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The purpose of this article is to derive interventions for disturbing behaviors (e.g., physical aggression) which are found in persons with dementia. These target behaviors were conceptualized by researchers (Algase et al., 1996) as Need-Driven Dementia-Compromised Behavior (NDB). In this article, a process known as theory synthesis, in which two theories are merged and modified, is used to derive NDB interventions. Specifically, this article addresses how portions of two synthesized theories might be used to derive NDB interventions. Two theories, that of Natural Environments (NE) (from environmental psychology) and Implicit Memory (IM) (from neuroscience) are used in this theory synthesis. The process used is based on the steps described for theory synthesis by Walker and Avant (1995).
It is important to realize that in theory synthesis, the product is not merely an addition of two sets of propositions from separate theories. Rather, in this effort, certain concepts and propositions are selected from these theories and then modified and merged. In essence, several new concepts and propositions are developed in this manner. Thus, the theory synthesis process affords a fair amount of license for modifying the parent theories to produce something new - something with greater applicability to NDB. The product of such theory synthesis must be examined in the usual manner, through practice and research.
The reason theory synthesis efforts are needed is because nursing interventions for patients with NDB are few. Specifically, only one of the 433 Nursing Intervention Classifications (NIC) address dementia behavior (McCloskey & Bulechek, 1996). Likewise, Benner (1999) suggests practice "know-how" is different from, and in some ways superior to, other types of knowledge, specifically abstract theoretic knowledge alone.
In this article, abstract theoretical knowledge from two sciences separate from nursing are combined with experiential and theoretic knowledge from nursing. This synthesis of knowledge holds great potential for making disparate clinical approaches to dementia behavior more understandable to clinicians. Thus, confusing and conflicting aspects of various clinical approaches may be modified and merged to improve practice usefulness.
PRACTICE KNOWLEDGE
The original study data, re-interpreted here, were reported in the Journal of Alzheimer's Disease (Whall et al., 1997). Participants living in nursing homes had late-stage dementia with a Mini-Mental-Status Examination (IVlMSE) score of ^ 5. The MMSE (Folstein, Folstein, & McHugh, 1975)...