Causal Influence of Linguistic Learning on Perceptual and Conceptual Processing: A Brain-Constrained Deep Neural Network Study of Proper Names and Category Terms.

Language influences cognitive and conceptual processing, but the mechanisms through which such causal effects are realized in the human brain remain unknown. Here, we use a brain-constrained deep neural network model of category formation and symbol learning and analyze the emergent model's internal mechanisms at the neural circuit level. In one set of simulations, the network was presented with similar patterns of neural activity indexing instances of objects and actions belonging to the same categories. Biologically realistic Hebbian learning led to the formation of instance-specific neurons distributed across multiple areas of the network, and, in addition, to cell assembly circuits of "shared" neurons responding to all category instances-the network correlates of conceptual categories. In two separate sets of simulations, the network learned the same patterns together with symbols for individual instances ["proper names" (PN)] or symbols related to classes of instances sharing common features ["category terms" (CT)]. Learning CT remarkably increased the number of shared neurons in the network, thereby making category representations more robust while reducing the number of neurons of instance-specific ones. In contrast, proper name learning prevented a substantial reduction of instance-specific neurons and blocked the overgrowth of category general cells. Representational similarity analysis further confirmed that the neural activity patterns of category instances became more similar to each other after category-term learning, relative to both learning with PN and without any symbols. These network-based mechanisms for concepts, PN, and CT explain why and how symbol learning changes object perception and memory, as revealed by experimental studies.

Designing tailored maintenance strategies for systematic reviews and clinical practice guidelines using the Portfolio Maintenance by Test-Treatment (POMBYTT) framework.

BACKGROUND: Organizations face diverse contexts and requirements when updating and maintaining their portfolio, or pool, of systematic reviews or clinical practice guidelines they need to manage. We aimed to develop a comprehensive, theoretical framework that might enable the design and tailoring of maintenance strategies for portfolios containing systematic reviews and guidelines. METHODS: We employed a conceptual approach combined with a literature review. Components of the diagnostic test-treatment pathway used in clinical healthcare were transferred to develop a framework specifically for systematic review and guideline portfolio maintenance strategies. RESULTS: We developed the Portfolio Maintenance by Test-Treatment (POMBYTT) framework comprising diagnosis, staging, management, and monitoring components. To illustrate the framework's components and their elements, we provided examples from both a clinical healthcare test-treatment pathway and a clinical practice guideline maintenance scenario. Additionally, our literature review provided possible examples for the elements in the framework, such as detection variables, detection tests, and detection thresholds. We furthermore provide three example strategies using the framework, of which one was based on living recommendations strategies. CONCLUSIONS: The developed framework might support the design of maintenance strategies that could contain multiple options besides updating to manage a portfolio (e.g. withdrawing and archiving), even in the absence of the target condition. By making different choices for variables, tests, test protocols, indications, management options, and monitoring, organizations might tailor their maintenance strategy to suit specific contexts and needs. The framework's elements could potentially aid in the design by being explicit about the operational aspects of maintenance strategies. This might also be helpful for end-users and other stakeholders of systematic reviews and clinical practice guidelines.

The influence of language on the formation of number concepts: Evidence from preschool children who are bilingual in English and Arabic.

We asked whether grammatical number marking has specific influence on the formation of early number concepts. In particular, does comprehension of dual case marking support young children's understanding of cardinality? We assessed number knowledge in 77 3-year-old Arabic-English bilingual children using the Give-a-Number task in both languages. Given recent concerns around the administration and scoring of the Give-a-Number task, we used two complementary approaches: one based on conceptual levels and the other based on overall test scores. We also tested comprehension of dual case marking in Arabic and number sequence knowledge in both languages. Regression analyses showed that dual case comprehension exerts a strong influence on cardinality tested in Arabic independent of age, general language skills, and number sequence knowledge. No such influence was found for cardinality tested in English, indicating a language-specific effect. Further analyses tested for transfer of cardinality knowledge between languages. These revealed, in addition to the findings outlined above, a powerful cross-linguistic transfer effect. Our findings are consistent with a model in which the direct effect of dual case marking is language specific, but concepts, once acquired, may be represented abstractly and transferred between languages.

Concept analysis of health system resilience.

