Barriers and facilitators to implementing person-centered dementia care in long-term care facilities: a qualitative meta-synthesis

Person-centered dementia care has been recognized as the gold standard for dementia care. However, implementing person-centered dementia care in long-term care facilities still faces many challenges, and there is still a lack of comprehensive analysis of barriers and facilitators from the perspective of formal caregivers. This review aims to systematically identify and synthesize qualitative evidence to explore the barriers and facilitators to implementing person-centered dementia care in long-term care facilities, thereby providing references for the development of clinical implementation plans. A systematic search was conducted databases to identify relevant primary studies from the inception of each database to September 24, 2025. The extracted data were mapped to the five domains of the updated Consolidated Framework for Implementation Research then subjected to a comprehensive analysis. A total of 21 eligible studies were included in this review, comprising 19 qualitative studies and 2 mixed-methods studies, with an overall methodological quality that was relatively high. After mapping the extracted data to the updated Consolidated Framework for Implementation Research, 49 implementation factors were identified, including 30 barrier factors and 19 facilitator factors. This review was guided by the updated Consolidated Framework for Implementation Research and systematically integrated the barriers and facilitators of implementing person-centered dementia care in long-term care facilities. Based on the results of this review, managers could understand the barriers and facilitators to implementing person-centered dementia care and develop corresponding implementation strategies to bridge the gap between evidence and practice. This review has been registered on PROSPERO (PROSPERO: CRD420251167358).