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Castillo-Hornero A, Rojano-Hidalgo M, López A, Alarcón A, Belmonte O, Caballer A. Reminiscence interventions for loneliness reduction in older adults: a systematic review. Aging Ment Health 2024; 28:1142-1152. [PMID: 38669147 DOI: 10.1080/13607863.2024.2345809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aims to review the use of reminiscence interventions in the reduction of loneliness in older adults by categorising the interventions by type, and comparing their effectiveness and methodological quality. METHOD This is a systematic review following PRISMA guidelines. The search was restricted to studies published in the Cochrane, CINAHL, Web of Science, Psycarticles, Psycinfo, and PubMed databases until December 2022. The inclusion criteria for the studies included in this review were: 1) reminiscence intervention 2) loneliness outcome measure 3) adults over 60 years old 4) experimental, pre-experimental, and quasi-experimental studies. RESULTS A total of twelve studies were eligible for inclusion. Only nine studies included a control group, and seven of those report significant effectiveness in reducing loneliness levels. The most popular type of intervention is simple reminiscence and life review, and in-group format. The interventions to date have been very heterogeneous, and the methodological quality of the existing literature is moderate to weak. CONCLUSION While reminiscence interventions hold some promise for reducing loneliness levels among older adults, future methodologically rigorous research is required, and standardised protocols need to be developed for application, with the specific aim of reducing levels of loneliness among older adults.
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Affiliation(s)
- Andrea Castillo-Hornero
- Department of Computer Languages and Systems, Institute of New Imaging Technologies, University Jaume I, Castellón de la Plana, Spain
| | - Mario Rojano-Hidalgo
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Agustín López
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Ana Alarcón
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
| | - Oscar Belmonte
- Department of Computer Languages and Systems, Institute of New Imaging Technologies, University Jaume I, Castellón de la Plana, Spain
| | - Antonio Caballer
- Department of Developmental Educational and Social Psychology and Methodology, University Jaume I, Castellón de la Plana, Spain
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El Haj M, Antoine P, Nahas N, Chapelet G. Autobiographical Storytelling in Patients with Mild Alzheimer's Disease: Focused, Reflected, and Entertaining; A Comparative Study. Clin Gerontol 2024:1-12. [PMID: 38992935 DOI: 10.1080/07317115.2024.2378773] [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] [Indexed: 07/13/2024]
Abstract
OBJECTIVES We assessed whether individuals with mild Alzheimer's disease (AD), despite some deficits in autobiographical memory, could effectively convey their personal experiences through storytelling. METHODS We invited 37 individuals with mild AD and 37 control participants to share their personal experiences. We rated these narratives based on five characteristics of storytelling: focus, reflection, entertainment, structure, and specificity. RESULTS Analyses demonstrated that individuals with AD conveyed more general than specific memories, and no significant differences were observed between structured and unstructured memories. Importantly, individuals with AD recounted more memories with focus than without, with reflection than without, and that were entertaining than were not. Compared with those of the control participants, the narratives of the individuals with AD were less focused, structured, and specific. However, no significant differences were observed between the two samples regarding reflection or entertainment. CONCLUSIONS AND CLINICAL IMPLICATIONS Individuals with mild AD can have difficulties in retrieving specific memories, but their storytelling of personal experience can be focused, exhibit reflection, and be entertaining. Individuals with mild AD can engage in reflective and entertaining autobiographical storytelling, potentially contributing to their sense of identity and connection with others.
