocial intervention use, in practice a range of competing priorities should be balanced to allow psychosocial intervention use. By providing a conceptual explanation of psychosocial intervention use, this grounded theory contributes understanding of staff motivation towards educational change within the institutional context. This thesis also provides recommendations to service developers and educational researchers. It explains how institutional factors impact upon and unbalance personal inclination towards psychosocial intervention utilisation. Therefore these institutional factors should be addressed as part of any staff educational programmes if these are to result in a positive change in psychosocial intervention use.
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