Who Responds Positively? Examining Factors Associated With Benefits From Exposure to the Individualized Positive Psychosocial Interaction (IPPI) Program.

OBJECTIVES

The Individualized Positive Psychosocial Interaction (IPPI) program is a person-centered intervention that has demonstrated positive effects on mood and behavioral expressions of distress for nursing home (NH) residents. This study sought to identify demographic and clinical factors associated with positive response to IPPI.

DESIGN

An embedded pragmatic clinical trial of IPPI was completed, whereby NH staff were trained in emotion-focused communication skills and how to conduct short and individualized, preference-based interactions (ie, IPPIs) 2 times per week for 6 months with persons living with dementia with current documentation of behavioral or depressive symptoms.

SETTING AND

PARTICIPANTS

Within 7 NHs owned or managed by 1 long-term care organization, 130 residents were enrolled in the IPPI program.

METHODS

We created a rate of positive response variable that computed the percentage of completed IPPIs that resulted in maintenance of a positive mood or improved mood for a resident. We examined the association (correlations and regression) of demographic and clinical attributes with positive response; we accounted for the number of IPPIs completed.

RESULTS

On average, 82% of IPPIs (SD, 21%) per person resulted in a positive response (ie, stable positive or improved mood). Positive response was associated with greater ability to make onseself understood and an ability to understand others, less incontinence (urinary and bowel), and greater functional ability. After accounting for the count of IPPIs a person completed, regression models indicate unique associations of making oneself understood and functional ability (self-care) with IPPI-positive response.

CONCLUSIONS AND IMPLICATIONS: Findings suggest that individuals who are more clinically complex (ie, communication challenges, incontinence, and functional disability) may be less likely to consistently respond positively to IPPIs. Individuals with clinical risk factors might need additional support to maximize positive impact.