Public Defence: Bjørn Lichtwarck Bjørn Lichtwarck at Institute of Health and Society will be defending the thesis “The development and evaluation of TIME - Targeted Interdisciplinary Model for Treatment and Evaluation of Neuropsychiatric Symptoms. An effectiveness-implementation cluster randomised hybrid trial in nursing homes” for the degree of PhD (Philosophiae Doctor).

Trial Lecture – time and place

See Trial Lecture.

Adjudication committee

  • First opponent: Docent Katarina Nägga, Lund University
  • Second opponent: Professor Signe Agnes Flottorp, University of Oslo
  • Third member and chair of the evaluation committee: Professor Reidar Pedersen, University of Oslo

Chair of the Defence

Professor Bjørn Morten Hofmann, University of Oslo

Principal Supervisor

 Head of Research Sverre Bergh, Sykehuset Innlandet


Nearly all people with dementia develop neuropsychiatric symptoms (NPS). Psychotropic drugs have a modest effect and their use is associated serious side effects. There is conflicting evidence about the effectiveness of non-pharmacological interventions. TIME, developed in Norway, is an interdisciplinary assessment and reflection model based on theories from cognitive behavioural therapy and person-centred care. The first aim of the thesis was to test the effectiveness of TIME to improve agitation (primary outcome), other NPS, quality of life, and the use of drugs in residents with dementia and agitation in nursing homes. Another aim was to perform a process evaluation of the intervention to explore the experiences of nursing home staff using TIME, with an emphasis on facilitators and barriers to the implementation and on possible causal assumptions of the effects of TIME.

A 3-month cluster randomised controlled trial in 33 nursing homes (clusters) in Norway, including 229 residents with dementia and agitation, was conducted. The effectiveness of TIME at a residential level was compared to a control condition with usual care supplemented with a brief educational intervention. The process evaluation was performed using mixed methods based on five focus group interviews with the staff in the intervention group, and a quasi-experimental study with questionnaires to the staff in both groups before the intervention, six and twelve months later.

TIME significantly reduced agitation, with a possible reduction in other NPS and an improvement in quality of life, compared to the control condition. An easy-to-grasp model and an engaged leadership facilitated the implementation. TIME contributed, through a broad assessment and a systematic group reflexion, to foster a situated learning environment for the staff members as well as a new and shared knowledge about individual residents. These results should inform training programmes for care staff in Norway and internationally.

Additional information

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Published Apr. 26, 2019 1:47 PM - Last modified Apr. 26, 2019 2:12 PM