Involvement of people with dementia is not self-evident. The aim of this study was to gain insight into the ways in which people with dementia participated in developing the DecideGuide, an interactive web tool facilitating shared decision-making in their care networks. An explanatory case study design was used when developing the DecideGuide. A secondary analysis focused on the data gathered from the participating people with dementia during the development stages: semi-structured interviews (n=23), four focus groups with a total of 18 participants, three usability tests, and a pilot study with 4 participants. Framework analysis was applied to the data. People with dementia participated especially as informants and advisors in most phases of the development. Four themes proved to be important regarding the impact of the participation by people with dementia: influence on content and design of the DecideGuide, motivation to participate, time investment, and the balance between challenge and concern. People with dementia can give essential feedback and, therefore, their contribution is valuable. Other roles than informant and advisor need to be explored. Significant participation of people with dementia takes time that should be taken into account. It is important for people with dementia to be able to reciprocate the efforts others make and to feel of significance to others.

BACKGROUND:Group living homes are a fast-growing form of nursing home care for older people with dementia. This study seeks to determine the differences in job characteristics of nursing staff in group living homes and their influence on well-being. METHODS:We examined the Job Demand Control Support (JDCS) model in relation to 183 professional caregivers in group living homes and 197 professional caregivers in traditional nursing homes. Multilevel linear regression analysis was used to study the mediator effect of the three job characteristics of the JDCS-model (demands, control and social support) on job satisfaction and three components of burnout (emotional exhaustion, depersonalization and decreased personal accomplishment). RESULTS:Demands were lower in group living homes, while control and social support from co-workers were higher in this setting. Likewise, job satisfaction was higher and burnout was lower in group living homes. Analysis of the mediator effects showed that job satisfaction was fully mediated by all three psychosocial job characteristics, as was emotional exhaustion. Depersonalization was also fully mediated, but only by control and social support. Decreased personal accomplishment was partially mediated, again only by job characteristics, control and support. CONCLUSION:This study indicates that working in a group living home instead of a traditional nursing home has a beneficial effect on the well-being of nursing staff, largely because of a positive difference in psychosocial job characteristics.