Methods

Design

The efficacy and cost-effectiveness of the implemented MCSP will be evaluated by means of a controlled trial (pretest-posttest control group design with matched patient-carer dyads; 75 dyads in the experimental group and 75 dyads in the control group).

Data will be collected at baseline and after 7 months of support.

 

Assessment instruments

Background information will be collected for all participants. To determine the severity of the dementia the Reisberg’s Global Deterioration Scale (Reisberg, 1982) will be used.

 

The outcome measures for the person with dementia are the Neuropsychiatric inventory (NPI Cummings et al., 1994), Cornell scale for depression in dementia (Alexopoulos et al, 1988), the Duke Social Support Index (George et al. 1989), the Stigma Impact Scale, the subscale self-esteem of the DQOL (Brod et al., 1999), and the QOL-AD (Logsdon, et al., 1999).

 

The outcome measure for the carers is the short Sense of Competence Scale (Vernooij-Dassen et al, 1999). For evaluation of the cost-effectiveness data will be collected on: service use, psychotropic medication, admissions into a hospital and into a long term care setting.

 

In order to assess the opinions of the people with dementia and their carers on the support they receive, all new participants in the support programme who agree to take part in the study will be interviewed by means of a questionnaire after three and six months of participation. Moreover a qualitative evaluation approach will be applied in each meeting center by means of separate focus groups for people with dementia and carers to explore their experiences with the MCSP.

 

For the process analysis quantitative and qualitative research methods will be used. Based on a theoretical model that was developed (Meiland et al., 2004, 2005) to trace facilitating and impeding factors in the implementation of the MCSP in the Netherlands, a questionnaire will be composed to inventory facilitators and barriers of successful implementation of the MCSP in the participating countries on a micro (primary process), meso (organization) and macro level (laws and regulations, funding). This questionnaire will also record characteristics of the innovation itself. Also, in each participating country data will be collected from key figures in the implementation process, who are selected by means of ‘purposive sampling’ (Barbour, 1999). The collected data will be analysed for each country and overall (international). Besides these quantitative data also written material obtained from the minutes and reports of the initiative groups will be analysed qualitatively to inventory facilitators and barriers of implementation.