1
|
Lee K, Kim S, Liu W. Assessing eating ability and mealtime behaviors of persons living with dementia: A systematic review of instruments. Geriatr Nurs 2024; 58:76-86. [PMID: 38781628 DOI: 10.1016/j.gerinurse.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
This systematic review aimed to describe the characteristics of instruments that assess eating ability and/or mealtime behaviors in persons living with dementia, and evaluate their psychometric properties. Five databases were searched for relevant records between 1/1/1980 and 5/25/2023. Records included instruments assessing eating ability and/or mealtime behaviors of people with dementia. The psychometric quality of the instruments was evaluated using the Psychometric Assessment for Self-report and Observational Tools (PAT). 45 eligible instruments were identified from 115 records. While 38 instruments were scored as having low psychometric quality, 7 had moderate quality. Edinburgh Feeding Evaluation in Dementia (EdFED), Mealtime Difficulty Scale for older adults with Dementia (MDSD), and Dementia Hyperphagic Behavior Scale (DHBS) were scored as having the highest quality (total PAT score = 9). Further refinement of existing instruments and additional psychometric testing in larger, diverse samples will improve pragmatic use in dementia mealtime care research and practice.
Collapse
Affiliation(s)
- Kyuri Lee
- University of Iowa College of Nursing, 50 Newton Road, Iowa City, Iowa 52242, United States.
| | - Sohyun Kim
- University of Texas at Arlington College of Nursing and Health Innovation, 411 S. Nedderman Drive, Arlington, Texas 76019, United States
| | - Wen Liu
- University of Iowa College of Nursing, 50 Newton Road, Iowa City, Iowa 52242, United States
| |
Collapse
|
2
|
Vasseur D, Ipakchian Askari S, Suijkerbuijk S, Nap HH, IJsselsteijn W. Sensory, Affective, and Social Experiences with Haptic Devices in Intramural Care Practice. NURSING REPORTS 2024; 14:230-253. [PMID: 38391064 PMCID: PMC10885019 DOI: 10.3390/nursrep14010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/24/2024] Open
Abstract
Previous work has shown that technology can facilitate the communication of emotions, social touch, and social presence through haptic devices, meaning devices that provide a haptic stimulation. However, for special user groups living in long-term care facilities, such as people with dementia, the applications of these haptic devices are not apparent. The aim of this study is to understand how haptic devices can be used in intramural care facilities in times of social isolation, focusing on haptic devices that utilize haptic sensation. Five haptic devices were tested at three care facilities. Insights from this study highlight the potential of haptic devices to enhance sensory, affective, and social experiences during video calling between residents and their relatives. Moreover, the importance of the tactile sensation and form factor of haptic devices in the care context is addressed, along with insights on how to create the appropriate atmosphere during video calling.
Collapse
Affiliation(s)
- Dianne Vasseur
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
| | - Sima Ipakchian Askari
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
| | - Sandra Suijkerbuijk
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - Henk Herman Nap
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - Wijnand IJsselsteijn
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| |
Collapse
|
3
|
Rochon EA, Sy M, Phillips M, Anderson E, Plys E, Ritchie C, Vranceanu AM. Bio-Experiential Technology to Support Persons With Dementia and Care Partners at Home (TEND): Protocol for an Intervention Development Study. JMIR Res Protoc 2023; 12:e52799. [PMID: 38157239 PMCID: PMC10787328 DOI: 10.2196/52799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Alzheimer disease and related dementias are debilitating and incurable diseases. Persons with dementia and their informal caregivers (ie, dyads) experience high rates of emotional distress and negative health outcomes. Several barriers prevent dyads from engaging in psychosocial care including cost, transportation, and a lack of treatments that target later stages of dementia and target the dyad together. Technologically informed treatment and serious gaming have been shown to be feasible and effective among persons living with dementia and their care partners. To increase access, there is a need for technologically informed psychosocial interventions which target the dyad, together in the home. OBJECTIVE This study aims to develop the toolkit for experiential well-being in dementia, a dyadic, "bio-experiential" intervention for persons with dementia and their caregivers. Per our conceptual model, the toolkit for experiential well-being in dementia platform aims to target sustained attention, positive emotions, and active engagement among dyads. In this paper, we outline the protocol and conceptual model for intervention development and partnership with design and development experts. METHODS We followed the National Institutes of Health (NIH) stage model (stage 1A) and supplemented the model with principles of user-centered design. The first step includes understanding user needs, goals, and strengths. We met this step by engaging in methodology and definition synthesis and conducting focus groups with dementia care providers (N=10) and persons with dementia and caregivers (N=11). Step 2 includes developing and refining the prototype. We will meet this step by engaging dyads in up to 20 iterations of platform β testing workshops. Step 3 includes observing user interactions with the prototype. We will meet this step by releasing the platform for feasibility testing. RESULTS Key takeaways from the focus groups include balancing individualization and the dyadic relationship and avoiding confusing stimuli. As of September 2023, we have completed focus groups with providers, persons with dementia, and their caregivers. Additionally, we have conducted 4 iterations of β testing workshops with dyads. Feedback from focus groups informed the β testing workshops; data have not yet been formally analyzed and will be reported in future publications. CONCLUSIONS Technological interventions, particularly "bio-experiential" technology, can be used in dementia care to support emotional health among persons with a diagnosis and caregivers. Here, we outline a collaborative intervention development process of bio-experiential technology through a research, design, and development partnership. Next, we are planning to test the platform's feasibility as well as its impact on clinical outcomes and mechanisms of action. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52799.
Collapse
Affiliation(s)
- Elizabeth A Rochon
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Maimouna Sy
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | | | | | - Evan Plys
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Christine Ritchie
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| |
Collapse
|
4
|
Tanner A, Urech A, Schulze H, Manser T. Older Adults' Engagement and Mood During Robot-Assisted Group Activities in Nursing Homes: Development and Observational Pilot Study. JMIR Rehabil Assist Technol 2023; 10:e48031. [PMID: 38145484 PMCID: PMC10775040 DOI: 10.2196/48031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/23/2023] [Accepted: 11/15/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Promoting the well-being of older adults in an aging society requires new solutions. One resource might be the use of social robots for group activities that promote physical and cognitive stimulation. Engaging in a robot-assisted group activity may help in the slowdown of physical and cognitive decline in older adults. Currently, our knowledge is limited on whether older adults engage in group activities with humanlike social robots and whether they experience a positive affect while doing so. Both are necessary preconditions to achieve the intended effects of a group activity. OBJECTIVE Our pilot study has 2 aims. First, we aimed to develop and pilot an observational coding scheme for robot-assisted group activities because self-report data on engagement and mood of nursing home residents are often difficult to obtain, and the existing observation instruments do have limitations. Second, we aimed to investigate older adults' engagement and mood during robot-assisted group activities in 4 different nursing care homes in the German-speaking part of Switzerland. METHODS We developed an observation system, inspired by existing tools, for a structured observation of engagement and mood of older adults during a robot-assisted group activity. In this study, 85 older adult residents from 4 different care homes in Switzerland participated in 5 robot-assisted group activity sessions, and they were observed using our developed system. The data were collected in the form of video clips that were assessed by 2 raters regarding engagement (direction of gaze, posture as well as body expression, and activity) and mood (positive and negative affects). Both variables were rated on a 5-point rating scale. RESULTS Our pilot study findings show that the engagement and mood of older adults can be assessed reliably by using the proposed observational coding scheme. Most participants actively engaged in robot-assisted group activities (mean 4.19, SD 0.47; median 4.0). The variables used to measure engagement were direction of gaze (mean 4.65, SD 0.49; median 5.0), posture and body expression (mean 4.03, SD 0.71; median 4.0), and activity (mean 3.90, SD 0.65; median 4.0). Further, we observed mainly positive affects in this group. Almost no negative affect was observed (mean 1.13, SD 0.20; median 1.0), while the positive affect (mean 3.22, SD 0.55; median 3.2) was high. CONCLUSIONS The developed observational coding system can be used and further developed in future studies on robot-assisted group activities in the nursing home context and potentially in other settings. Additionally, our pilot study indicates that cognitive and physical stimulation of older adults can be promoted by social robots in a group setting. This finding encourages future technological development and improvement of social robots and points to the potential of observational research to systematically evaluate such developments.
Collapse
Affiliation(s)
- Alexandra Tanner
- School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
- City of Bern (Digital Stadt Bern), Bern, Switzerland
| | - Andreas Urech
- School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Hartmut Schulze
- School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Tanja Manser
- School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| |
Collapse
|
5
|
Rashid NLA, Leow Y, Klainin-Yobas P, Itoh S, Wu VX. The effectiveness of a therapeutic robot, 'Paro', on behavioural and psychological symptoms, medication use, total sleep time and sociability in older adults with dementia: A systematic review and meta-analysis. Int J Nurs Stud 2023; 145:104530. [PMID: 37348392 DOI: 10.1016/j.ijnurstu.2023.104530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a therapeutic robot, 'Paro', on anxiety, agitation, depression, apathy, medication use, total sleep time, and sociability among older adults with dementia. DESIGN Systematic review and meta-analysis with narrative synthesis. SETTING AND PARTICIPANTS Older adults aged 60 years and above with any form of dementia in the community, nursing homes, or care facilities. METHODS A three-step search strategy was conducted by two independent reviewers. Nine databases were searched (January 2003 to November 2022). Randomised controlled, crossover, and cluster trials on Paro for older adults with dementia published in English were included. All relevant trials were screened and assessed for risk of bias. Data were extracted using the Cochrane data collection form. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence. RESULTS In total, 12 articles involving 1461 participants were included. Results of the meta-analysis showed that Paro had a moderate effect on medication use (SMD: -0.63) and small effect on anxiety (SMD: -0.17), agitation (SMD: -0.27) and depression (SMD: -0.40). However, Paro exhibited negligible effect on total sleep time (SMD: -0.12). The overall quality of evidence for all outcomes were graded as low due to methodological limitations, small sample size, and wide confidence intervals. Narrative synthesis suggested that Paro reduced apathy and increase sociability. CONCLUSION AND IMPLICATIONS Paro could be a beneficial non-pharmacological approach to improve behavioural and psychological symptoms of dementia, reducing medication use, and increasing sociability for older adults with dementia. However, the results should be interpreted with caution as limited studies were available. Additionally, there were a variety of approaches across the studies (i.e. group and individual interventions, facilitated and non-facilitated) which made it difficult to determine which interventional approach is optimal to produce beneficial effects of Paro. Hence, more rigorous studies with a larger sample size are needed to fully understand the mechanism and effectiveness of Paro in older adults with dementia. The protocol was registered on PROSPERO (CRD42022296504).
Collapse
Affiliation(s)
- Nur Lidiya Abdul Rashid
- Major Operating Theatre Department, Woodlands Health, 2 Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore.
| | - Yihong Leow
- Emergency Medicine, Woodlands Health, 2 Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore.