BACKGROUND: There are several definitions of resilience in health systems, many of which share some characteristics, but no agreed-upon framework is universally accepted. Here, we review the concept of resilience, identifying its definitions, attributes, antecedents and consequences, and present the findings of a concept analysis of health system resilience. METHODS: We follow Schwarz-Barcott and Kim's hybrid model, which consists of three phases: theoretical, fieldwork and final analysis. We identified the concept definitions, attributes, antecedents and consequences of health system resilience and constructed an evidence-informed framework on the basis of the findings of this review. We searched PubMed, PsycINFO, CINAHL Complete, EBSCOhost-Academic Search and Premier databases and downloaded identified titles and abstracts on Covidence. We screened 3357 titles and removed duplicate and ineligible records; two reviewers then screened each title, and disagreements were resolved by discussion with the third reviewer. From the 130 eligible manuscripts, we identified the definitions, attributes, antecedents and consequences using a pre-defined data extraction form. RESULTS: Resilience antecedents are decentralization, available funds, investments and resources, staff environment and motivation, integration and networking and finally, diversification of staff. The attributes are the availability of resources and funds, adaptive capacity, transformative capacity, learning and advocacy and progressive leadership. The consequences of health system resilience are improved health system performance, a balanced governance structure, improved expenditure and financial management of health and maintenance of health services that support universal health coverage (UHC) throughout crises. CONCLUSION: A resilient health system maintains quality healthcare through times of crisis. During the coronavirus disease 2019 (COVID-19) epidemic, several seemingly robust health systems were strained under the increased demand, and services were disrupted. As such, elements of resilience should be integrated into the functions of a health system to ensure standardized and consistent service quality and delivery. We offer a systematic, evidence-informed method for identifying the attributes of health system resilience, intending to eventually be used to develop a measuring tool to evaluate a country's health system resilience performance.

An interview study about how nurses and physicians talk about the same concepts differently.

BACKGROUND: How healthcare professionals understand and use concepts of social and cognitive capabilities will influence their behaviour and their understanding of others' behaviour. Differing understandings of concepts might lead to healthcare professionals not acting in accordance with other healthcare professionals' expectations. Therefore, part of the problem concerning errors and adverse incidents concerning social and cognitive capabilities might be due to varying understandings of concepts among different healthcare professionals. This study aimed to examine the variations in how educators at the Copenhagen Academy for Medical Education and Simulation talk about social and cognitive capabilities. METHODS: The study was conducted using semi-structured interviews and directed content analysis. The codes for the analysis process were derived from existing non-technical skills models and used to show variations in how the participants talk about the same concepts. RESULTS: Educators with a background as nurses and physicians, talked differently about leadership and decision-making, with the nurses paying greater attention to group dynamics and external factors when describing both leadership and decision-making, whereas physicians focus on their individual efforts. CONCLUSION: We found patterned differences in how the participants described leadership and decision-making that may be related to participants' professional training/background. As it can create misunderstandings and unsafe situations if nurses and physicians disagree on the meaning of leadership and decision-making (without necessarily recognising this difference), it could be beneficial to educate healthcare professionals to be aware of the specificity of their own concepts, and to communicate what exactly they mean by using a particular concept, e.g. "I want you to coordinate tasks" instead of "I want better leadership".

Concept analysis of Neonatal Near Miss.

OBJECTIVE: To analyze the concept of Neonatal Near Miss (NNM) using Walker and Avant's method. METHOD: This study employs conceptual analysis following Walker and Avant's model, involving concept selection, objective definition, identification of potential uses, determination of attributes, model case creation, additional case consideration, antecedent identification, consequent analysis, and empirical reference examination. To elucidate the concept, a scoping review was conducted across journals indexed in scientific databases such as Web of Science, EMBASE, SCOPUS, and MEDLINE/PubMed. RESULTS: The analysis encompassed 43 articles, revealing diverse definitions of neonatal near miss across different contexts. A comprehensive definition emerged from identified antecedents: risk of death, susceptibility to adverse outcomes, and potential adverse events. These antecedents were categorized into maternal conditions, neonatal conditions, and healthcare assistance. CONCLUSION: The analysis and definition of the NNM concept was successful, and its antecedents, attributes, and consequences were delineated. IMPLICATIONS: Identifying the risk factors associated with NNM cases may contribute to reducing infant morbidity and mortality and improving the quality of care, facilitating future research and improving the use of the NNM concept.

Retrieving Rare Cases: A Protocol for Searching Complex Medical Cases.