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Affiliation(s)
- Mohamad El Haj
- Clinical Gerontology Department, CHU Nantes, Nantes, France
| | - Pascal Antoine
- Univ.Lille, CNRS, CHU Lille, UMR 9193 SCA Lab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Nayla Nahas
- Department of Psychology, University of Balamand, Balamand, Lebanon
| | - Guillaume Chapelet
- Clinical Gerontology Department, CHU Nantes, Nantes, France
- Université de Nantes, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Nantes, France
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Lin CL, Chen R, Kustanti CY, Chu H, Lee CK, Banda KJ, Sung CM, Niu SF, Liu SY, Chou KR. The effectiveness of emotion-oriented approaches on psychological outcomes and cognitive function in older adults: A meta-analysis of randomised controlled trials. J Glob Health 2024; 14:04123. [PMID: 38939961 PMCID: PMC11211973 DOI: 10.7189/jogh.14.04123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
Background Emotion-oriented approaches have demonstrated effectiveness in the care of the elderly. However, related studies have reported conflicting results. We aimed to explore the pooled effect of emotion-oriented approaches on the psychological outcomes and cognitive function of older adults through a meta-analysis of randomised controlled trials (RCTs). Methods We searched eight databases - CINAHL, Cochrane, Embase, Ovid MEDLINE, PsycINFO, PubMed, Scopus, and Web of Science - for RCTs from inception to 11 January 2024. Participants aged 60 years or older who received emotion-oriented approaches as the intervention, and reported outcomes of interest in the studies were included. The primary outcome was psychological outcomes (depression, self-esteem, life satisfaction and loneliness), and the secondary outcome was global cognitive function. The pooled effect size was computed in comprehensive meta-analysis 3.0 software using Hedges' g (g) with random-effects model. Furthermore, heterogeneity was assessed through Cochrane's Q and I2 tests. The quality of the included studies was evaluated using the Cochrane Risk of Bias tool. To explore potential sources of heterogeneity, moderator analyses were conducted. Results We included 37 RCTs and found that emotion-oriented approaches improve depression (g = -0.82, 95% CI = -1.08, -0.56), self-esteem (g = 0.98, 95% CI = 0.31, 1.64), life satisfaction (g = 0.63, 95% CI = 0.37, 0.88), loneliness (g = -2.22, 95% CI = -3.80, -0.64) and global cognitive function (g = 0.34, 95% CI = 0.19, 0.49) in older adults. We also observed significant follow-up effects on depression (g = -1.40, 95% CI = -2.45, -0.34) and loneliness (g = -3.48, 95% CI = 6.02, -0.94). Conclusions Emotion-oriented approaches are promising interventions in improving psychological outcomes and global cognitive function in older adults. Health care workers should receive training to promote and integrate emotion-oriented approaches into routine care of older adults emphasising the importance of collaborative efforts among health care professionals and caregivers to ensure holistic care delivery.
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Affiliation(s)
- Chiao-Ling Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | | | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chiu-Kuei Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Ministry of Health, Malawi
| | - Chien-Mei Sung
- Department of Nursing, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan
| | - Shu-Fen Niu
- Department of Nursing, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Fu Jen Catholic University, New Taipei, Taiwan
| | - Shu-Yen Liu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center for Neuroscience, Taipei Medical University, Taipei, Taiwan
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Dessureault M, Dubuc G, Leblanc MÈ, Marcoux L. Group Reminiscence Programs for Older Adults Without Cognitive Impairment: A Scoping Review. J Psychosoc Nurs Ment Health Serv 2024; 62:15-21. [PMID: 37646606 DOI: 10.3928/02793695-20230821-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Reminiscence interventions have been tested with people with and without cognitive impairment. However, the literature on reminiscence interventions for the latter is less extensive. The purpose of the current scoping review was to list and describe group session reminiscence protocols used with older adults without cognitive impairment and not involving psychotherapy. Arksey and O'Malley's five stages scoping framework was used for this review. Seven databases were searched, and nine articles were included. Results show the heterogeneity of reminiscence programs available for older adults without cognitive impairment and highlight that key elements for replication are often lacking. Well-defined reminiscence programs should be selected for replication and evaluation studies. However, few well-defined reminiscence programs not involving psychotherapy are available for older adults without cognitive impairment. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 15-21.].
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Engelbrecht R, Bhar S, Shoemark H, Elphinstone B, Ciorciari J. Reminiscence Therapy and Music With Older Adults: A Descriptive Study Investigating the Current Views and Practices of Australian Aged Care Providers and Volunteers. J Appl Gerontol 2024:7334648241236236. [PMID: 38423075 DOI: 10.1177/07334648241236236] [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: 03/02/2024] Open
Abstract
Reminiscence therapy and music are often used to improve the wellbeing of older people; however, we do not know how these interventions are used in practice. This study explored how those working with older people view and use verbal Reminiscence Therapy (VRT) and Music-assisted Reminiscence Therapy (MRT). A total of 110 participants who worked or volunteered with older people in Australia were surveyed in this descriptive, mixed-method study. VRT and MRT were frequently and spontaneously used to respond to the varied needs of older adults. VRT and MRT lead to reported positive outcomes including better care practices, positive affect and mood, and improved social connections. MRT was used as a compensatory strategy when traditional VRT was not possible. This study describes the current practices of VRT and MRT, and an overview of how reminiscence-based approaches are used in Australia to address the health and wellbeing of older people.
