Comparing occupational adaptation-based and traditional educational programs for dementia care teams: An embedded mixed methods study
McKay, Mary Heather
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Abstract With growing demand for an effective dementia care workforce, attention is shifting from disseminating knowledge of proven care strategies to considering knowledge transfer frameworks that help interdisciplinary teams implement knowledge in practice. Occupational Adaptation (OA) is a theoretical framework used by occupational therapists to support clients’ ability to respond to real-world challenges through an active problem-solving process (Schkade & Schultz, 1992). Applied in educational program development for dementia care teams, this framework includes relative mastery, in which teams evaluate their actions based on effectiveness, efficiency, and satisfaction to self and others (George, Schkade, & Ishee, 2004). Added to the OA-specific outcome, an OA-based program for teams also targets team development. To investigate whether an OA-based educational program improves a dementia care team’s relative mastery and team development more than a skills-based program, this study compared effectiveness of each program and explored participants’ experiences. A quasi-experimental embedded mixed methods design drove concurrent collection of quantitative and qualitative data, analyzing each separately first, then merging for mixed comparisons. In the quasi-experiment phase, 28 employees were divided into two equally blended groups for nine-week educational programs in one continuing care retirement community in North Carolina. Quantitative data was collected using two surveys pre-, mid-, and post-intervention and analyzed using a 3(time)x2(group) analysis of variance. Qualitative data from the 28 direct participants and 7 key informants was analyzed using a descriptive qualitative approach to produce an accounting of the events. Results of the two data sets were merged to deepen understanding of both programs and clarify exemplar and exception cases. Quantitative results show, as expected, the OA-based group experienced significantly greater improvement in relative mastery and team development than the control group. Qualitative findings describe how participants’ actions, behaviors, and perceptions differed when merely learning about dementia care versus engaging in a collaborative process of occupational adaptation. The mixed comparison results elucidate how the OA-based program achieved better results for the team, but did not work for everyone. I recommend a larger mixed methods study to further examine an OA-based program’s effects for other dementia care teams, including its costs and benefits to organizations.