This study sought to provide a protocol for searching complex medical cases of grand rounds. A clinical informationist was embedded in gastroenterology grand rounds to use comprehensive search strategies and summarize patients' information through concept mapping. Our proposed protocol classifies into three categories: (1) The general search strategy, (2) The protocol for searching for evidence about rare diseases, and (3) Identifying other resources more than routine medical databases. This approach represents a novel method beyond previous studies which were focused on usual ward rounds to facilitate evidence-based decision-making by providing and simplifying a comprehensive summary view of complex medical cases.

A concept analysis of cultural competence in nursing: A hybrid model approach.

BACKGROUND: Cultural competence is considered one of the criteria for high-quality nursing care. AIM: This study aimed to analyse cultural competence in nursing. METHODS: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi-structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. RESULTS: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient- and justice-oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. CONCLUSION: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care.

Researcher practitioner engagement in health research: The development of a new concept.

The engagement of frontline practitioners in the production of research-derived knowledge is often advocated. Doing so can address perceived gaps between what is known from research and what happens in clinical practice. Engagement practices span a continuum, from co-production approaches underpinned by principles of equality and power sharing to those which can minimalize practitioners' contributions to the knowledge production process. We observed a conceptual gap in published healthcare literature that labels or defines practitioners' meaningful contribution to the research process. We, therefore, aimed to develop the concept of "Researcher Practitioner Engagement" in the context of academically initiated healthcare research in the professions of nursing, midwifery, occupational therapy, physiotherapy, and speech and language therapy. Guided by Schwartz-Barcott et al.'s hybrid model of concept development, published examples were analyzed to establish the attributes, antecedents, and consequences of this type of engagement. Academic researchers (n = 17) and frontline practitioners (n = 8) with relevant experience took part in online focus groups to confirm, eliminate, or elaborate on these proposed concept components. Combined analysis of theoretical and focus group data showed that the essence of this form of engagement is that practitioners' clinical knowledge is valued from a study's formative stages. The practitioner's clinical perspectives inform problem-solving and decision-making in study activities and enhance the professional and practice relevance of a study. The conceptual model produced from the study findings forms a basis to guide engagement practices, future concept testing, and empirical evaluation of engagement practices.

Crisis leadership: An evolutionary concept analysis.

AIM: The purpose of this study was to define crisis leadership in the nursing context. BACKGROUND: Leadership during critical situations is perhaps the most crucial element for crisis resolution. METHODS: Rodgers' evolutionary approach was used to conduct a concept analysis on crisis leadership and find its critical attributes, antecedents, and consequences. The researchers examined articles published in English and Korean from six databases. Articles from 2000 to 2016-with the key terms of crisis leadership, crisis management, crisis intervention, crisis, and disaster-were considered for analysis. Eleven studies were included in the final review. RESULTS: The core attributes of crisis leadership from a nursing perspective consisted of six attributes: clear, fast, frank communication; a high degree of collaboration; sharing of information; decision-making and fair prioritization; building trust; competency. CONCLUSIONS: Based on this review, crisis leadership should be revised to focus on competency, nursing interventions, measurement tools, and training protocol development.

The nurse without a nurse: the antecedents of presenteeism in nursing.

BACKGROUND: Presenteeism describes the state in which staff who lack the conditions for being present at work and need rest and leave for various reasons (such as illness, low spirits, fatigue, etc.) are present at the workplace. Due to the lack of knowledge about the antecedents of presenteeism in nurses and the context-based nature of this concept, the present study was conducted to explain the reasons for presenteeism in nurses. METHODS: This qualitative study was performed using the qualitative content analysis method. The study population consisted of 17 nurses working in different wards of hospitals. In this regard, data were collected from February to June 2020 using individual, face-to-face, in-depth, semi-structured interviews and were analyzed using qualitative content analysis. RESULTS: The nurse without a nurse was a category introduced as an antecedent of presenteeism. In this respect, nurses experienced limited power, injustice, compulsory presence, inadequate structural facilities, damaged professional identity, manager-nurse disconnect, insufficient knowledge, physical and mental health complications, job stress, job burnout, multitasking, and impaired communication. CONCLUSION: The nurse, who has been responsible for caring, supporting, advising, advocating, and educating the patient, has now been left without a nurse. In other words, not nursing the nurse has given rise to the emergence of presenteeism. It is recommended that the results of this study be used in making health policies. The results of this study can make nurses' voices heard by health leaders and managers. A voice that has never been heard as it deserves.

