Open Access Study protocol

Grip on challenging behaviour: a multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol

Sandra A Zwijsen1*, Martin Smalbrugge1, Sytse U Zuidema2, Raymond TCM Koopmans2, Judith E Bosmans3, Maurits W van Tulder3, Jan A Eefsting1, Debby L Gerritsen2 and Anne-Margriet Pot145

Author Affiliations

1 Department of Nursing Home Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands

2 Department of Primary and Community Care: Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

3 Department of Health Sciences/EMGO + Institute for Health and Care Research, VU University, Amsterdam, The Netherlands

4 Department of Clinical Psychology, Faculty of Psychological and Educational Sciences, VU University, Amsterdam, The Netherlands

5 Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

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BMC Health Services Research 2011, 11:41  doi:10.1186/1472-6963-11-41

Published: 21 February 2011



Behavioural problems are common in nursing home residents with dementia and they often are burdensome for both residents and nursing staff. In this study, the effectiveness and cost-effectiveness of a new care programme for managing behavioural problems will be evaluated.


The care programme is based on Dutch national guidelines. It will consist of four steps: detection, analysis, treatment and evaluation. A stepped wedge design will be used. A total of 14 dementia special care units will implement the care programme. The primary outcome is behavioural problems. Secondary outcomes will include quality of life, prescription rate of antipsychotics, use of physical restraints and workload and job satisfaction of nursing staff. The effect of the care programme will be estimated using multilevel linear regression analysis. An economic evaluation from a societal perspective will also be carried out.


The care programme is expected to be cost-effective and effective in decreasing behavioural problems, workload of nursing staff and in increasing quality of life of residents.

Trial registration

The Netherlands National Trial Register (NTR). Trial number: NTR 2141