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Affiliation(s)
- Romy Engelbrecht
- School of Health Sciences, Department of Psychological Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Sunil Bhar
- School of Health Sciences, Department of Psychological Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Shoemark
- Department of Music Therapy, Boyer College of Music and Dance, Temple University, Philadelphia, PA, USA
| | - Bradley Elphinstone
- School of Health Sciences, Department of Psychological Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Joseph Ciorciari
- School of Health Sciences, Department of Psychological Science, Swinburne University of Technology, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
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Diwan S, Eliazar A, Pham D, Fuentes M. Evaluation of a culturally adapted reminiscence therapy intervention: Improving mood, family and community connectedness in Spanish- and Vietnamese-speaking older adults. Transcult Psychiatry 2023; 60:973-984. [PMID: 37615171 DOI: 10.1177/13634615231191996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Reminiscence therapy (RT) is an evidence-based treatment for alleviating depression and improving life satisfaction among elders, yet less is known about its efficacy in diverse ethnic groups. We report on the evaluation of a cultural adaptation of the RT intervention that combines reminiscence with three innovative elements: including family members in RT; conducting community events for participants to present their artwork and life-story books created during the intervention; and using ethnically matched bilingual community workers. The 12-week intervention with pre- and post-test assessments was completed by 73 Hispanic and 92 Vietnamese elders (mean age = 75 years; 62% female; mostly foreign-born, with limited English proficiency). Paired t-tests indicated statistically significant improvement in depression, loneliness, and life satisfaction. Sixty-two percent of participants noted improved relationships with family/friends through improved communication and shared understanding of the participant's life story. Fifty percent of respondents participated in a community event and the qualitative comments noted improved connection with their community through listening to others' life experiences and sharing their own. Participant perceptions of ethnically matched community workers were positive, but several indicated they could work with someone from a different ethnic background. Similar to general RT findings, the culturally adapted RT intervention demonstrated improvement in depression, loneliness, and life satisfaction among elders from two different ethnic backgrounds. Implications for future projects are discussed based on the findings and experience of conducting this intervention.
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Affiliation(s)
- Sadhna Diwan
- School of Social Work, Center for Healthy Aging in Multicultural Populations (CHAMP), San Jose State University
| | | | - Duy Pham
- Asian Americans for Community Involvement
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Wu Y, Xu H, Sui X, Zeng T, Leng X, Li Y, Li F. Effects of group reminiscence interventions on depressive symptoms and life satisfaction in older adults with intact cognition and mild cognitive impairment: A systematic review. Arch Gerontol Geriatr 2023; 114:105103. [PMID: 37354738 DOI: 10.1016/j.archger.2023.105103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE Reminiscence interventions have been extensively used to improve the psychological health of people with dementia. However, there is uncertainty about the effectiveness of group reminiscence interventions for older adults with intact cognition and mild cognitive impairment. Based on the large number of older adults and strained health care resources in China, we conducted a systematic review of the evidence on the effectiveness of group reminiscence interventions for older adults with intact cognition or mild cognitive impairment. MATERIALS AND METHODS Five English databases were searched from inception to 21 August 2022. The quality of the included articles was assessed by using the Cochrane Risk of Bias Scale or Criteria (2020) and the Australian Evidence-Based Health Care Centre (2020). Data related to study and intervention characteristics were extracted. RESULTS Twenty-four articles were included, of which eight were quasiexperimental studies and sixteen were randomized controlled studies. The overall study quality was high, but most studies did not blind the participants. Group reminiscence interventions were beneficial in improving depressive symptoms and life satisfaction in older adults with intact cognition or mild cognitive impairment, but no valid conclusions could be drawn about the effect on quality of life. CONCLUSIONS Group reminiscence interventions are an effective type of psychological intervention to improve the psychological health of older people. In addition, group reminiscence interventions are simple and easy to implement and can be considered a routine care activity to meet the spiritual needs of cognitively intact and mildly cognitively impaired older people.