Prerequisite Skills in Cognitive Testing: Innovations in theory and recommendations for practice.

Testing cognitive skill development is important for diagnostic, prognostic, and monitoring purposes, especially for young children and individuals with neurodevelopmental disorders. Developmental tests have been created for infants and toddlers, while traditional IQ tests are often employed beginning in the later preschool period. However, IQ tests rely on developmental skills that are rapidly changing during early childhood. Here, we introduce the idea of prerequisite skills in developmental domains, which are discrete skills required for, but not explicitly tested by, traditional IQ tests. Focusing on general cognition, particularly among children with a chronological or mental age under 4 years, may fail to capture important nuances in skill development. New skill-based assessments are needed in general, and in particular for categorization, which is foundational to higher-order cognitive skills. Novel measures quantifying categorization skills would provide a more sensitive measure of development for young children and older individuals with low developmental levels.

Social participation in occupational therapy: Is it possible to establish a consensus?

BACKGROUND: Social participation has been incorporated by occupational therapists in Brazil, and worldwide, as a professional concept to guide practice. The concept has been studied, defined, and constructed from multiple fields of knowledge and can be defined as the social and political involvement of people in social groups and /or public and community spaces. There are different understandings of social participation in occupational therapy and the objective of this study was to explore how Brazilian occupational therapists define social participation in their fields of knowledge. METHOD: Through application of the Delphi technique, Brazilian occupational therapy academics and professionals who have worked in the state of São Paulo, Brazil, collaboratively responded to an online questionnaire. In the consultation phase, occupational therapists wrote their conceptions about social participation and, in the consensus phase, expressed their opinions and judgements, in order to, in a collective construction, establish a consensus on the definition of social participation. RESULTS: In the first round of the consensus phase, 38 academics and 27 professionals participated and in the second round, 20 and 14, respectively. Results were analysed quantitatively, through the establishment of degrees of agreement for conceptions arranged in statements. Then, six categories of analysis were built, which identified the multiple ways of understanding social participation: social participation and social interactions, social participation and freedom of movement, social participation as an experience in public and political life, social participation and human activities, social participation and the process of social inclusion, and social participation in the fields of knowledge and practice in occupational therapy. CONCLUSION: There are theoretical-conceptual differences in the understandings and uses of social participation in occupational therapy that delimit specificity and design the identities of the profession in society. The need to discuss knowledge production, accumulation, and dissemination and practices is debated.

Historic concepts of dementia and Alzheimer's disease: From ancient times to the present.

The aim of this work is to describe the history of dementia and Alzheimer's disease (AD) concepts, from early descriptions in antiquity, through studies and authors from different historical periods throughout the centuries, to the latest updates of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The article also presents the inclusion of the biomarkers from the cerebrospinal fluid, such as Tau and phosphorylated Tau proteins and beta-amyloid peptide in the most recent diagnostic criteria. A literature search was carried out in order to construct a reflexive narrative review of studies dated up to 2015 in the LILACS and Medline databases and with the inclusion of bibliographical references of the area. The different terms used throughout the history of the dementia and Alzheimer's disease concepts were contextualized according to the scientific perspective of a given epoch and its way of producing and reproducing knowledge. The concepts of dementia and AD continue to evolve, largely due to their complexity. Considering the importance and the growth of AD cases in the last and the next decades, this review may contribute in practice with the historical knowledge of the concepts related to dementia and AD.

Exploring Heterogeneity on the Wisconsin Card Sorting Test in Schizophrenia Spectrum Disorders: A Cluster Analytical Investigation.