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore 117597, Singapore.
| | - Sakiko Itoh
- Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore 117597, Singapore; NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, 28 Medical Drive, Singapore 117456, Singapore.
| |
Collapse
|
6
|
Esfandbod A, Rokhi Z, Meghdari AF, Taheri A, Alemi M, Karimi M. Utilizing an Emotional Robot Capable of Lip-Syncing in Robot-Assisted Speech Therapy Sessions for Children with Language Disorders. Int J Soc Robot 2023; 15:165-183. [PMID: 36467283 PMCID: PMC9684761 DOI: 10.1007/s12369-022-00946-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
This study scrutinizes the impacts of utilizing a socially assistive robot, the RASA robot, during speech therapy sessions for children with language disorders. Two capabilities were developed for the robotic platform to enhance children-robot interactions during speech therapy interventions: facial expression communication (containing recognition and expression) and lip-syncing. Facial expression recognition was conducted by training several well-known CNN architectures on one of the most extensive facial expressions databases, the AffectNet database, and then modifying them using the transfer learning strategy performed on the CK+ dataset. The robot's lip-syncing capability was designed in two steps. The first step was concerned with designing precise schemes of the articulatory elements needed during the pronunciation of the Persian phonemes (i.e., consonants and vowels). The second step included developing an algorithm to pronounce words by disassembling them into their components (including consonants and vowels) and then morphing them into each other successively. To pursue the study's primary goal, two comparable groups of children with language disorders were considered, the intervention and control groups. The intervention group attended therapy sessions in which the robot acted as the therapist's assistant, while the control group only communicated with the human therapist. The study's first purpose was to compare the children's engagement while playing a mimic game with the affective robot and the therapist, conducted via video coding. The second objective was to assess the efficacy of the robot's presence in the speech therapy sessions alongside the therapist, accomplished by administering the Persian Test of Language Development, Persian TOLD. According to the first scenario, playing with the affective robot is more engaging than playing with the therapist. Furthermore, the statistical analysis of the study's results indicates that participating in robot-assisted speech therapy (RAST) sessions enhances children with language disorders' achievements in comparison with taking part in conventional speech therapy interventions.
Collapse
Affiliation(s)
- Alireza Esfandbod
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Zeynab Rokhi
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Ali F. Meghdari
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
- Fereshtegaan International Branch, Islamic Azad University, Tehran, Iran
| | - Alireza Taheri
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
| | - Minoo Alemi
- Social and Cognitive Robotics Laboratory, Center of Excellence in Design, Robotics, and Automation (CEDRA), Sharif University of Technology, Tehran, Iran
- Department of Humanities, West Tehran Branch, Islamic Azad University, Tehran, Iran
| | | |
Collapse
|
7
|
Park K, Moon S. Informative and semantic language features of people with dementia displayed during reminiscence therapy. Psychogeriatrics 2022; 22:843-850. [PMID: 36075583 DOI: 10.1111/psyg.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/25/2022] [Accepted: 08/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Communication is essential for people with dementia (PWD) to independently perform activities of daily living. While cognitive training could improve communication abilities in PWD, there is limited evidence of the effect of reminiscence therapy (RT) on communication. Therefore, this study examines this effect, focusing on language features. METHOD This study used data from randomised controlled trials applying RT to women with dementia registered in a day-care center. RT using digital material or storytelling was conducted with PWD for 4 weeks. Outcome measures included general characteristics and communicative ability, such as the number of correct information units (CIUs, a measure of informativeness in discourse), the Holden Communication Scale (HCS) score, and verbal engagement. Repeated-measures multivariate analysis of variance and the paired t-test were performed to confirm the effect of RT on communicative ability. RESULTS There was a significant change over time in the ratio of CIUs (F = 4.35, P = 0.016). In the first 2 weeks of the intervention, there were significant differences in the ratio of CIUs (t = -3.00, P = 0.005), total HCS score (t = 2.28, P = 0.028), and conversation score (HCS subdomain) (t = 2.44, P = 0.019) between two measurement time points (T0, T1), while the number of syllables did not significantly change (t = -1.60, P = 0.117). CONCLUSIONS Informative/semantic linguistic ability was significantly increased in PWD, while the amount of discourse did not change after RT. This result may be helpful to improve effective communication with PWD and train healthcare staff working with PWD.
Collapse
Affiliation(s)
- Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, Wonju-si, Gangwon-do, South Korea
| | - SeolHwa Moon
- Research Institute of Nursing Science, Hanyang University, Seoul, South Korea
| |
Collapse
|
8
|
Cheung DSK, Wang SS, Li Y, Ho KHM, Kwok RKH, Mo SH, Bressington D. Sensory-based interventions for the immediate de-escalation of agitation in people with dementia: A systematic review. Aging Ment Health 2022:1-12. [PMID: 36073320 DOI: 10.1080/13607863.2022.2116404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: Sensory-based interventions are commonly used to reduce the occurrence of agitation in people with dementia over extended periods. However, the evidence regarding their immediate de-escalation effects is unclear. The objectives of this systematic review are to (a) identify which sensory-based interventions have been used for de-escalating agitation and (b) examine the immediate effects of these interventions on de-escalating agitation in people with dementia.Methods: A systematic review was performed in accordance with PRISMA guidelines. Data sources were identified by searching Embase, Medline, PsycINFO, and CINAHL for publications up to 2 March 2022. The de-escalating agitation effect had to be measured during the intervention or within 15 min after commencing the treatment. Only randomized controlled trials or quasi-experimental studies published in English were included.Results: Nine studies met the inclusion criteria: two randomized controlled trials, one cross-over study, and six quasi-experimental studies. All were conducted in Western countries, involving a total of 246 participants. Music-related interventions were investigated in seven studies, and a positive effect on de-escalating agitation was found, with no side-effects. All of the studies had methodological limitations, including a single group design, blinding, an insufficient sample size, and imprecisely reported results.Conclusion: There is a profound dearth of rigorous studies examining the immediate agitation de-escalating effects of sensory-based interventions on people with dementia. However, the limited evidence on music-related interventions is encouraging. More rigorous research is recommended to confirm the effects.
Collapse
Affiliation(s)
| | - Shan Shan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Robin Ka Ho Kwok
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Siu Hong Mo
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Casuarina, Northern Territory, Australia
| |
Collapse
|
9
|
Tanaka H, Umeda R, Kurogi T, Nagata Y, Ishimaru D, Fukuhara K, Nakai S, Tenjin M, Nishikawa T. Clinical utility of an assessment scale for engagement in activities for patients with moderate-to-severe dementia: additional analysis. Psychogeriatrics 2022; 22:433-444. [PMID: 35434907 DOI: 10.1111/psyg.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND We developed the assessment scale for engagement in activities (ASEA), an assessment tool used to quantify engagement in therapeutic activities for patients with moderate-to-severe dementia. In this study, we report additional analyses to confirm the viability of ASEA as a reliable measurement scale. METHODS This study included 195 patients with moderate-to-severe dementia in a psychiatric acute-phase hospital. Additional analyses based on the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist were as follows: (i) exploratory and confirmatory factor analysis; (ii) standard error of measurement (SEM), minimal detectable change (MDC) and limit of agreement (LOA); (iii) short change score from baseline to 2 weeks; and (iv) correlation to the facial expression analysis system. RESULTS Exploratory factor analysis yielded two factors. This two-factor model of ASEA exhibited an acceptable and validated model fit (comparative fit index = 0.954, Tucker Lewis index = 0.936, goodness-of-fit index = 0.927, adjusted goodness-of-fit index = 0.873, root mean square error of approximation = 0.091, standardised root mean square residual = 0.045) by confirmatory factor analysis. SEM and MDC were 1.29 and 3.80, respectively. The Bland-Altman plot for examining LOA showed no apparent fixed bias. From baseline to 2 weeks later, 129 participants were retested. The mean ASEA total score improved significantly (Wilcoxon signed-rank test; P < 0.01, effect size = 0.25) from baseline (14.30 ± 2.63) to 2 weeks later (15.00 ± 2.73). The correlation between each emotion value was calculated using Kokoro sensor, which is an affect analysis based on human facial expression data using deep learning. For the 36 video data samples, the total score and domains of arousal, interaction, and affect in ASEA were statistically significantly correlated with the emotion value of joy, engagement, and valence (Spearman rank correlation; P < 0.05). CONCLUSIONS Among the few evaluation methods specific to severe dementia, ASEA is a useful scale for quantifying and evaluating the state of engagement in therapeutic activities.
Collapse
Affiliation(s)
- Hiroyuki Tanaka
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan
| | - Ren Umeda
- Hokutokai Sawa Hospital Department of Rehabilitation, Toyonaka, Japan
| | - Tatsunari Kurogi
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan.,Hokutokai Sawa Hospital Department of Rehabilitation, Toyonaka, Japan
| | - Yuma Nagata
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daiki Ishimaru
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keita Fukuhara
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan.,Division of Occupational Therapy, Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara, Japan
| | - Shunsuke Nakai
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan
| | - Masahiro Tenjin
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan
| | - Takashi Nishikawa
- Osaka Metropolitan University Graduate School of Rehabilitation Science, Habikino, Japan.,Division of Occupational Therapy, Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara, Japan
| |
Collapse
|
10
|
Cartwright J, Roberts K, Oliver E, Bennett M, Whitworth A. Montessori mealtimes for dementia: A pathway to person-centred care. DEMENTIA 2022; 21:1098-1119. [PMID: 35259303 DOI: 10.1177/14713012211057414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examined the impact of a Montessori mealtime intervention for people living with dementia to support the mealtime experience of residents and mealtime care practices of staff in a memory support unit. The mealtime intervention was part of a broader culture change project. METHOD An observational research design was used to evaluate changes in the mealtime experience and care practices across three time points (baseline, post-implementation, maintenance), spanning 30 months. Five video recordings of the lunch time service (range: 19-32 min) were analysed. The coding protocol comprised pre-determined indicators related to accepted dimensions of person-centred care. Resident and staff behaviours were quantified across four categories: providing choice and preferences, promoting the social side of eating, supporting independence and showing respect towards residents. Staff behaviours that reflected personal enhancing actions and personal detractors were also coded during each mealtime service. RESULTS A significant increase in staff providing residents with the opportunity for choice and a subsequent significant increase in residents demonstrating choice behaviours was evident. Staff and residents both significantly increased their interactional behaviours, with greater social interaction between staff and residents. Staff further demonstrated greater support for mealtime independence that reached and maintained significance during the final two sampling points. Significant gains observed post implementation were largely maintained and, on specific measures, further increased over time. A significant increase in staff use of personal enhancing actions during mealtime care was also evident. Variability in individual staff and resident behaviour highlighted the complexity of mealtime care and culture change processes. IMPLICATIONS The study provides novel evidence to support the use of a Montessori mealtime intervention to achieve more person-centred mealtime care, and which resulted in a more respectful, enabling and social dining experience. Clinical implications and direction for future research are presented to build on these findings.