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Affiliation(s)
- Yuejin Wu
- School of Nursing, Jilin University, Changchun, China
| | - Haiyan Xu
- School of Nursing, Jilin University, Changchun, China
| | - Xin Sui
- School of Nursing, Jilin University, Changchun, China
| | - Ting Zeng
- School of Nursing, Jilin University, Changchun, China
| | - Xin Leng
- School of Nursing, Jilin University, Changchun, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, China.
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Xu L, Li S, Yan R, Ni Y, Wang Y, Li Y. Effects of reminiscence therapy on psychological outcome among older adults without obvious cognitive impairment: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1139700. [PMID: 37065888 PMCID: PMC10098219 DOI: 10.3389/fpsyt.2023.1139700] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/14/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Reminiscence therapy has been a high-benefit and low-cost measure of psychosocial intervention for older adults in recent years. It has attracted much attention in the intervention study of older adults without obvious cognitive impairment. This study aimed to evaluate the effects of reminiscence therapy on psychosocial outcomes among older adults without obvious cognitive impairment and analyze the divergences of different intervention programs (form, duration, and setting) on outcomes. Methods We searched the commonly used databases and used RevMan 5.4 in the meta-analysis (PROSPERO-ID: CRD42022315237). All eligible trials used the Cochrane Risk of Bias Tool and the Effective Public Health Practice Project quality assessment tool to identify the quality and determine the bias risk grade. Results Twenty-seven studies were included, involving 1,755 older adults. Meta-analysis showed that reminiscence therapy has a significant effect on both depression and life satisfaction. Group reminiscence played a significant role in improving life satisfaction. Depression symptoms were not affected by the intervention duration (P = 0.06), while life satisfaction was significantly improved after more than 8 weeks of intervention (P < 0.00001). Intervention settings drove differences in depressive symptoms (P = 0.02), and the effect size of the community was larger. Conclusion Reminiscence therapy can significantly reduce depressive symptoms and improve life satisfaction. There are different effects of reminiscence therapy in different intervention schemes on psychological outcomes among older adults. More well-designed trials with large sample sizes and long-term follow-ups are necessary to confirm and expand the present results. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315237, identifier: CRD42022315237.
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Affiliation(s)
- Lijun Xu
- Department of Nursing, College of Medical Science, Huzhou University, Huzhou, Zhejiang, China
| | - Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, Huzhou, Zhejiang, China
| | - Renfu Yan
- Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China
| | - Yingyuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, Huzhou, Zhejiang, China
| | - Yuecong Wang
- Department of Nursing, College of Medical Science, Huzhou University, Huzhou, Zhejiang, China
| | - Yue Li
- Department of Nursing, College of Medical Science, Huzhou University, Huzhou, Zhejiang, China
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Miyawaki CE, McClellan A, Bouldin ED, Brohard C, Spencer H, Tahija N, Kunik ME. Feasibility and Efficacy of Life Review Delivered by Virtually-Trained Family Caregivers. J Alzheimers Dis 2023; 95:573-583. [PMID: 37545241 DOI: 10.3233/jad-230371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Due to the high prevalence of depressive symptoms and Alzheimer's disease and related dementias in older Americans (≥65 years), we developed a six-week depression intervention, Caregiver-Provided Life Review (C-PLR) for care recipients (CRs) with early-stage dementia and mild depression. OBJECTIVE The objective of the study was to examine the feasibility and efficacy of C-PLR delivered by virtually-trained caregivers (CGs) on CRs who live with dementia and depression in community and long-term care settings (N = 25 CG-CR dyads). METHODS We used fidelity scores as a measure of CG's feasibility to provide C-PLR. We collected the pre- and post-measures on CRs' depression (primary outcome), life satisfaction, CGs' burden, positive aspects of caregiving, and CG-CR relationship quality (secondary outcomes) and compared them using paired t-tests. We evaluated if the effect differed by race/ethnicity, residential setting, or living alone. RESULTS The average fidelity check-in score was 14.8±0.78 indicating high feasibility. CGs were 52 years old (mean), 88% female, 64% working, 72% college-educated, and 72% in good-excellent health. CRs were 81 years old (mean), 84% female, and 56% in poor-fair health. CRs' depression significantly improved (p < 0.001), and this effect was found in CRs who were Asian (p = 0.017), White (p = 0.040), community-dwelling (p < 0.001), lived alone (p = 0.045), or with others (p = 0.002). CONCLUSION This study demonstrated that the C-PLR can be successfully taught to CGs virtually and is effective in reducing CR's depressive symptoms. C-PLR could be implemented more broadly to improve symptoms among CRs in community and residential settings, as well as among a diverse population of CRs.