OBJECTIVES: The Wisconsin Card Sorting Test (WCST) is a complex measure of executive function that is frequently employed to investigate the schizophrenia spectrum. The successful completion of the task requires the interaction of multiple intact executive processes, including attention, inhibition, cognitive flexibility, and concept formation. Considerable cognitive heterogeneity exists among the schizophrenia spectrum population, with substantive evidence to support the existence of distinct cognitive phenotypes. The within-group performance heterogeneity of individuals with schizophrenia spectrum disorder (SSD) on the WCST has yet to be investigated. A data-driven cluster analysis was performed to characterise WCST performance heterogeneity. METHODS: Hierarchical cluster analysis with k-means optimisation was employed to identify homogenous subgroups in a sample of 210 schizophrenia spectrum participants. Emergent clusters were then compared to each other and a group of 194 healthy controls (HC) on WCST performance and demographic/clinical variables. RESULTS: Three clusters emerged and were validated via altered design iterations. Clusters were deemed to reflect a relatively intact patient subgroup, a moderately impaired patient subgroup, and a severely impaired patient subgroup. CONCLUSIONS: Considerable within-group heterogeneity exists on the WCST. Identification of subgroups of patients who exhibit homogenous performance on measures of executive functioning may assist in optimising cognitive interventions. Previous associations found using the WCST among schizophrenia spectrum participants should be reappraised. (JINS, 2019, 25, 750-760).

Non-specialist palliative care: A principle-based concept analysis.

BACKGROUND: Building palliative care capacity among all healthcare practitioners caring for patients with chronic illnesses, who do not work in specialist palliative care services (non-specialist palliative care), is fundamental in providing more responsive and sustainable palliative care. Varying terminology such as 'generalist', 'basic' and 'a palliative approach' are used to describe this care but do not necessarily mean the same thing. Internationally, there are also variations between levels of palliative care which means that non-specialist palliative care may be applied inconsistently in practice because of this. Thus, a systematic exploration of the concept of non-specialist palliative care is warranted. AIM: To advance conceptual, theoretical and operational understandings of and clarity around the concept of non-specialist palliative care. DESIGN: The principle-based method of concept analysis, from the perspective of four overarching principles, such as epistemological, pragmatic, logical and linguistic, were used to analyse non-specialist palliative care. DATA SOURCES: The databases of CINAHL, PubMed, PsycINFO, The Cochrane Library and Embase were searched. Additional searches of grey literature databases, key text books, national palliative care policies and websites of chronic illness and palliative care organisations were also undertaken. CONCLUSION: Essential attributes of non-specialist palliative care were identified but were generally poorly measured and understood in practice. This concept is strongly associated with quality of life, holism and patient-centred care, and there was blurring of roles and boundaries particularly with specialist palliative care. Non-specialist palliative care is conceptually immature, presenting a challenge for healthcare practitioners on how this clinical care may be planned, delivered and measured.

Self-stigma among Korean patients with diabetes: A concept analysis.

AIMS AND OBJECTIVES: To conduct a concept analysis of self-stigma among patients with diabetes and introduce an operational definition of self-stigma. BACKGROUND: Due to fears of being monitored, patients with diabetes often conceal their disease and/or withdraw from social relationships. These behaviours negatively affect patients' self-care and socialisation. DESIGN: A concept analysis was conducted using a three-phase (theoretical phase, fieldwork phase and final analysis phase) hybrid method by Schwartz-Barcott and Kim (Nursing research methodology: Issues and implementations, 1986, Rockville, MD: Aspen). METHODS: During the theoretical phase, a literature search was conducted using PubMed and CINAHL. Using COREQ guidelines, in the fieldwork phase, in-depth interviews were conducted with nine participants with diabetes. The recorded data were analysed using a grounded theory approach. Results from both were included in the analytic phase. RESULTS: In the fieldwork phase, nine patients with diabetes (four men and five women; mean age = 57.00 ± 21.93 years) participated in the interview. The mean duration of diabetes was 21.44 ± 12.39 years. The self-stigma concept included three categories with nine attributes: affective (negative feelings and feeling sorry for others who have concerns about me), cognitive (low self-esteem and self-efficacy, perceived weakness, low expectations for the future, worry for children and disease burden) and behavioural factors (social withdrawal and avoiding disease disclosure). The nine attributes included 23 indicators. CONCLUSIONS: Self-stigma among patients with diabetes is defined as a state in which patients develop negative self-feelings as they deal with the disease. This can cause diminished self-esteem and self-efficacy, as well as a tendency to avoid disclosing the illness along with social withdrawal. RELEVANCE TO CLINICAL PRACTICE: Based on this self-stigma concept analysis, we clarified the attributes of diabetes self-stigma and distinguished it from social stigma in nurse professionals during patient education and clinical assessment.

Conspiracy of Silence in Palliative Care: A Concept Analysis.

