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Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience

Published online by Cambridge University Press:  27 February 2014

David Edvardsson*
School of Nursing and Midwifery, La Trobe University, Melbourne, Australia Department of Nursing, Umeå University, Umeå, Sweden
P. O. Sandman
Department of Neurobiology, Care Sciences and Society (NVS), Division of Nursing, Karolinska Institutet, Stockholm, Sweden
Lena Borell
Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
Correspondence should be addressed to: David Edvardsson, Associate Professor/Director of Nursing Research, Austin Health Clinical School of Nursing, La Trobe University, Level 4, Austin Tower, PO Box 5555, Heidelberg, Melbourne, Victoria 3084, Australia. Phone: +61 3 9496 4455. E-mail:



Person-centeredness has had substantial uptake in the academic literature on care of older people and people with dementia. However, challenges exist in interpreting and synthesizing the evidence on effects of providing person-centered care, as the person-centered components of some intervention studies are unclear – targeting very different and highly specific aspects of person-centeredness, as well as not providing empirical data to indicate the extent to which care practice was actually perceived to become more person-centered post-intervention.


The study employed a quasi-experimental, one-group pre-test–post-test design with a 12-month follow-up to explore intervention effects on person-centeredness of care and the environment (primary endpoints), and on staff strain and stress of conscience (secondary endpoints).


The intervention resulted in significantly higher scores on person-centeredness of care at follow-up, and the facility was rated as being significantly more hospitable at follow-up. A significant reduction of staff stress of conscience was also found at follow-up, which suggests that, to a larger extent, staff could provide the care and activities they wanted to provide after the intervention.


The results indicated that an interactive and step-wise action-research intervention consisting of knowledge translation, generation, and dissemination, based on national guidelines for care of people with dementia, increased the staff self-reported person-centeredness of care practice, perceived hospitality of the setting, and reduced staff stress of conscience by enabling staff to provide the care and activities they want to provide.

Research Article
Copyright © International Psychogeriatric Association 2014 

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