Collapse
Affiliation(s)
- Jade Cartwright
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia;1649 Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Karen Roberts
- Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia
| | - Elizabeth Oliver
- Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia
| | - Michelle Bennett
- School of Allied Health, 580091Australian Catholic University, North Sydney, Australia
| | - Anne Whitworth
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia; Curtin School of Allied Health, 1649Curtin University, Perth, WA, Australia
| |
Collapse
|
11
|
Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2022; 6:150. [PMID: 35243005 PMCID: PMC8864187.3 DOI: 10.12688/wellcomeopenres.16856.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve wellbeing for people with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate using simulation modelling analysis. Results: In study 1, the singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster tempos. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during singing compared to a baseline control. In study 2 EDA (p < 0.0001 for 14/18 data points [3 music conditions across 6 participants]) and ST (p < 0.001 for 10/18 data points) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 data points). EDA was higher during slower music (p < 0.0001 for 13/18 data points), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different music genre. Conclusions: Physiological measures provide valuable information about the experiences of people with dementia participating in musical activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures. video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
Collapse
Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
12
|
Steinert L, Putze F, Küster D, Schultz T. Predicting Activation Liking of People With Dementia. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.770492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical, social and cognitive activation is an important cornerstone in non-pharmacological therapy for People with Dementia (PwD). To support long-term motivation and well-being, activation contents first need to be perceived positively. Prompting for explicit feedback, however, is intrusive and interrupts the activation flow. Automated analyses of verbal and non-verbal signals could provide an unobtrusive means of recommending suitable contents based on implicit feedback. In this study, we investigate the correlation between engagement responses and self-reported activation ratings. Subsequently, we predict ratings of PwD based on verbal and non-verbal signals in an unconstrained care setting. Applying Long-Short-Term-Memory (LSTM) networks, we can show that our classifier outperforms chance level. We further investigate which features are the most promising indicators for the prediction of activation ratings of PwD.
Collapse
|
13
|
Lin YC, Fan J, Tate JA, Sarkar N, Mion LC. Use of robots to encourage social engagement between older adults. Geriatr Nurs 2022; 43:97-103. [PMID: 34847509 PMCID: PMC8821416 DOI: 10.1016/j.gerinurse.2021.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023]
Abstract
We designed a robotic architecture system within a commercially available socially assistive robot to engage pairs of older adults in multimodal activities over 3 weeks for 6 sessions. The study took place in two assisted living facilities. Seven pairs (14 individuals) completed the experiment. Ages ranged from 70 to 90 years with a mean age of 83.0 (± 6.1). Most were women (79%). Three adults were screened as having normal cognition, 10 had mild cognitive impairment, and 1 adult self-reported a diagnosis of Alzheimer's disease. All sessions were video recorded and analyzed using Noldus Observer XT. Individuals demonstrated high levels of both human-human interaction and human-robot interaction, but the activity influenced the type of interaction. Engagement measures (visual, verbal, behavioral) also varied by type of activity. Future studies will focus on further development of activities that can engage older adults with varying levels of cognitive impairment and apathy.
Collapse
Affiliation(s)
- Yi-Chun Lin
- At the time of the study, Research Assistant at the Ohio State University College of Nursing, Columbus OH
| | - Jing Fan
- At the time of the study, Research Assistant at Vanderbilt University Electrical and Engineering and Computer Science Department, Nashville TN
| | - Judith A. Tate
- Associate Professor, College of Nursing, Ohio State University, Columbus OH
| | - Nilanjan Sarkar
- David K. Wilson Professor of Engineering at Vanderbilt University School of Engineering; Chair of Mechanical Engineering and Professor of Electrical and Computer Science
| | - Lorraine C. Mion
- Research Professor, College of Nursing, Ohio State University, Columbus OH
| |
Collapse
|
14
|
Madsø KG, Flo-Groeneboom E, Pachana NA, Nordhus IH. Assessing Momentary Well-Being in People Living With Dementia: A Systematic Review of Observational Instruments. Front Psychol 2021; 12:742510. [PMID: 34887803 PMCID: PMC8649635 DOI: 10.3389/fpsyg.2021.742510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022] Open
Abstract
Optimizing the possibility to lead good lives is at the core of treatment and care for people with dementia. This may be monitored by assessing well-being and quality of life. However, cognitive impairment following dementia may complicate recall-based assessment with questionnaires, and proxy-ratings from family-caregivers do not correspond well to self-reports. Thus, using observational measures represents a potentially advanced option. Systematic reviews evaluating measurement properties, interpretability and feasibility of observational instruments assessing well-being in people living with dementia are lacking. Thus, this review performed systematic searches to find peer reviewed validated instruments of relevance in the databases MEDLINE, EMBASE, PsycINFO, Web of Science, CINAHL and ProQuest. Twenty-two instruments assessing well-being were included for evaluation of measurement properties based on the systematic approach of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The evaluation included risk of bias on study level, and assessment of measurement properties on instrument level including content validity, construct validity, structural validity, internal consistency, measurement invariance, cross-cultural validity, measurement error and inter-rater/intra-rater/test-retest reliability and responsiveness. Additionally, the feasibility and interpretability of the measures were evaluated. No single instrument could be recommended based on existing publications. Thus, we provide general recommendations about further assessment and development of these instruments. Finally, we describe the most promising instruments and offer guidance with respect to their implementation and use in clinical and research contexts.
Collapse
Affiliation(s)
- Kristine Gustavsen Madsø
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- NKS Olaviken Gerontopsychiatric Hospital, Bergen, Norway
| | | | - Nancy A. Pachana
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
15
|
Bradwell HL, Edwards K, Shenton D, Winnington R, Thill S, Jones RB. User-Centered Design of Companion Robot Pets Involving Care Home Resident-Robot Interactions and Focus Groups With Residents, Staff, and Family: Qualitative Study. JMIR Rehabil Assist Technol 2021; 8:e30337. [PMID: 34723825 PMCID: PMC8593804 DOI: 10.2196/30337] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/04/2021] [Accepted: 09/27/2021] [Indexed: 01/30/2023] Open
Abstract
Background Globally, pressure is increasing on health and social care resources due to the aging population and growing prevalence of dementia. Companion robots, such as Paro, demonstrate strong potential for helping reduce this pressure through reported benefits including reduced agitation, depression, loneliness, care provider burden, and medication use. However, we previously identified that user-centered design of robot pets is both essential and understudied. We observed that commonly used robot pets are poorly matched to end-user requirements, and that end users and developers of robot pets differ significantly in their perception of appropriate design. This may explain some of the contradictory outcome research and variance in results for robot pets, such as Paro. Objective In response to the literature gap, we aimed to provide user-centered insights into the design of robot pets from key stakeholders to inform future robot development and the choice of robots for real-world implementation and research. We focused on understanding user requirements. Methods We conducted a qualitative study with 65 participants from 5 care homes (26 care home residents, 29 staff members. and 10 family members). Care home residents formed groups of between 3 and 4 individuals and experienced free interactions with a range of 8 companion robots and toys, including Paro and more affordable alternatives. The robots provided had a range of esthetics, shell types, interactivity levels, and designs for comparison. Care staff and family members observed the interactions. All participants then engaged in focus groups within their stakeholder category to discuss preferences and user requirements in companion robot design. Both free interactions and focus groups were video and audio recorded, transcribed, and subjected to thematic analysis. Results Care home residents, family members, and staff were open and accepting of the use of companion robot pets, with the majority suggesting that they would keep a device for themselves or the residents. The most preferred device was the Joy for All cat, followed by the Joy for All dog. In discussions, the preferred design features included familiar animal embodiment (domestic pet), soft fur, interactivity, big appealing eyes, simulated breathing, and movements. Unfamiliar devices were more often seen as toy-like and suitable for children, producing some negative responses. Conclusions This work provides important and user-centered insights into future robot designs for care home residents by means of a comprehensive comparison with key stakeholders. This work strongly supports the use of familiar embodiment in future robot pet designs, with domestic cat and dog morphologies appearing most acceptable. The results have implications for future robot designs and the selection of robot pets for both research and real-world implementations.
Collapse
Affiliation(s)
- Hannah Louise Bradwell
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Katie Edwards
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Deborah Shenton
- Faculty of Arts and Humanities, University of Plymouth, Plymouth, United Kingdom
| | | | - Serge Thill
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Ray B Jones
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| |
Collapse
|
16
|
Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2021; 6:150. [PMID: 35243005 PMCID: PMC8864187.2 DOI: 10.12688/wellcomeopenres.16856.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
Collapse
Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
17
|
Context-Enhanced Human-Robot Interaction: Exploring the Role of System Interactivity and Multimodal Stimuli on the Engagement of People with Dementia. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00823-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractEngaging people with dementia (PWD) in meaningful activities is the key to promote their quality of life. Design towards a higher level of user engagement has been extensively studied within the human-computer interaction community, however, few extend to PWD. It is generally considered that increased richness of experiences can lead to enhanced engagement. Therefore, this paper explores the effects of rich interaction in terms of the role of system interactivity and multimodal stimuli by engaging participants in context-enhanced human-robot interaction activities. The interaction with a social robot was considered context-enhanced due to the additional responsive sensory feedback from an augmented reality display. A field study was conducted in a Dutch nursing home with 16 residents. The study followed a two by two mixed factorial design with one within-subject variable - multimodal stimuli - and one between-subject variable - system interactivity. A mixed method of video coding analysis and observational rating scales was adopted to assess user engagement comprehensively. Results disclose that when additional auditory modality was included besides the visual-tactile stimuli, participants had significantly higher scores on attitude, more positive behavioral engagement during activity, and a higher percentage of communications displayed. The multimodal stimuli also promoted social interaction between participants and the facilitator. The findings provide sufficient evidence regarding the significant role of multimodal stimuli in promoting PWD’s engagement, which could be potentially used as a motivation strategy in future research to improve emotional aspects of activity-related engagement and social interaction with the human partner.
Collapse
|
18
|
Obayashi K, Kodate N, Masuyama S. Assessing the Impact of an Original Soft Communicative Robot in a Nursing Home in Japan: Will Softness or Conversations Bring more Smiles to Older People? Int J Soc Robot 2021; 14:645-656. [PMID: 34394770 PMCID: PMC8349236 DOI: 10.1007/s12369-021-00815-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 11/07/2022]
Abstract
It has been reported that robotics-aided care can contribute to enhancing older people's social participation and quality of life in nursing homes, while simultaneously reducing the burden on care professionals at nighttime. Due to increasing demand for social care and the relative workforce shortage, it is likely that a greater number and variety of robots will be introduced and implemented in the future. While the benefits of applying robots and assistive technologies are recognized, the current limitations and weaknesses have also been identified. One of these is the difficulty associated with a user-centered design, involving older adults with impaired cognitive and sensory abilities in nursing homes. In order to overcome this challenge, a project was carried out to develop a soft and compact bedside communication robot with an input/output device, connected to existing technologies (e.g. monitoring camera, biological sensor). Drawing on the principle of gemba (deference to frontline professionals' experience, expertise and skills), users' feedback was reflected in the iterative steps of robot development. The original soft and communicative robot was introduced and its effectiveness was tested by measuring older people's reactions and changes in their behaviors and engagement levels. The article reports the development process and results of a small-scale evaluation study, comparing the impact of this original soft-type robot with and without its communicative functions. The human-robot interactions were captured on video, and the analysis revealed that while communicative robots reduced the psychosocial burden on older adults, positive emotional, verbal, visual and behavioral engagement was generated with the help of the non-verbal plush toy.