BACKGROUND AND AIM: With chronic diseases on the rise, there is a growing demand for palliative care. The global landscape of the integration of palliative care into health-care systems is incipient, which leads to a lack of social awareness of this reality and consequently, to communication failures, particularly a conspiracy of silence. The aim of this study was to analyze the concept of conspiracy of silence in palliative care. MATERIALS AND METHODS: Walker and Avant method of concept analysis was used. Review and synthesis of literature supported the analysis process. Forty-seven articles were analyzed. RESULTS: Results showed that the conspiracy of silence in palliative care is a communication failure, typical of limited life expectancy prognosis, and involves patients, their families, and health-care teams. Lack of autonomy, overburden, family malfunctioning and coping, and health-care dehumanization are consequences of the conspiracy of silence in palliative care. CONCLUSIONS: The present study had found that scales to measure this concept as well as interventions that consider important factors in the communication process in palliative care identified in this analysis are needed.

Multi-stakeholder perspectives in defining health-services quality in cataract care.

OBJECTIVE: To develop a method to define a multi-stakeholder perspective on health-service quality that enables the expression of differences in systematically identified stakeholders' perspectives, and to pilot the approach for cataract care. DESIGN: Mixed-method study between 2014 and 2015. SETTING: Cataract care in the Netherlands. PARTICIPANTS: Stakeholder representatives. INTERVENTION(S): We first identified and classified stakeholders using stakeholder theory. Participants established a multi-stakeholder perspective on quality of cataract care using concept mapping, this yielded a cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined in a plenary stakeholder session. MAIN OUTCOME MEASURE(S): Stakeholders and multi-stakeholder perspective on health-service quality. RESULTS: Our analysis identified seven definitive stakeholders, as follows: the Dutch Ophthalmology Society, ophthalmologists, general practitioners, optometrists, health insurers, hospitals and private clinics. Patients, as dependent stakeholders, were considered to lack power by other stakeholders; hence, they were not classified as definitive stakeholders. Overall, 18 stakeholders representing ophthalmologists, general practitioners, optometrists, health insurers, hospitals, private clinics, patients, patient federations and the Dutch Healthcare Institute sorted 125 systematically collected indicators into the seven following clusters: patient centeredness and accessibility, interpersonal conduct and expectations, experienced outcome, clinical outcome, process and structure, medical technical acting and safety. Importance scores from stakeholders directly involved in the cataract service delivery process correlated strongly, as did scores from stakeholders not directly involved in this process. CONCLUSIONS: Using a case study on cataract care, the proposed methods enable different views among stakeholders concerning quality dimensions to be systematically revealed, and the stakeholders jointly agreed on these dimensions. The methods helped to unify different quality definitions and facilitated operationalisation of quality measurement in a way that was accepted by relevant stakeholders.

[Stability of home based care arrangements for people with dementia : Development of a consensus definition of stability using expert focus groups]. / Stabilität von häuslichen Versorgungsarrangements für Menschen mit Demenz : Entwicklung und Konsentierung einer Definition von Stabilität durch Expertenfokusgruppen.

BACKGROUND: The majority of people with dementia in Germany live at home. These informal care arrangements, which are mostly coordinated by informal carers, are the backbone of home-based dementia care. Creating and maintaining stability is an underlying theme in informal care; however, a definition of the complex phenomenon of 'stability' in this context is still lacking. AIM: The aim was to develop a working definition of stability of home-based care arrangements for people with dementia, which can be applied in current and future research projects at the German Center for Neurodegenerative Diseases in Witten (DZNE Witten) and others. MATERIAL AND METHODS: Ensuing from prior research a preliminary version of the definition was formulated. This definition was discussed in a focus group of scientific experts with expertise in dementia research and care (n = 8). After data analysis using content analysis, the definition was revised during a scientific colloquium (n = 18) and a consensus was finally reached. RESULTS: There were four major themes which were considered by the experts as being relevant for the definition of stability: (1) creating and maintaining stability as a continuous adaptation process, (2) a qualitative component of stability, (3) persons with dementia and informal carers as pivotal players and (4) transitions to residential care. CONCLUSION: The working definition introduced in this article reflects the authors' understanding of the phenomenon of stability of home-based care arrangements for people with dementia. In times of increasing need for evidence-based interventions it is necessary to develop elaborated definitions of complex phenomena in order to be able to systematically evaluate the efficacy of interventions on the basis of a common understanding.