Enhancing healthcare professionals' confidence in ethical decision-making when caring for people with dementia: A qualitative evaluation of the CARE intervention

Aim(s): To evaluate the impact of the CARE intervention on healthcare professionals' perceived confidence levels and understand the factors influencing confidence in ethical decision-making in dementia care. Design: Thematic analysis of post-intervention focus-group interviews. Methods: Twelve focus-group interviews were conducted post-intervention with nurses and other healthcare professionals providing direct caregiving for people with dementia in a Danish municipality. Braun and Clarke's framework guided thematic analysis, which assessed the participants' perceived influence of the CARE intervention on their confidence and gained insights into the factors perceived by participants as impacting confidence in ethical decision-making. Results: Analysis revealed five themes across two overarching domains: the perceived influence of the CARE intervention on healthcare professionals' confidence and factors impacting their confidence. While the intervention reinforced confidence for many, some reported no change due to pre-existing high confidence levels. Factors contributing to confidence included reassurance of ethical practice, peer dialogue, family interaction, and critical reflection, underscoring the importance of peer support and dialogue in bolstering ethical confidence in dementia care. Conclusion: This study presents findings on the CARE intervention's impact on enhancing healthcare professionals' confidence in ethical decision-making in dementia care and offers insights on the potential of peer interaction and support in bolstering ethical confidence.