Collapse
Affiliation(s)
- Kazuko Obayashi
- Faculty of Healthcare Management, Nihon Fukushi University, Mihama, Japan
- Social Welfare Corporation Tokyo Seishin-kai, Nishitokyo, Japan
- Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan
| | - Naonori Kodate
- Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan
- School of Social Policy, Social Work and Social Justice, University College Dublin, Hanna Sheehy Skeffington Building, Belfield, Dublin 4, D04 N9Y1 Ireland
- Institute for Future Initiatives, University of Tokyo, Tokyo, Japan
- Public Policy Research Center, Hokkaido University, Sapporo, Japan
- La Fondation France-Japon, L’ École des hautes études en sciences sociales, Paris, France
| | - Shigeru Masuyama
- Universal Accessibility and Ageing Research Centre, Nishitokyo, Japan
- Traveler’s Medical Center, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
19
|
Daniel Lai LL, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
Collapse
Affiliation(s)
- L L Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
20
|
Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [PMID: 34368465 PMCID: PMC8311801 DOI: 10.12688/wellcomeopenres.16189.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 08/08/2023] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
Collapse
Affiliation(s)
- L.L. Daniel Lai
- Clinical Psychology, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong
| | - Sebastian J. Crutch
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, Royal Academy of Music, London, UK
| | - Emma Harding
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Rohan Takhar
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Nicholas Firth
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Queens Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
21
|
Walker N, Crutch SJ, West J, Jones FW, Brotherhood EV, Harding E, Camic PM. Singing and music making: physiological responses across early to later stages of dementia. Wellcome Open Res 2021; 6:150. [PMID: 35243005 PMCID: PMC8864187 DOI: 10.12688/wellcomeopenres.16856.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Music based interventions have been found to improve the wellbeing of people living with dementia. More recently there has been interest in physiological measures to provide additional information about how music and singing impact this population. Methods: This multiple-case study design explored physiological responses (heart rate-HR, electrodermal activity-EDA, movement, and skin temperature-ST) of nine people with mild-to-moderate dementia during a singing group, and six people in the later stages of dementia during an interactive music group. The interactive music group was also video recorded to provide information about engagement. Data were analysed using simulation modelling analysis. Results: The singing group showed an increase in EDA (p < 0.01 for 8/9 participants) and HR (p < 0.01 for 5/9 participants) as the session began. HR (p < 0.0001 for 5/9 participants) and ST (p < 0.0001 for 6/9 participants) increased during faster paced songs. EDA (p < 0.01 all), movement (p < 0.01 for 8/9 participants) and engagement were higher during an interactive music group compared to a control session (music listening). EDA (p < 0.0001 for 14/18 participants) and ST (p < 0.001 for 10/18 participants) increased and in contrast to the responses during singing, HR decreased as the sessions began (p < 0.002 for 9/18 participants). EDA was higher during slower music (p < 0.0001 for 13/18 participants), however this was less consistent in more interactive sessions than the control. There were no consistent changes in HR and movement responses during different styles of music. Conclusions: Physiological measures may provide valuable information about the experiences of people with dementia participating in arts and other activities, particularly for those with verbal communication difficulties. Future research should consider using physiological measures with video-analysis and observational measures to explore further how engagement in specific activities, wellbeing and physiology interact.
Collapse
Affiliation(s)
- Nina Walker
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Julian West
- Open Academy, The Royal Academy of Music, London, UK
| | - Fergal W. Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Emilie V. Brotherhood
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| | - Paul M. Camic
- Dementia Research Centre, Department of Neurodegeneration, Queen Square Institute of Neurology, University College London, London, UK
| |
Collapse
|
22
|
Daniel Lai L, Crutch SJ, West J, Harding E, Brotherhood EV, Takhar R, Firth N, Camic PM. Development of the Video Analysis Scale of Engagement (VASE) for people with advanced dementia. Wellcome Open Res 2021; 5:230. [DOI: 10.12688/wellcomeopenres.16189.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The current study sought to develop a valid, reliable and unobtrusive tablet computer-based observational measure to assess engagement of people with advanced dementia. The Video Analysis Scale of Engagement (VASE) was designed to enable the rating of moment-by-moment changes in engagement during an activity, which would be useful for both future research and current residential care. Methods: An initial version of the VASE was tested. Face validity and content validity were assessed to validate an operational definition of engagement and develop an acceptable protocol for the scale. Thirty-seven non-professional and professional volunteers were recruited to view and rate level of engagement in music activities using the VASE. Results: An inter-class coefficient (ICC) test gave a high level of rating agreement across professionals and non-professionals. However, the ICC results of within-professionals were mixed. Linear mixed modelling suggested that the types of interventions (active or passive music listening), the particular intervention session being rated, time period of video and the age of raters could affect the ratings. Conclusions: Results suggested that raters used the VASE in a dynamic fashion and that the measure was able to distinguish between interventions. Further investigation and adjustments are warranted for this to be considered a valid and reliable scale in the measurement of engagement of people with advanced dementia in a residential care setting.
Collapse
|
23
|
Re-imagining care transitions for people with dementia and complex support needs in residential aged care: using co-designed sensory objects and a focused ethnography to recognise micro transitions. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x2100043x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The concept of transition is often used in health and lifecourse research to understand a significant movement from one state or place to another. While people with dementia experience more major transitions than their peers, they are often excluded from transitional care research. This study set out to develop meaningful transitional supports for people with dementia and complex support needs who were undertaking a significant planned geographical transition from their current residential aged care facility to a new purpose-built facility. Using the language of complex support needs acknowledges that participants in this study have a breadth and depth of need, including cognitive, physical, psycho-social and communication impairments and social and cultural disadvantage associated with ageing, institutionalisation and social isolation. To support their move, Participatory Action Research was used to support the co-creation of transitional objects (personalised scarves and blankets) with 15 people with dementia, their families and care staff. Whilst these objects were useful in supporting transition, it was not in the way we imagined. Whilst our initial focus had been on supporting a significant geographical transition, rather it was four types of micro transitions in which the transitional objects were used: small physical transitions (from one place to another); social transitions (entering or exiting personal interactions); activity transitions (moving between activities); and time travel (moving between different times). Reimagining transitions from the perspective of people with dementia and complex support needs involves the recognition of the need for supports for micro as well as macro transitions. Personalised objects to support these everyday micro transitions have the potential to make the lives of people with dementia and complex support needs more manageable, meaningful and comprehensible. Reimagining transitions in dementia in this way helps us reimagine dementia itself, as a constantly fluid, dynamic and responsive series of moments which also has implications for the re-imagination of dementia care.
Collapse
|
24
|
Berenbaum R, Tziraki C, Baum R, Rosen A, Reback T, Abikhzer J, Naparstek D, Ben-David BM. Focusing on Emotional and Social Intelligence Stimulation of People With Dementia by Playing a Serious Game—Proof of Concept Study. FRONTIERS IN COMPUTER SCIENCE 2020. [DOI: 10.3389/fcomp.2020.536880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Context: Dementia is one of the top five chronic diseases, which has an overwhelming impact on patients' life quality, family, and caregivers. Currently, research relating to people with dementia (PwD) focuses on the deterioration of cognitive abilities. A more innovative approach, and the one taken by this paper, is focusing on methods to maintain and improve functionality, communication and quality of life of PwD by building on remaining capacities in the yet unexplored domain of emotional and social intelligence (ESI). The use of serious games for PwD (SG4D) aimed at building social and emotional capacity is a budding field of research.Objectives: Proof of concept that the, low cost, easy to deploy SG4D, called “My Brain Works” (MBW), co-designed with PwD, enhances ESI, based on the Bar-On ESI model.Methods: 27 PwD, clients at MELABEV dementia day center, participated in a mixed methods 12 weeks pilot, proof of concept study using a tablet SG4D co-designed with PwD. Quantitative performance data was collected automatically by the tablet during game sessions. In this paper we focus on the analysis of the qualitative and quantitative data related to ESI, observed by 10 different researchers, during each game session.Results: Quantitative data revealed: both the PwD with high and low MoCA scores had similar average ESI scores. Qualitative analysis revealed that the PwD demonstrated 9 sub-components of the Bar-On ESI Model.Conclusion: While there is no drug to stop cognitive decline associated with dementia, interventions related to ESI, on the other hand, may improve functioning and quality of life. Despite declines in cognitive abilities, our study shows that a tablet based SG4D can stimulate their ESI and evoke responses in self-awareness, empathy, social and communication capacities. Using SG4D to exercise and maintain social skills is an area that may be promising in the future and may help counter the negative effects of social isolation and loneliness. Such games, while not focusing on cognitive improvement, may also impact on cognitive functioning and help bridge the gap between caregiver and PwD. More research is needed with larger sample sizes.
Collapse
|
25
|
Maddali HT, Dixon E, Pradhan A, Lazar A. Supporting Remote Participation when Designing with People with Dementia. CSCW '20 COMPANION : CONFERENCE COMPANION PUBLICATION OF THE 2020 CONFERENCE ON COMPUTER SUPPORTED COOPERATIVE WORK AND SOCIAL COMPUTING : OCTOBER 17-21, 2020, VIRTUAL EVENT, USA. CONFERENCE ON COMPUTER-SUPPORTED COOPERATIVE WORK AND SO... 2020; 2020:335-340. [PMID: 35098257 PMCID: PMC8798922 DOI: 10.1145/3406865.3418316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Exploring accessible remote design methods has become the need of the hour for supporting participation in research and collaborative design with individuals with dementia. Existing remote design approaches face specific challenges when facilitating best practices for co-design with participants with dementia. These challenges include, enabling sensory engagement with physical design materials and prototypes and observing these interactions in a natural manner. We present a system architecture and use cases for a portable system with a range of connected devices that support real-time, embodied design activities with individuals with dementia.
