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Table 4 Major indications for the revision of the initial programme theory as implied by the results

From: Mechanisms of impact and contextual aspects of a dementia special care unit in long-term care: a process evaluation

Domain Theme Major indications for confirmation, extension and modification of the initial programme theory as implied by the results of the process evaluation
Interventions focusing on nurses Development of nurses’ skills and knowledge Confirmation: interventions for nurses increase their competence and communication skills
Modification: interventions for nurses do not reduce the strain related to dementia care but do increase self-efficacy
Extension: an increased competence of the entire team is needed so that nurses can respond flexibly and adequately to changing resident behaviours
Promotion of a positive work climate Extension: a positive work climate is regarded as being essential to maintaining a stable team, which is needed for sustainable implementation
Spatial and personnel composition of the unit Adjusted spatial structures Confirmation: spatial layout reduces stress among residents
Extension: spatial layout promotes engagement in activities and social interaction
Adjusted personnel deployment strategy “dedicated time for activities” Extension: the important role of the personnel deployment strategy in shaping the understanding of nursing and facilitating its implementation only became clear in the process evaluation; all findings regarding this theme complement the initial programme theory
Interventions focusing on residents Promotion of relaxation, engagement in activities and social interaction Confirmation: interventions focusing on residents promote relaxation, engagement in activities and social interaction
Modification: interventions focusing on residents, their mechanisms and outcomes are strongly intertwined; for example, the same intervention can promote relaxation and engagement in activity but can be experienced differently interindividually