Percorrer por autor "Hoti, Kreshnik"
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- Barriers and strategies for pain management in non-verbal people with dementia in residential care facilities : protocol for an e-Delphi studyPublication . Félix, Isa Brito; Ramos, Catarina; Guerreiro, Rui; Hughes, Jeffery David; Hoti, Kreshnik; Andrade, Teresa; Guerreiro, Mara PereiraIntroduction: Pain is a prevalent symptom in people living with dementia. Evidence shows that pain frequently remains unrecognised and untreated in this vulnerable population, leading to avoidable suffering. Effective pain management is hindered by multifactorial barriers at the individual, organisational and policy level. This study aims to achieve expert consensus on the key barriers to pain management in non-verbal people living with dementia and strategies to address these barriers within Portuguese residential care facilities. Methods and analysis: An e-Delphi study will be conducted using two rounds of online questionnaires. The Behaviour Change Wheel (BCW) framework guided the development of e-Delphi statements by linking identified determinants (i.e., barriers and facilitators) to intervention functions. Barriers were extracted from the literature reviews and mapped into the capability, opportunity and motivation–behaviour model. Intervention functions were then selected using the BCW linkage matrices and operationalised into practical strategies. A purposive and snowball sampling approach will be used to recruit a heterogeneous panel of experts across national residential care facilities, including nurses, physicians, managers and policymakers with relevant experience in dementia. During the e-Delphi rounds, participants will be invited to rate the relevance of each barrier and associated strategy(ies) on a five-point Likert scale and provide comments or suggestions. Consensus will be defined as ≥75% agreement on each statement. Ethics and dissemination: Ethical approval for this study was obtained from the Egas Moniz Ethics Committee (Ref. 1586), and all procedures will comply with the Declaration of Helsinki. Informed consent will be obtained from all participants. The findings will be disseminated through a peer-reviewed publication, scientific events and stakeholder networks, including residential care facilities, to inform future practice and policy in dementia care.
- Protocol for a usability and pilot implementation study of a digital medical device to assess pain in non-verbal people with dementia in Portuguese residential care facilitiesPublication . Guerreiro, Mara Pereira; Félix, Isa Brito; Tomé, Morgane; Hoti, Kreshnik; Ramos, Catarina; Dias, Beatriz; Andrade, Teresa; Brito, José; Hughes, JeffObjective: People living with moderate to severe dementia (PLWD) are often unable to self-report pain. This matter is of particular concern given that up to 80% experience chronic pain. Mistreated or untreated pain in PLWD is associated with symptoms such as agitation and aggression, and unnecessary use of antipsychotic agents. Further, it can also engender mental burden in formal caregivers. The PainChek® App, a regulatory cleared class I medical device, enables the assessment and monitoring of pain in people who cannot verbalise it, such as those with moderate to severe dementia. To date there are no data on the real-world use of the PainChek® App in Portugal. To address this gap, we report the protocol of a pilot study, which combines usability evaluation and implementation research. Methods: Usability evaluation of the PainChek® (Portuguese) App will be guided by the ISO framework, focused on effectiveness, efficiency and user satisfaction. Implementation research will combine qualitative interviews to inform the implementation process, a longitudinal study of formal caregivers’ psychological variables, implementation outcomes, plus qualitative interviews to explore the ‘hows’ and ‘whys’ of implementation. The NASSS framework will be used as an implementation framework, together with the COM-B model and the Theoretical Domains Framework. Results: The usability and implementation studies have received ethics approval from the Egas Moniz Ethics Committee, under numbers 1367 and 64/24, respectively. Conclusion: This study is expected to inform the scale-up of the PainChek® (Portuguese) App in real-world settings and establish a foundation for a larger effectiveness and implementation study.