Collapse
Affiliation(s)
| | - Emma Dixon
- University of Maryland College Park, MD, USA
| | | | | |
Collapse
|
26
|
Golenko X, Radford K, Fitzgerald JA, Vecchio N, Cartmel J, Harris N. Uniting generations: A research protocol examining the impacts of an intergenerational learning program on participants and organisations. Australas J Ageing 2020; 39:e425-e435. [PMID: 31919942 PMCID: PMC7687250 DOI: 10.1111/ajag.12761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 06/18/2019] [Accepted: 12/01/2019] [Indexed: 11/30/2022]
Abstract
Economic, health and social issues associated with the ageing population and the disconnect between the generations call for novel approaches to care services. Intergenerational programs are known to enhance engagement between generations, improve health and well-being and create a stronger sense of community. While the health and social benefits are well documented, little attention has been given to the operational aspects of intergenerational programs within care facilities. This paper describes the research protocol used to develop, implement and evaluate an intergenerational learning program for preschool-aged children and older people attending care services. The research focuses on five key areas: (a) impact on older people and children; (b) intergenerational learning; (c) workforce development; (d) socio-economic implications and costs; and (e) program fidelity and sustainability. Findings from this research are expected to contribute to building age-friendly communities through the development of practical operational guidelines for intergenerational learning programs to be implemented more broadly across Australia.
Collapse
Affiliation(s)
- Xanthe Golenko
- Department of Business Strategy and InnovationGriffith Business SchoolCold Coast CampusGriffith UniversityGold CoastQldAustralia
| | - Katrina Radford
- Department of Business Strategy and InnovationGriffith Business SchoolCold Coast CampusGriffith UniversityGold CoastQldAustralia
| | - Janna Anneke Fitzgerald
- Department of Business Strategy and InnovationGriffith Business SchoolCold Coast CampusGriffith UniversityGold CoastQldAustralia
| | - Nerina Vecchio
- Department of Accounting, Finance and EconomicsGriffith Business SchoolGriffith UniversityGold CoastQldAustralia
| | - Jennifer Cartmel
- School of Human Services and Social WorkGriffith UniversityLogan CityQldAustralia
| | - Neil Harris
- Public Health, School of MedicineGriffith UniversityGold CoastQldAustralia
| |
Collapse
|
27
|
Lee OE, Davis B. Adapting 'Sunshine,' A Socially Assistive Chat Robot for Older Adults with Cognitive Impairment: A Pilot Study. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:696-698. [PMID: 32635827 DOI: 10.1080/01634372.2020.1789256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Affiliation(s)
| | - Boyd Davis
- The University of North Carolina , Charlotte, North Carolina, USA
| |
Collapse
|
28
|
Ke C, Lou VWQ, Tan KCK, Wai MY, Chan LL. Changes in technology acceptance among older people with dementia: the role of social robot engagement. Int J Med Inform 2020; 141:104241. [PMID: 32739611 DOI: 10.1016/j.ijmedinf.2020.104241] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/18/2020] [Accepted: 07/25/2020] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Emerging technologies such as social robots have shown to be effective in reducing loneliness and agitation for older people with dementia. However, the acceptance of technology (specifically social robots) was found to be low for older people with dementia. The current understanding of changes in technology acceptance following direct exposure is limited and lacks rigorous study design. This study examined the change in technology acceptance after a direct interaction with a humanoid social robot (Kabochan) that was deployed for long-term care facilities' residents with dementia. METHODS The technology acceptance was assessed using randomised control trials for a time frame of 32 weeks. A total of 103 residents clinically diagnosed with dementia, with a mean age of 87.2 years (SD = 7.4), were recruited from seven long-term care facilities in Hong Kong and were randomly allocated to either Kabochan-engagement group or control group. Participants in the engagement group interacted with Kabochan in an individual, non-facilitated approach. The behavioural engagement with Kabochan was observed by care workers and recorded into constructive engagement and non-engagement. Questionnaire surveys were taken placed at pre- and post-exposure with Kabochan to measure attitudes and beliefs towards technology. The questionnaire was based on previous studies on technology acceptance and included attitudes towards technology, perceived usefulness, perceived ease of use, technology self-efficacy, technology anxiety, and facilitating conditions. RESULTS Perceived ease of use was improved at week 32 for participants who interacted with Kabochan (F = 4.239, p = 0.042) with a small effect (ηp2 = 0.043) in comparison to usual care group. Results further demonstrated that the magnitude of belief changes was related to the intensity of constructive behavioural engagement. Specifically, resident-robot behavioural engagement moderately improved attitudes towards technology (F = 11.62, p < 0.001, ηp2 = 0.11) and perceived usefulness (F = 5.75, p = 0.02, ηp2 = 0.06). CONCLUSIONS The study tentatively supports that exposure to Kabochan has potential for changing perceived ease of use but not for other beliefs and attitudes towards technology among long-term care residents with dementia. Direct engagement with a humanoid social robot might be promising in improving the perceived ease of use towards technology.
Collapse
Affiliation(s)
- Chen Ke
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong.
| | - Vivian Wei-Qun Lou
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong; Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Kelvin Cheng-Kian Tan
- Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Man Yi Wai
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong.
| | - Lai Lok Chan
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong.
| |
Collapse
|
29
|
Zhang L, Arandjelovic O, Dewar S, Astell A, Doherty G, Ellis M. Quantification of Advanced Dementia Patients' Engagement in Therapeutic Sessions: An Automatic Video Based Approach using Computer Vision and Machine Learning. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5785-5788. [PMID: 33019289 DOI: 10.1109/embc44109.2020.9176632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Most individuals with advanced dementia lose the ability to communicate with the outside world through speech. This limits their ability to participate in social activities crucial to their well-being and quality of life. However, there is mounting evidence that individuals with advanced dementia can still communicate non-verbally and benefit greatly from these interactions. A major problem in facilitating the advancement of this research is of a practical and methodical nature: assessing the success of treatment is currently done by humans, prone to subjective bias and inconsistency, and it involves laborious and time consuming effort. The present work is the first attempt at exploring if automatic (artificial intelligence based) quantification of the degree of patient engagement in Adaptive Interaction sessions, a highly promising intervention developed to improve the quality of life of nonverbal individuals with advanced dementia. Hence we describe a framework which uses computer vision and machine learning as a potential first step towards answering this question. Using a real-world data set of videos of therapeutic sessions, not acquired specifically for the purposes of the present work, we demonstrate highly promising results.
Collapse
|
30
|
Moon S, Park K. The effect of digital reminiscence therapy on people with dementia: a pilot randomized controlled trial. BMC Geriatr 2020; 20:166. [PMID: 32375661 PMCID: PMC7204054 DOI: 10.1186/s12877-020-01563-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Reminiscence therapy (RT) can improve various dysfunctions in people with dementia (PWD), but it may not be a cost-effective intervention. Digital RT allows multiple users to participate in a therapy simultaneously. Moreover, digital RT offers convenience, such as for uploading personal materials and presenting individual triggers of personal memories. This pilot study aimed to evaluate the effect of digital RT through a comparison with conventional RT and to develop a strategy for designing larger RCTs. Methods An Android application and digital content were developed for digital RT. Overall, 49 PWD enrolled in nine daycare centers in Korea met the inclusion criteria. Eight sessions of digital RT in an intervention group (n = 25) and storytelling in a control group (n = 24) with no digital materials were performed over 4 weeks from February to June 2019. Cognition, depression, behavioral and psychological symptoms of dementia (BPSD), and engagement were measured as the primary outcomes to evaluate the effect of digital RT. All outcomes except for engagement were evaluated at baseline before the intervention (T0), post-intervention (T1), and 4 weeks after the intervention (T2). Engagement was measured at the first and last intervention sessions. Differences in cognition, depression and BPSD between groups and across time points (T0, T1, and T2) were analyzed by repeated measures ANOVA. Differences in engagement between the groups and time points (the first and last sessions) were analyzed by independent t-tests. This study adhered to the CONSORT guidelines. Results Depression (F = 7.62, p = .001, partial η2 = .17) was significantly decreased at T1 and T2, and engagement (t = − 2.71, p = .011) was significantly increased at the last session in the digital RT group compared to the control group. However, cognition (F = 0.13, p = .821) and BPSD (F = 0.67, p = .485) were not significantly different between groups and time points. Conclusions Digital RT proved an innovative approach to manage PWD and will thus help PWD achieve a better mood and have more opportunities to engage in social interactions. Trial registration KCT0003446 in the Clinical Research Information Service. Registered 24 January 2019, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=14391
Collapse
Affiliation(s)
- SeolHwa Moon
- College of Nursing, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Korea
| | - Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, 150 Namwon-ro, Heungeop-myeon, Wonju-si, Gangwon-do, 26403, Korea.
| |
Collapse
|
31
|
Tierney L, Beattie E. Enjoyable, engaging and individualised: A concept analysis of meaningful activity for older adults with dementia. Int J Older People Nurs 2020; 15:e12306. [PMID: 32022414 DOI: 10.1111/opn.12306] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/22/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
AIM The term "meaningful activity" is widely used in policy, practice and the research literature. However, definition and use of the term is unclear and inconsistent. A concept analysis was conducted to explore the fundamental attributes that make an activity meaningful for older adults with dementia and propose a conceptual model for understanding "meaningful activity" in this population. METHODS This study followed Walker and Avant's method of concept analysis. Searches were conducted in the Scopus, MEDLINE, CINAHL, PubMed, Academic Search Elite and Web of Science databases for literature using the term "meaningful activity." Papers published before 1996 were excluded. RESULTS Twenty-nine papers concerned with "meaningful activity" were analysed. This analysis identified five attributes that make activities meaningful for people with dementia: (a) enjoyable; (b) suited to the individual's skills, abilities and preferences; (c) related to personally relevant goals; (d) engaging; and (e) related to an aspect of identity. The conceptual model illustrates how individual and opportunity factors influence participation in "meaningful activity" and the consequences of this participation as discussed in the existing literature. CONCLUSION The findings of this concept analysis provide insight into what characteristics make an activity meaningful. Specific activities that are meaningful are different for each person and participation in personally 'meaningful activities' has the potential to positively impact the lives of people with dementia. IMPLICATIONS FOR PRACTICE This understanding of 'meaningful activity' can be used by those involved in research, planning or delivery of services and care for people with dementia to encourage and support participation in activities that are meaningful to individuals.
Collapse
Affiliation(s)
- Laura Tierney
- Queensland University of Technology, Brisbane, Qld, Australia
| | | |
Collapse
|
32
|
Obayashi K, Masuyama S. Pilot and Feasibility Study on Elderly Support Services Using Communicative Robots and Monitoring Sensors Integrated With Cloud Robotics. Clin Ther 2020; 42:364-371.e4. [DOI: 10.1016/j.clinthera.2020.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/20/2019] [Accepted: 01/03/2020] [Indexed: 01/27/2023]
|
33
|
Kang HS, Makimoto K, Konno R, Koh IS. Review of outcome measures in PARO robot intervention studies for dementia care. Geriatr Nurs 2019; 41:207-214. [PMID: 31668459 DOI: 10.1016/j.gerinurse.2019.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study was to describe interventions for PARO, as well as the outcomes evaluated and found following use of PARO, and to identify outcome measures in PARO intervention studies for older adults with dementia. Multiple databases (Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane, and Scopus) were searched and eight studies were included in the systematic review. The review demonstrated that interventions using PARO can be beneficial for improving QOL, affect, social interaction, and reducing NPS and psychotropic or pain medication use. This study identified three domains of outcome measures used to assess the effects of interventions using the PARO robot: quality of life, biological and physiological conditions, and medical treatment.
