Research Article

Personalising Management of Behavioural and Psychological Symptoms of Dementia in Nursing Homes: Exploring the Synergy of Quantitative and Qualitative Data

Table 3

Themes and examples identified for the proximal factors (the number in the brackets indicates the code number used in thematic analysis).

Three aspects of proximal factors given in the Need-driven Dementia-compromised Behaviour modelThemes for each aspectExamples of each theme

Personal needsNegative emotional stateUnfamiliarity (1, 4, 5)
Stress (20)
Confusion (7)

Personal needsUnmet physiological needsWrong diet (10, 11)
Hunger and overeating (12)
Lack of movement (13)
Lack of sleep (14, 15)
Toilet needs (17)

Personal needsA mismatch between functional ability and performanceLack of freedom of movement (18, 19)
Break of routine (21, 22)

Physical environmentUnsuitable light levelNot enough light to see clearly (31)

Physical environmentUnsuitable sound levelToo low (23)
Too high (24, 25, 26, 27)
Echo (28, 29, 30)

Physical environmentUnsuitable temperatureToo low or high (36)

Physical environmentNumber of people in the surroundingsToo many people walking in the surroundings (32, 33, 34)
Staying by oneself in a room for too long (35)

Physical environmentSmellUnpleasant smell (37, 38)

Physical environmentWeatherLack of sunshine (3, 40)
Bad weather has a negative influence (39)

Physical environmentInterior decorationMatch personal identity (41)

Social environmentCaregiver demeanourLack of interaction with PwD (42)

Social environmentFamily visitThe contrast during and after the family visit (6)
Tiredness after a family visit (8, 51)
A family member could give more rules to PwD (49, 52)

Social environmentOther staff visitsNormally do not interact with PwD (43)

Social environmentFellow residentsRealising oneself is different from the others (48)
Disliking the behaviours of other residents (44, 45)
Physical closeness and interactions are normally negative (46, 47)