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dc.contributor.authorDe Poli, C.
dc.contributor.authorOyebode, Jan R.
dc.contributor.authorAiroldi, M.
dc.contributor.authorGlover, R.
dc.date.accessioned2020-10-19T21:39:59Z
dc.date.accessioned2020-11-03T16:06:48Z
dc.date.available2020-10-19T21:39:59Z
dc.date.available2020-11-03T16:06:48Z
dc.date.issued2020-07
dc.identifier.citationDe Poli C, Oyebode J, Airoldi M et al (2020) A need-based, multi-level, cross-sectoral framework to explain variations in satisfaction of care needs among people living with dementia. BMC Health Services Research. 20: 657.en_US
dc.identifier.urihttp://hdl.handle.net/10454/18149
dc.descriptionYesen_US
dc.description.abstractBACKGROUND: Provision of care and support for people with dementia and family carers is complex, given variation in how dementia manifests, progresses and affects people, co-morbidities associated with ageing, as well as individual preferences, needs, and circumstances. The traditional service-led approach, where individual needs are assessed against current service provision, has been recognised as unfit to meet such complexity. As a result, people with dementia and family members often fail to receive adequate support, with needs remaining unmet. Current research lacks a conceptual framework for explaining variation in satisfaction of care needs. This work develops a conceptual framework mapped onto the care delivery process to explain variations in whether, when and why care needs of people with dementia are met and to expose individual-, service-, system-level factors that enable or hinder needs satisfaction. METHODS: Data collected through 24 in-depth interviews and two focus groups (10 participants) with people with dementia and family carers living in the North East of England (UK) were analysed thematically to develop a typology of care needs. The need most frequently reported for people with dementia (i.e. for support to go out and about) was analysed using themes stemming from the conceptual framework which combined candidacy and discrepancy theories. RESULTS: The operationalisation of the framework showed that satisfaction of the need to go out was first determined at the point of service access, affected by issues about navigation, adjudication, permeability, users' resistance to offers, users' appearance, and systems-level operating conditions, and, subsequently, at the point of service use, when factors related to service structure and care process determined (dis)satisfaction with service and, hence, further contributed to met or unmet need. CONCLUSION: The conceptual framework pinpoints causes of variations in satisfaction of care needs which can be addressed when designing interventions and service improvements.en_US
dc.description.sponsorshipWe gratefully acknowledge financial support from the Health Foundation (grant number 1274233).en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1186/s12913-020-05416-xen_US
dc.rights© The Author(s). 2020 Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.en_US
dc.subjectDementiaen_US
dc.subjectCare needsen_US
dc.subjectConceptual frameworksen_US
dc.subjectSatisfactionen_US
dc.subjectInterventionsen_US
dc.subjectService improvementsen_US
dc.titleA need-based, multi-level, cross-sectoral framework to explain variations in satisfaction of care needs among people living with dementiaen_US
dc.status.refereedYesen_US
dc.date.Accepted2020-06-09
dc.date.application2020-07-15
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.date.updated2020-10-19T20:40:04Z
refterms.dateFOA2020-11-03T16:07:24Z


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