Collapse
Affiliation(s)
- Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Rd, Dongjak-Gu, Seoul 156-756, South Korea.
| | - Kiyoko Makimoto
- School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Rie Konno
- Kansai University of International Studies, Hyogo, Japan
| | - In Soon Koh
- Department of Nursing, Andong Science College, South Korea.
| |
Collapse
|
34
|
Gerritzen EV, Hull MJ, Verbeek H, Smith AE, de Boer B. Successful Elements of Intergenerational Dementia Programs: A Scoping Review. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2019. [DOI: 10.1080/15350770.2019.1670770] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E V Gerritzen
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht, Netherlands
| | - M J Hull
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - H Verbeek
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht, Netherlands
| | - A E Smith
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - B de Boer
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht, Netherlands
| |
Collapse
|
35
|
Abbott R, Orr N, McGill P, Whear R, Bethel A, Garside R, Stein K, Thompson‐Coon J. How do "robopets" impact the health and well-being of residents in care homes? A systematic review of qualitative and quantitative evidence. Int J Older People Nurs 2019; 14:e12239. [PMID: 31070870 PMCID: PMC6766882 DOI: 10.1111/opn.12239] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Robopets are small animal-like robots which have the appearance and behavioural characteristics of pets. OBJECTIVE To bring together the evidence of the experiences of staff, residents and family members of interacting with robopets and the effects of robopets on the health and well-being of older people living in care homes. DESIGN Systematic review of qualitative and quantitative research. DATA SOURCES We searched 13 electronic databases from inception to July 2018 and undertook forward and backward citation chasing. METHODS Eligible studies reported the views and experiences of robopets from residents, family members and staff (qualitative studies using recognised methods of qualitative data collection and analysis) and the effects of robopets on the health and well-being of care home residents (randomised controlled trials, randomised crossover trials and cluster randomised trials). Study selection was undertaken independently by two reviewers. We used the Wallace criteria and the Cochrane Risk of Bias tool to assess the quality of the evidence. We developed a logic model with stakeholders and used this as a framework to guide data extraction and synthesis. Where appropriate, we used meta-analysis to combine effect estimates from quantitative studies. RESULTS Nineteen studies (10 qualitative, 2 mixed methods and 7 randomised trials) met the inclusion criteria. Interactions with robopets were described as having a positive impact on aspects of well-being including loneliness, depression and quality of life by residents and staff, although there was no corresponding statistically significant evidence from meta-analysis for these outcomes. Meta-analysis showed evidence of a reduction in agitation with the robopet "Paro" compared to control (-0.32 [95% CI -0.61 to -0.04, p = 0.03]). Not everyone had a positive experience of robopets. CONCLUSIONS Engagement with robopets appears to have beneficial effects on the health and well-being of older adults living in care homes, but not all chose to engage. Whether the benefits can be sustained are yet to be investigated. IMPLICATIONS FOR PRACTICE Robopets have the potential to benefit people living in care homes, through increasing engagement and interaction. With the robopet acting as a catalyst, this engagement and interaction may afford comfort and help reduce agitation and loneliness.
Collapse
Affiliation(s)
- Rebecca Abbott
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Noreen Orr
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Paige McGill
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Rebecca Whear
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Alison Bethel
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Ruth Garside
- European Centre for Environment and Human HealthUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Ken Stein
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Jo Thompson‐Coon
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| |
Collapse
|
36
|
Hanratty B, Craig D, Brittain K, Spilsbury K, Vines J, Wilson P. Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BackgroundFlexible, integrated models of service delivery are being developed to meet the changing demands of an ageing population. To underpin the spread of innovative models of care across the NHS, summaries of the current research evidence are needed. This report focuses exclusively on care homes and reviews work in four specific areas, identified as key enablers for the NHS England vanguard programme.AimTo conduct a rapid synthesis of evidence relating to enhancing health in care homes across four key areas: technology, communication and engagement, workforce and evaluation.Objectives(1) To map the published literature on the uses, benefits and challenges of technology in care homes; flexible and innovative uses of the nursing and support workforce to benefit resident care; communication and engagement between care homes, communities and health-related organisations; and approaches to the evaluation of new models of care in care homes. (2) To conduct rapid, systematic syntheses of evidence to answer the following questions. Which technologies have a positive impact on resident health and well-being? How should care homes and the NHS communicate to enhance resident, family and staff outcomes and experiences? Which measurement tools have been validated for use in UK care homes? What is the evidence that staffing levels (i.e. ratio of registered nurses and support staff to residents or different levels of support staff) influence resident outcomes?Data sourcesSearches of MEDLINE, CINAHL, Science Citation Index, Cochrane Database of Systematic Reviews, DARE (Database of Abstracts of Reviews of Effects) and Index to Theses. Grey literature was sought via Google™ (Mountain View, CA, USA) and websites relevant to each individual search.DesignMapping review and rapid, systematic evidence syntheses.SettingCare homes with and without nursing in high-income countries.Review methodsPublished literature was mapped to a bespoke framework, and four linked rapid critical reviews of the available evidence were undertaken using systematic methods. Data were not suitable for meta-analysis, and are presented in narrative syntheses.ResultsSeven hundred and sixty-one studies were mapped across the four topic areas, and 65 studies were included in systematic rapid reviews. This work identified a paucity of large, high-quality research studies, particularly from the UK. The key findings include the following. (1) Technology: some of the most promising interventions appear to be games that promote physical activity and enhance mental health and well-being. (2) Communication and engagement: structured communication tools have been shown to enhance communication with health services and resident outcomes in US studies. No robust evidence was identified on care home engagement with communities. (3) Evaluation: 6 of the 65 measurement tools identified had been validated for use in UK care homes, two of which provide general assessments of care. The methodological quality of all six tools was assessed as poor. (4) Workforce: joint working within and beyond the care home and initiatives that focus on staff taking on new but specific care tasks appear to be associated with enhanced outcomes. Evidence for staff taking on traditional nursing tasks without qualification is limited, but promising.LimitationsThis review was restricted to English-language publications after the year 2000. The rapid methodology has facilitated a broad review in a short time period, but the possibility of omissions and errors cannot be excluded.ConclusionsThis review provides limited evidential support for some of the innovations in the NHS vanguard programme, and identifies key issues and gaps for future research and evaluation.Future workFuture work should provide high-quality evidence, in particular experimental studies, economic evaluations and research sensitive to the UK context.Study registrationThis study is registered as PROSPERO CRD42016052933, CRD42016052933, CRD42016052937 and CRD42016052938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Barbara Hanratty
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Katie Brittain
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - John Vines
- Northumbria School of Design, Northumbria University, Newcastle upon Tyne, UK
| | - Paul Wilson
- Alliance Manchester Business School, University of Manchester, Manchester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Greater Manchester, University of Manchester, Manchester, UK
| |
Collapse
|
37
|
Khosla R, Chu MT, Khaksar SMS, Nguyen K, Nishida T. Engagement and experience of older people with socially assistive robots in home care. Assist Technol 2019; 33:57-71. [PMID: 31063044 DOI: 10.1080/10400435.2019.1588805] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Social isolation is one of the most common consequences of older people with dementia, especially for those who live at their own dwellings alone due to limited access to social activities. Research relating to the use of social robots in aged care has increasing attention to facilitating the support to care services for older people with dementia. Particularly less attention has focused on the applicability of social robots in home care services. This paper aims to study the engagement and robot experience of older people with dementia while interacting with a social robot named Betty in the context of home-based care. This paper contributes to the research relating to care service embedded robots by expanding the knowledge regarding longitudinal research in home based care, while there is limited long-term study in this context. The results show that social robots are evident to be able to engage with older people with dementia at home. Consequently, designing social robots in a social context is desirable. While the robots enabled service for the human partner within the social context is possible, there is a need to underpin the concept of personhood to realize personalization of services and its contents to suit individual preferences.
Collapse
Affiliation(s)
- Rajiv Khosla
- Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Melbourne, Australia
| | - Mei-Tai Chu
- Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Melbourne, Australia
| | | | - Khanh Nguyen
- Research Centre for Computers, Communication and Social Innovations, Department of Entrepreneurship, Innovation and Marketing, La Trobe Business School, La Trobe University, Melbourne, Australia
| | - Toyoaki Nishida
- Graduate School of Informatics, Kyoto University, Kyoto, Japan
| |
Collapse
|
38
|
Pu L, Moyle W, Jones C, Todorovic M. The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. THE GERONTOLOGIST 2019; 59:e37-e51. [PMID: 29897445 DOI: 10.1093/geront/gny046] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives Social robots may promote the health of older adults by increasing their perceived emotional support and social interaction. This review aims to summarize the effectiveness of social robots on outcomes (psychological, physiological, quality of life, or medications) of older adults from randomized controlled trials (RCTs). Research Design and Methods A mixed-method systematic review of RCTs meeting the study inclusion criteria was undertaken. Eight databases were electronically searched up to September 2017. Participants' characteristics, intervention features, and outcome data were retrieved. The mean difference and standardized mean difference with 95% confidence intervals (CI) were synthesized to pool the effect size. Results A total of 13 articles from 11 RCTs were identified from 2,204 articles, of which 9 studies were included in the meta-analysis. Risk of bias was relatively high in allocation concealment and blinding. Social robots appeared to have positive impacts on agitation, anxiety, and quality of life for older adults but no statistical significance was found in the meta-analysis. However, results from a narrative review indicated that social robot interactions could improve engagement, interaction, and stress indicators, as well as reduce loneliness and the use of medications for older adults. Discussion and Implications Social robots appear to have the potential to improve the well-being of older adults, but conclusions are limited due to the lack of high-quality studies. More RCTs are recommended with larger sample sizes and rigorous study designs.
Collapse
Affiliation(s)
- Lihui Pu
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Cindy Jones
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Michael Todorovic
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| |
Collapse
|
39
|
Moyle W, Jones C, Murfield J, Thalib L, Beattie E, Shum D, Draper B. Using a therapeutic companion robot for dementia symptoms in long-term care: reflections from a cluster-RCT. Aging Ment Health 2019; 23:329-336. [PMID: 29282989 DOI: 10.1080/13607863.2017.1421617] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We undertook a cluster-randomised controlled trial exploring the effect of a therapeutic companion robot (PARO) compared to a look-alike plush toy and usual care on dementia symptoms of long-term care residents. Complementing the reported quantitative outcomes , this paper provides critical reflection and commentary on individual participant responses to PARO, observed through video recordings , with a view to informing clinical practice and research. METHOD A descriptive, qualitative design with five participants selected from the PARO intervention arm of the trial. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). RESULTS The five participants and their responses to PARO are presented in terms of three issues: i.) Different pre-intervention clinical presentations and different responses; ii.) Same individual, different response - the need for continual assessment and review; and iii.) The ethics of giving and retrieving PARO. Implications for clinical practice and future research are discussed in relation to each issue. CONCLUSION The findings suggest that one approach does not fit all, and that there is considerable variation in responses to PARO. A number of recommendations are discussed to aid the delivery of psychosocial interventions with PARO in practice, as well as to guide future research.