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Affiliation(s)
| | - Angela McClellan
- Baylor University Diana R. Garland School of Social Work, Waco, TX, USA
| | - Erin D Bouldin
- Health Services Research & Development, Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA
| | - Cheryl Brohard
- University of Houston College of Nursing, Sugar Land, TX, USA
| | - Helen Spencer
- University of Houston Graduate College of Social Work, Houston, TX, USA
| | | | - Mark E Kunik
- VA South Central Mental Illness Research, Education and Clinical Center & Baylor College of Medicine, Houston, TX, USA
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Roüast NM, Schönauer M. Continuously changing memories: a framework for proactive and non-linear consolidation. Trends Neurosci 2023; 46:8-19. [PMID: 36428193 DOI: 10.1016/j.tins.2022.10.013] [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: 08/11/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 11/23/2022]
Abstract
The traditional view of long-term memory is that memory traces mature in a predetermined 'linear' process: their neural substrate shifts from rapidly plastic medial temporal regions towards stable neocortical networks. We propose that memories remain malleable, not by repeated reinstantiations of this linear process but instead via dynamic routes of proactive and non-linear consolidation: memories change, their trajectory is flexible and reversible, and their physical basis develops continuously according to anticipated demands. Studies demonstrating memory updating, increasing hippocampal dependence to support adaptive use, and rapid neocortical plasticity provide evidence for continued non-linear consolidation. Although anticipated demand can affect all stages of memory formation, the extent to which it shapes the physical memory trace repeatedly and proactively will require further dedicated research.
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Affiliation(s)
- Nora Malika Roüast
- Institute for Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany.
| | - Monika Schönauer
- Institute for Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany.
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Miyawaki CE, Tahija N, McClellan A, Chen NW. Feasibility Study of Caregiver-Provided Life Review: Implementation, Adaptation, and Effects on Care Recipients' Depressive Symptoms. Clin Gerontol 2022:1-12. [PMID: 36369922 DOI: 10.1080/07317115.2022.2144578] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aimed to examine the feasibility of unpaid, family/friend caregivers conducting life reviews with people with dementia in long-term care and community settings and reported on how we adapted the intervention modality under the COVID-19 pandemic. METHODS Twenty-one caregiver-care recipient dyads completed 6 weekly life review sessions. The intervention format was modified to accommodate COVID-19 restrictions. Primary and secondary outcome measures were analyzed based on repeated measures at baseline and post-intervention. RESULTS Due to the changing nature of the pandemic, we iterated the caregiver training intervention four times to accommodate caregivers' needs while having faced multiple recruitment challenges with care facility residents. Care recipients' depression appeared to have improved (p = .001). CONCLUSIONS Although the COVID-19 pandemic created unique recruitment challenges, all the care recipients seemed to enjoy the life review activities supported by the positive outcomes in gaining socialization opportunities. It may be beneficial to offer a more self-paced intervention modality to ease the burden on caregivers. CLINICAL IMPLICATIONS It appears that unpaid family/friend caregivers can provide life reviews to their loved ones with dementia. Training the caregivers on how to provide life reviews can be an easy, low-risk activity that might ameliorate depressive symptoms in the care recipients.
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Affiliation(s)
| | - Nina Tahija
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Angela McClellan
- The Diana R. Garland School of Social Work, Baylor University, Waco, Texas, USA
| | - Nai-Wei Chen
- Beaumont Health System, Beaumont Research Institute, Royal Oak, Michigan, USA
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Yan Z, Dong M, Lin L, Wu D. Effectiveness of reminiscence therapy interventions for older people: Evidence mapping and qualitative evaluation. J Psychiatr Ment Health Nurs 2022; 30:375-388. [PMID: 36371647 DOI: 10.1111/jpm.12883] [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] [Received: 08/09/2022] [Revised: 10/08/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Reminiscence therapy is a common psychosocial intervention in mental health nursing. Numerous secondary studies have explored the effects of reminiscence therapy interventions in older adults, and while the effects are significant, conflicting results remain. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To date, research on reminiscence therapy has examined different disorders in isolation from one another. By illustrating the evidence gaps between studies, this paper highlights the need for a new evidence-based summary overview of reminiscence therapy research. The results suggest that reminiscence therapy can be beneficial to the improvement of mental health and quality of life for older people. However, we found that the secondary studies were not of high quality and that further high-quality literature supporting the evidence is still needed. WHAT ARE THE IMPLICATION FOR PRACTICE?: Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. However, there is a lack of normative guidelines for reminiscence therapy in terms of intervention time, frequency, and form. The development of a global standard protocol for the application of reminiscence therapy may be necessary for future randomized controlled trials (RCTs). ABSTRACT INTRODUCTION: Reminiscence therapy is an alternative to pharmaceutical intervention provided during long-term care, especially for older people with mental and psychological problems. However, the effects of reminiscence therapy remain inconclusive. AIM The present study aimed to systematically identify, synthesize and describe the research evidence and quality of systematic reviews (SRs) related to reminiscence interventions for older people through an evidence-mapping approach. METHODS Commonly used English and Chinese databases, including PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, WANFANG, VIP and SinoMed, were searched from inception till 31 March 2022. The study type was restricted to SRs with or without meta-analysis. The methodological quality of the included SRs was assessed by A Measurement Tool to Assess Systematic Reviews (AMSTAR-2). The Microsoft Excel 2019 tool was used for data extraction and coding, and bubble charts were used to synthesize information on the study population, intervention category, original study sample size and classification of findings. RESULTS A total of 28 SRs were enrolled, including 514 original studies, 91.4% of which were randomized controlled trials. The main participants of the study were depressed older people (7 publications), older people with dementia (10 publications) and ordinary older people (8 publications). The findings of 26 (92.8%) publications were categorized as either "beneficial" or "potentially beneficial." The primary outcome indicators of the effectiveness of the reminiscence intervention for older people are mental and psychological problems (especially depressive symptoms and cognitive functioning), quality of life and categories of positive psychology (e.g., life satisfaction, happiness and self-esteem). The main factors influencing the intervention effect were the intervention period, residential setting, intervention format (group/individual) and intervention intensity. The intervention settings/contexts were mainly community and long-term care facilities. However, the methodological quality of 27 (96.4%) of the SRs was scored as either "Low" or "Critically Low." DISCUSSION Reminiscence therapy has been used to study the mental health and quality of life of older people in various conditions, with significant results. However, due to the limited evidence included in the studies and the low methodological quality, there is still a need to focus on the issue of effectiveness and evidence gaps for different interventions in the field of recall in the future, in addition to efforts to improve the methodological quality and standardize the reporting process for the evaluation of reminiscence intervention systems. IMPLICATIONS FOR PRACTICE Reminiscence therapy may be considered a useful non-pharmacological intervention for older people with mental and psychological problems. A standard protocol for reminiscence therapy may be necessary for future studies.
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Affiliation(s)
- Zhangrong Yan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Meijun Dong
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lunwei Lin
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Shryock SK, Meeks S. Activity, Activity Personalization, and Well-Being in Nursing Home Residents With and Without Cognitive Impairment: An Integrative Review. Clin Gerontol 2022; 45:1058-1072. [PMID: 33218291 DOI: 10.1080/07317115.2020.1844356] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Engagement in personally relevant and pleasant activity is a facet of many theories of well-being. This integrated review and narrative synthesis explored the hypothesis that activity participation improves well-being for nursing home residents. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, PsycINFO, Academic Search Complete, Psychology and Behavioral Sciences Collection, Embase, and CINAHL for research published between 2006 and 2018. We included peer-reviewed, English-language studies of nursing-home residents, with interventions focused on activities and on well-being or affect outcomes. RESULTS After screening, the search yielded 45 studies: 15 reviews of specific activities and 30 empirical articles. We found consistent support for tailored activity interventions and less consistent support for specific or generic activity interventions with the possible exception of music therapy. Research focused on specific activity types had methodological limitations and confounds with activity preferences. CONCLUSIONS Participation in activities may improve well-being in residents of nursing homes. Tailored activities are likely to be superior to those provided indiscriminately to all residents. CLINICAL IMPLICATIONS Improving quality of life in long-term care should include opportunities to engage in activities; those most effective will be tailored to individuals and no single activity will be effective for everyone.