Collapse
Affiliation(s)
- Wendy Moyle
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Cindy Jones
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,b School of Nursing and Midwifery, Nathan Campus, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Jenny Murfield
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia
| | - Lukman Thalib
- c Department of Public Health, College of Health Sciences , Qatar University , Qatar
| | - Elizabeth Beattie
- d School of Nursing , Queensland University of Technology , Kelvin Grove, Brisbane , Queensland , Australia
| | - David Shum
- a Menzies Health Institute Queensland, Griffith University , Nathan, Brisbane , Queensland , Australia.,e School of Applied Psychology, Mt Gravatt Campus, Griffith University , Brisbane , Queensland , Australia.,f Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China
| | - Brian Draper
- g School of Psychiatry, University of New South Wales , Sydney , Australia
| |
Collapse
|
40
|
Perugia G, van Berkel R, Díaz-Boladeras M, Català-Mallofré A, Rauterberg M, Barakova E. Understanding Engagement in Dementia Through Behavior. The Ethographic and Laban-Inspired Coding System of Engagement (ELICSE) and the Evidence-Based Model of Engagement-Related Behavior (EMODEB). Front Psychol 2018; 9:690. [PMID: 29881360 PMCID: PMC5976786 DOI: 10.3389/fpsyg.2018.00690] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/20/2018] [Indexed: 11/18/2022] Open
Abstract
Engagement in activities is of crucial importance for people with dementia. State of the art assessment techniques rely exclusively on behavior observation to measure engagement in dementia. These techniques are either too general to grasp how engagement is naturally expressed through behavior or too complex to be traced back to an overall engagement state. We carried out a longitudinal study to develop a coding system of engagement-related behavior that could tackle these issues and to create an evidence-based model of engagement to make meaning of such a coding system. Fourteen elderlies with mild to moderate dementia took part in the study. They were involved in two activities: a game-based cognitive stimulation and a robot-based free play. The coding system was developed with a mixed approach: ethographic and Laban-inspired. First, we developed two ethograms to describe the behavior of participants in the two activities in detail. Then, we used Laban Movement Analysis (LMA) to identify a common structure to the behaviors in the two ethograms and unify them in a unique coding system. The inter-rater reliability (IRR) of the coding system proved to be excellent for cognitive games (kappa = 0.78) and very good for robot play (kappa = 0.74). From the scoring of the videos, we developed an evidence-based model of engagement. This was based on the most frequent patterns of body part organization (i.e., the way body parts are connected in movement) observed during activities. Each pattern was given a meaning in terms of engagement by making reference to the literature. The model was tested using structural equation modeling (SEM). It achieved an excellent goodness of fit and all the hypothesized relations between variables were significant. We called the coding system that we developed the Ethographic and Laban-Inspired Coding System of Engagement (ELICSE) and the model the Evidence-based Model of Engagement-related Behavior (EMODEB). To the best of our knowledge, the ELICSE and the EMODEB constitute the first formalization of engagement-related behavior for dementia that describes how behavior unfolds over time and what it means in terms of engagement.
Collapse
Affiliation(s)
- Giulia Perugia
- Designed Intelligence, Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands.,Technical Research Center for Dependency Care and Autonomous Living, Automatic Control Department, Technical University of Catalonia, Vilanova i la Geltrú, Spain
| | - Roos van Berkel
- Designed Intelligence, Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marta Díaz-Boladeras
- Technical Research Center for Dependency Care and Autonomous Living, Automatic Control Department, Technical University of Catalonia, Vilanova i la Geltrú, Spain
| | - Andreu Català-Mallofré
- Technical Research Center for Dependency Care and Autonomous Living, Automatic Control Department, Technical University of Catalonia, Vilanova i la Geltrú, Spain
| | - Matthias Rauterberg
- Designed Intelligence, Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Emilia Barakova
- Designed Intelligence, Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| |
Collapse
|
41
|
Jones C, Sung B, Moyle W. Engagement of a Person with Dementia Scale: Establishing content validity and psychometric properties. J Adv Nurs 2018; 74:2227-2240. [PMID: 29772602 DOI: 10.1111/jan.13717] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/26/2022]
Abstract
AIM To develop and psychometrically test the Engagement of a Person with Dementia Scale. BACKGROUND It is important to study engagement in people with dementia when exploring the effectiveness of psychosocial interventions that can promote meaningful activity, stimulation and well-being, through an increase in positive emotions and an improvement in quality of life. The Engagement of a Person with Dementia Scale was developed based on current literature and previous research work on a video coding tool to ascertain the effect of psychosocial interventions on engagement in people with dementia. DESIGN/METHOD Using the Delphi technique, the content validity of the scale was evaluated by 15 dementia experts and formal/informal dementia carers. Psychometric properties of the scale were evaluated using 131 videos of people with dementia presented with PARO-a therapeutic, interactive, robotic seal-in long-term aged care facilities. RESULTS A 10-item scale was established following the rewording, combining and elimination of prospective items, with revisions made to the instructions for using and scoring the scale. An overall consensus with agreement for the scale was established among the panel of experts. The scale demonstrated robust internal consistency, inter-rater and test-retest reliability and convergent and discriminant validity. CONCLUSION This study successfully developed the Engagement of a Person with Dementia Scale, with established content validity and psychometric properties. The scale assesses the behavioural and emotional expressions and responses of engagement by people with dementia when partaking in a psychosocial activity in five areas: affective, visual, verbal, behavioural and social engagement.
Collapse
Affiliation(s)
- Cindy Jones
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Healthcare Practice & Surviorship Program, Menzies Health Institute Queensland, Nathan, Queensland, Australia
| | - Billy Sung
- Healthcare Practice & Surviorship Program, Menzies Health Institute Queensland, Nathan, Queensland, Australia
- Curtin Business School of Marketing, Curtin University, Perth, Western Australia, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Healthcare Practice & Surviorship Program, Menzies Health Institute Queensland, Nathan, Queensland, Australia
| |
Collapse
|
42
|
Jones C, Moyle W, Murfield J, Draper B, Shum D, Beattie E, Thalib L. Does Cognitive Impairment and Agitation in Dementia Influence Intervention Effectiveness? Findings From a Cluster-Randomized-Controlled Trial With the Therapeutic Robot, PARO. J Am Med Dir Assoc 2018; 19:623-626. [PMID: 29656838 DOI: 10.1016/j.jamda.2018.02.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To explore whether severity of cognitive impairment and agitation of older people with dementia predict outcomes in engagement, mood states, and agitation after a 10-week intervention with the robotic seal, PARO. DESIGN Data from the PARO intervention-arm of a cluster-randomized controlled trial was used, which involved individual, nonfacilitated, 15-minute sessions with PARO 3 afternoons per week for 10 weeks. SAMPLE AND PARTICIPANTS One hundred thirty-eight residents-aged ≥60 years, with dementia-from 9 long-term care facilities. MEASURES A series of stepwise multiple linear regressions were conducted. Dependent variables were participants' levels of engagement, mood states, and agitation at week 10 [assessed by video observation and Cohen Mansfield Agitation Inventory-Short Form (CMAI-SF)]. Predictor variables were baseline levels of cognitive impairment [assessed by Rowland Universal Dementia Assessment Scale (RUDAS)] and agitation (CMAI-SF). RESULTS Five models were produced. The strongest finding was that participants with more severe agitation at baseline had higher levels of agitation at week 10 (R2 = .82, P < .001). Predictors of positive response were less significant. Low levels of agitation at baseline predicted greater positive behavioral engagement with PARO (R2 = .054, P = .009) and fewer observed instances of agitation (R2 = .033, P = .045) at week 10, whereas greater visual engagement was predicted by both lower levels of agitation and cognitive impairment (R2 = .082, P = .006). Less severe cognitive impairment predicted greater pleasure at week 10 (R2 = .067, P = .004). CONCLUSIONS/IMPLICATIONS Participants with severe agitation had poor response to PARO. Lower levels of agitation and higher cognitive functioning were associated with better responses. In clinical practice, we recommend PARO should be restricted to people with low-moderate severity of agitation. Further research is needed to determine the optimal participant characteristics for response to PARO.
Collapse
Affiliation(s)
- Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Jenny Murfield
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Brian Draper
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - David Shum
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Lukman Thalib
- Department of Public Health, College of Health Sciences, Qatar University, Qatar
| |
Collapse
|
43
|
Perugia G, Diaz Doladeras M, Mallofre AC, Rauterberg M, Barakova E. Modelling engagement in dementia through behaviour. Contribution for socially interactive robotics. IEEE Int Conf Rehabil Robot 2018; 2017:1112-1117. [PMID: 28813970 DOI: 10.1109/icorr.2017.8009398] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this paper, we present a novel tool to measure engagement in people with dementia playing board games and interacting with a social robot, Pleo. We carried out two studies to reach a comprehensive inventory of behaviours accounting for engagement in dementia. The first one is an exploratory study aimed at modelling engagement in cognitive board games. The second one is a longitudinal study to investigate how people with dementia express engagement in cognitive games and in interactions with social robots. We adopted a technique coming from Ethology to mould behaviour, the ethogram. Ethogram is founded on low level behaviours, and allows hierarchical structuring. Herein, we present preliminary results consisting in the description of two ethograms and in their structuring obtained through thematic analysis. Such results show that an underlying structure of engagement exists across activities, and that different activities trigger different behavioural displays of engagement that adhere to such a structure.
Collapse
|
44
|
Perugia G, Rodríguez-Martín D, Boladeras MD, Mallofré AC, Barakova E, Rauterberg M. Quantity of Movement as a Measure of Engagement for Dementia: The Influence of Motivational Disorders. Am J Alzheimers Dis Other Demen 2017; 33:112-121. [PMID: 29148293 PMCID: PMC5784456 DOI: 10.1177/1533317517739700] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Engagement in activities is crucial to improve quality of life in dementia. Yet, its measurement relies exclusively on behavior observation and the influence that behavioral and psychological symptoms of dementia (BPSD) have on it is overlooked. This study investigated whether quantity of movement, gauged with a wrist-worn accelerometer, could be a sound measure of engagement and whether apathy and depression negatively affected engagement. Fourteen participants with dementia took part in 6 sessions of activities: 3 of cognitive games (eg, jigsaw puzzles) and 3 of robot play (Pleo). Results highlighted significant correlations between quantity of movement and observational scales of engagement and a strong negative influence of apathy and depression on engagement. Overall, these findings suggest that quantity of movement could be used as an ancillary measure of engagement and underline the need to profile people with dementia according to their concurrent BPSD to better understand their engagement in activities.
Collapse
Affiliation(s)
- Giulia Perugia
- 1 Department of Industrial Design, Eindhoven University of Technology (TU/e), Eindhoven, the Netherlands.,2 Department of Automatic Control, Technical University of Catalonia (UPC), Vilanova i la Geltrú, Barcelona, Spain
| | - Daniel Rodríguez-Martín
- 2 Department of Automatic Control, Technical University of Catalonia (UPC), Vilanova i la Geltrú, Barcelona, Spain
| | - Marta Díaz Boladeras
- 3 Department of Management, Technical University of Catalonia (UPC), Vilanova i la Geltrú, Barcelona, Spain
| | - Andreu Català Mallofré
- 2 Department of Automatic Control, Technical University of Catalonia (UPC), Vilanova i la Geltrú, Barcelona, Spain
| | - Emilia Barakova
- 1 Department of Industrial Design, Eindhoven University of Technology (TU/e), Eindhoven, the Netherlands
| | - Matthias Rauterberg
- 1 Department of Industrial Design, Eindhoven University of Technology (TU/e), Eindhoven, the Netherlands
| |
Collapse
|
45
|
Morse N, Chatterjee H. Museums, health and wellbeing research: co-developing a new observational method for people with dementia in hospital contexts. Perspect Public Health 2017; 138:152-159. [PMID: 29130813 DOI: 10.1177/1757913917737588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this article is to present a new observational tool for assessing the impacts of museum object handling for people with moderate-to-severe dementia in hospital settings, focusing on wellbeing, social interaction, level of engagement and agitation. This article presents a four-step approach to collaboration towards co-developing the tool, which involved a range of academics, museums professionals, and health and social care partners, and describes the process of integrating multiple perspectives towards common research methodologies. METHODS The research team organised a series of meetings and workshops with museum and healthcare partners to identify commonly used assessments and their perspectives on the objectives and possible outcomes of museum object handling activities. These were integrated with findings from a review of current conceptualisations of engagement in people with dementia (PWD) to produce a fit-for-purpose video evaluation method of the health and wellbeing impacts of the museum object handling programmes. RESULTS This article presents the Museum Engagement Observation Tool for use in hospital settings for people with moderate-to-severe dementia. CONCLUSION This article suggests that collaborative approaches can inform the development of future methods for creative health research and evaluation initiatives and to support this, it outlines the process of development of a new observational tool for people with dementia.
Collapse
Affiliation(s)
- Nuala Morse
- Research Associate, Whitworth Art Gallery, University of Manchester and Honorary Researcher, UCL Culture, University College London, London, UK
| | - Helen Chatterjee
- Professor of Biology, UCL Biosciences and Head of Research and Teaching, UCL Culture, University College London, Gower Street, London WC1E 6BT, UK
| |
Collapse
|
46
|
Moyle W, Jones CJ, Murfield JE, Thalib L, Beattie ERA, Shum DKH, O'Dwyer ST, Mervin MC, Draper BM. Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial. J Am Med Dir Assoc 2017; 18:766-773. [PMID: 28780395 DOI: 10.1016/j.jamda.2017.03.018] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To test the effects of individual, nonfacilitated sessions with PARO (version 9), when compared against a look-alike plush toy and usual care, on the emotional and behavioral symptoms of dementia for people living in long-term care facilities. DESIGN Parallel, 3-group, cluster-randomized controlled trial conducted between June 14, 2014, and May 16, 2015. SETTING Twenty-eight long-term care facilities operated by 20 care organizations located in South-East Queensland, Australia. PARTICIPANTS Four hundred fifteen participants aged ≥60 years, with a documented diagnosis of dementia. INTERVENTION Stratified by private/not-for-profit status and randomized using a computer-generated sequence, 9 facilities were randomized to the PARO group (individual, nonfacilitated, 15-minute sessions 3 times per week for 10 weeks); 10 to plush toy (same, but given PARO with robotic features disabled); and 9 to usual care. Treatment allocation was masked to assessors. MEASUREMENTS Primary outcomes were changes in levels of engagement, mood states, and agitation after a 10-week intervention, assessed by coded video observations (baseline, weeks 1, 5, 10, and 15) and Cohen-Mansfield Agitation Inventory-Short Form (baseline, weeks 10 and 15). Analyses followed intention-to-treat, using repeated measures mixed effects models. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). RESULTS Video data showed that participants in the PARO group were more verbally [3.61, 95% confidence interval (CI): 6.40-0.81, P = .011] and visually engaged (13.06, 95% CI: 17.05-9.06, P < .0001) than participants in plush toy. Both PARO (-3.09, 95% CI: -0.45 to -5.72, P = .022) and plush toy (-3.58, 95% CI: -1.26 to -5.91, P = .002) had significantly greater reduced neutral affect compared with usual care, whilst PARO was more effective than usual care in improving pleasure (1.12, 95% CI: 1.94-0.29, P = .008). Videos showed that PARO was more effective than usual care in improving agitation (3.33, 95% CI: 5.79-0.86, P = .008). When measured using the CMAI-SF, there was no difference between groups. CONCLUSIONS Although more effective than usual care in improving mood states and agitation, PARO was only more effective than a plush toy in encouraging engagement.
Collapse
Affiliation(s)
- Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
| | - Cindy J Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Jenny E Murfield
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Lukman Thalib
- Department of Public Health, College of Health Sciences, Qatar University, Qatar
| | - Elizabeth R A Beattie
- School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - David K H Shum
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia
| | - Siobhan T O'Dwyer
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Medical School, University of Exeter, Exeter, United Kingdom
| | - M Cindy Mervin
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Center for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Brian M Draper
- School of Psychiatry, University of New South Wales, Sydney, Australia
| |
Collapse
|
47
|
Rouaix N, Retru-Chavastel L, Rigaud AS, Monnet C, Lenoir H, Pino M. Affective and Engagement Issues in the Conception and Assessment of a Robot-Assisted Psychomotor Therapy for Persons with Dementia. Front Psychol 2017; 8:950. [PMID: 28713296 PMCID: PMC5491651 DOI: 10.3389/fpsyg.2017.00950] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
The interest in robot-assisted therapies (RAT) for dementia care has grown steadily in recent years. However, RAT using humanoid robots is still a novel practice for which the adhesion mechanisms, indications and benefits remain unclear. Also, little is known about how the robot's behavioral and affective style might promote engagement of persons with dementia (PwD) in RAT. The present study sought to investigate the use of a humanoid robot in a psychomotor therapy for PwD. We examined the robot's potential to engage participants in the intervention and its effect on their emotional state. A brief psychomotor therapy program involving the robot as the therapist's assistant was created. For this purpose, a corpus of social and physical behaviors for the robot and a “control software” for customizing the program and operating the robot were also designed. Particular attention was given to components of the RAT that could promote participant's engagement (robot's interaction style, personalization of contents). In the pilot assessment of the intervention nine PwD (7 women and 2 men, M age = 86 y/o) hospitalized in a geriatrics unit participated in four individual therapy sessions: one classic therapy (CT) session (patient- therapist) and three RAT sessions (patient-therapist-robot). Outcome criteria for the evaluation of the intervention included: participant's engagement, emotional state and well-being; satisfaction of the intervention, appreciation of the robot, and empathy-related behaviors in human-robot interaction (HRI). Results showed a high constructive engagement in both CT and RAT sessions. More positive emotional responses in participants were observed in RAT compared to CT. RAT sessions were better appreciated than CT sessions. The use of a social robot as a mediating tool appeared to promote the involvement of PwD in the therapeutic intervention increasing their immediate wellbeing and satisfaction.
Collapse
Affiliation(s)
- Natacha Rouaix
- Sciences and Technology, Université Pierre et Marie CurieParis, France
| | | | - Anne-Sophie Rigaud
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France.,CEN STIMCOParis, France
| | - Clotilde Monnet
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
| | - Hermine Lenoir
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
| | - Maribel Pino
- Arts et Métiers ParisTechParis, France.,Broca Hospital, Assistance Publique-Hôpitaux de ParisParis, France.,LUSAGE Living Lab, Research Unit EA4468, Faculty of Medicine, Paris Descartes UniversityParis, France
| |
Collapse
|
48
|
Moyle W, Jones C, Dwan T, Petrovich T. Effectiveness of a Virtual Reality Forest on People With Dementia: A Mixed Methods Pilot Study. THE GERONTOLOGIST 2017; 58:478-487. [DOI: 10.1093/geront/gnw270] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/01/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wendy Moyle
- Optimising Health Outcomes, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Australia
| | - Cindy Jones
- Optimising Health Outcomes, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, Australia
| | - Toni Dwan
- Optimising Health Outcomes, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Australia
| | | |
Collapse
|
49
|
Dröes RM, Chattat R, Diaz A, Gove D, Graff M, Murphy K, Verbeek H, Vernooij-Dassen M, Clare L, Johannessen A, Roes M, Verhey F, Charras K. Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice. Aging Ment Health 2017; 21:4-17. [PMID: 27869503 DOI: 10.1080/13607863.2016.1254596] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia. METHOD Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD). RESULTS The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified. CONCLUSION A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.
Collapse
Affiliation(s)
- R M Dröes
- a Department of Psychiatry, Alzheimer Centre , EMGO Institute for Health and Care Research, VU University Medical Centre , Amsterdam , The Netherlands
| | - R Chattat
- b Department of Psychology , University of Bologna , Bologna , Italy
| | - A Diaz
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - D Gove
- c Alzheimer Europe , Luxembourg , Luxembourg
| | - M Graff
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - K Murphy
- e School of Nursing and Midwifery, Aras Loyola, National University of Irelands , Galway , Ireland
| | - H Verbeek
- f Research School CAPHRI, Department of Health Services Research , Maastricht University , Maastricht , The Netherlands
| | - M Vernooij-Dassen
- d Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud Alzheimer Centre , Nijmegen , The Netherlands
| | - L Clare
- g Centre for Research in Ageing and Cognitive Health (REACH) , School of Psychology, University of Exeter, and PenCLAHRC, University of Exeter Medical School , Exeter , United Kingdom
| | - A Johannessen
- h Norwegian National Advisory Unit on Ageing and Health , VID Specialized University , Oslo , Norway
| | - M Roes
- i German Center for Neurodegenerative Diseases, Department of Nursing Science, Faculty of Health , University of Witten/Herdecke , Witten , Germany
| | - F Verhey
- j Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , The Netherlands
| | - K Charras
- k Fondation Médéric Alzheimer , Psychosocial Interventions Department , Paris , France
| | | |
Collapse
|