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Li S, Dai Y, Zhou Y, Zhang J, Zhou C. Efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) on loneliness and perceived stress of rural older adults living alone in China: a randomized controlled trial. Aging Ment Health 2022; 26:1377-1384. [PMID: 34180278 DOI: 10.1080/13607863.2021.1935457] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to explore the efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) to mediate the loneliness and perceived stress of older adults living alone in rural China. The results can provide a scientific foundation for improving psychological health. METHOD A randomized controlled trial of 64 (aged 65.70 ± 3.69 years) Chinese rural older adults living alone was conducted. They were randomly divided into either an eight-month intervention group or a control group. The perceived stress scale (PSS) and the UCLA loneliness scale (UCLA-LS) evaluated the perceived stress and loneliness of the two groups at three different times. A repeated-measures analysis of variance model was used to compare each outcome measure of the two groups. RESULTS The CTFA-GRT yielded a benefit for the perceived stress and loneliness of rural older adults living alone in the intervention group. Combined with a simple effects test, the PSS and UCLA-LS of those in the intervention groups significantly decreased at eight months after the baseline (F PSS = 23.540, F UCLA-LS = 40.159; all P < 0.01). In addition, the sustainable effect of this program lasted three months after the intervention (F PSS = 65.756, F UCLA-LS = 60.983; all P < 0.01). CONCLUSION The CTFA-GRT significantly decreased the perceived stress and loneliness of rural older adults living alone in China.
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Affiliation(s)
- Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Yanyan Dai
- Huzhou Central Hospital, Zhejiang, China
| | - Yuqiu Zhou
- Department of Nursing, Daqing Campus, University of Harbin Medical, Heilongjiang, China
| | - Jiayuan Zhang
- Department of Nursing, Daqing Campus, University of Harbin Medical, Heilongjiang, China
| | - Chiteng Zhou
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
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Wilson SJ, Kiecolt-Glaser JK. The Story of Us: Older and Younger Couples' Language Use and Emotional Responses to Jointly Told Relationship Narratives. J Gerontol B Psychol Sci Soc Sci 2022; 77:2192-2201. [PMID: 35738871 PMCID: PMC9799216 DOI: 10.1093/geronb/gbac080] [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: 01/08/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Social-emotional well-being is said to improve over adulthood, and studies of couples' age differences have focused primarily on marital conflict. The way couples discuss their relationship story predicts marital quality among newlyweds and long-married couples alike, yet older and younger couples' accounts have never been compared. The current study examined age differences in couples' use of I/we-talk, emotion words, and immediacy (i.e., an urgent and unresolved style) during a relationship history discussion and their subsequent mood reactivity and appraisals. METHOD Married couples (N = 186 individuals within 93 couples, aged 22-77) recounted the story of their relationship then rated the discussion and their negative mood. Mediation models assessed the 3 linguistic features as parallel dyadic mediators linking couple age to negative mood responses and appraisals, controlling for global marital satisfaction, and baseline negative mood. Secondary analyses examined partners' concordance in language use. RESULTS Compared with younger couples, older couples used more positive than negative words and less immediacy which, in turn, was associated with husbands' and wives' less negative mood and more positive appraisals, only among husbands. Partners in older couples used more similar I/we-talk and emotional language, but these were unrelated to mood or appraisals. DISCUSSION This study extends our understanding of how marital interactions differ by age in the understudied context of relationship history discussions, which may grow increasingly important for couples' well-being with older age. Findings broadly align with social-emotional aging theories and uncover novel linguistic features relevant to the age-related emotional benefits of joint reminiscing.
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Affiliation(s)
- Stephanie J Wilson
- Address correspondence to: Stephanie J. Wilson, PhD, Psychology, Southern Methodist University, 6116 N. Central Expressway, Dallas, TX 75206, USA. E-mail:
| | - Janice K Kiecolt-Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Psychiatry and Behavioral Health, OSUMC, Columbus, OH, USA
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Yang Z, Wildschut T, Izuma K, Gu R, Luo YLL, Cai H, Sedikides C. Patterns of brain activity associated with nostalgia: a social-cognitive neuroscience perspective. Soc Cogn Affect Neurosci 2022; 17:1131-1144. [PMID: 35560158 PMCID: PMC9714426 DOI: 10.1093/scan/nsac036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 04/19/2022] [Accepted: 05/12/2022] [Indexed: 01/12/2023] Open
Abstract
Nostalgia arises from tender and yearnful reflection on meaningful life events or important persons from one's past. In the last two decades, the literature has documented a variety of ways in which nostalgia benefits psychological well-being. Only a handful of studies, however, have addressed the neural basis of the emotion. In this prospective review, we postulate a neural model of nostalgia. Self-reflection, autobiographical memory, regulatory capacity and reward are core components of the emotion. Thus, nostalgia involves brain activities implicated in self-reflection processing (medial prefrontal cortex, posterior cingulate cortex and precuneus), autobiographical memory processing (hippocampus, medial prefrontal cortex, posterior cingulate cortex and precuneus), emotion regulation processing (anterior cingulate cortex and medial prefrontal cortex) and reward processing (striatum, substantia nigra, ventral tegmental area and ventromedial prefrontal cortex). Nostalgia's potential to modulate activity in these core neural substrates has both theoretical and applied implications.
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Affiliation(s)
- Ziyan Yang
- Correspondence should be addressed to Huajian Cai, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China. E-mail:
| | - Tim Wildschut
- Center for Research on Self and Identity, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK
| | - Keise Izuma
- School of Economics and Management, Kochi University of Technology, Kochi 780-8515, Japan
| | - Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yu L L Luo
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Huajian Cai
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Constantine Sedikides
- Center for Research on Self and Identity, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK
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Lee H, Kim E, Yoon JY. Effects of a multimodal approach to food art therapy on people with mild cognitive impairment and mild dementia. Psychogeriatrics 2022; 22:360-372. [PMID: 35229407 DOI: 10.1111/psyg.12822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/19/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Food art therapy (FAT) has multiple modalities in which cognition, emotion, and social changes are stimulated. The purpose of this study was to design a multimodal approach to a food art therapy (MM-FAT) program and identify its effects on cognitive ability, daily living functioning, depression, self-esteem, self-efficacy, self-expression, and social functioning in individuals with mild cognitive impairment (MCI) and mild dementia by employing a mixed methods research design. METHODS The participants included 39 patients from a public dementia care centre in Seoul, Korea. The intervention group, which comprised 20 participants, received 12 MM-FAT sessions 3 times a week for 4 weeks, and the control group, which included 19 participants, received usual care. The MM-FAT program was evaluated based on its effectiveness on cognitive, daily living, emotional, and social functioning outcome measures at three time points using repeated measures analysis of variance. Semi-structured interviews (n = 9) were conducted to evaluate the overall experience of the MM-FAT program and its outcomes. RESULTS The findings reveal that MM-FAT has a positive effect on the cognitive, emotional, and social functioning of individuals with MCI and mild dementia. However, there were no enhancements in individuals' daily living functioning, and the lasting effects of the intervention could not be assessed. Cognition and depression increased significantly at the end of the MM-FAT program. Self-expression and self-efficacy were significantly higher in the MM-FAT group than in the control group. The semi-structured interviews revealed improvements in participants' behaviour, communication, and interaction. CONCLUSION This mixed methods study focused on individuals with MCI or mild dementia contributes to an understanding of the effectiveness of a FAT program employing a multimodal approach. Despite the COVID-19 pandemic, the study was able to enrich the effects of MM-FAT on cognitive, emotional, and social functioning through qualitative findings.
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Affiliation(s)
- Hyojin Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Eunjoo Kim
- Center for Human-Caring Nurse Leaders for the Future, College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21(BK 21) Four Project, Seoul, South Korea
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Lam JA, Feingold-Link M, Noguchi J, Quinn A, Chofay D, Cahill K, Rougas S. My Life, My Story: Integrating a Life Story Narrative Component Into Medical Student Curricula. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2022; 18:11211. [PMID: 35136835 PMCID: PMC8789965 DOI: 10.15766/mep_2374-8265.11211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/06/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Medical students experience burnout, depersonalization, and decreases in empathy throughout medical training. My Life, My Story (MLMS) is a narrative medicine project that aims to combat these adverse outcomes by teaching students to interview patients about their life story, with the goal of improving patient-centered care competencies, such as empathy. METHODS The MLMS project was started in the Veterans Affairs (VA) system and has since spread to dozens of VA sites. We adapted and integrated this project into the Warren Alpert Medical School of Brown University curriculum. As part of the required curriculum, first- and third-year medical students participated in a life story interview with a community-based volunteer or a patient in the inpatient hospital setting, transcribed the story, and reviewed the written story with the patient. We assessed student perceptions of the project, changes in empathy, and changes in burnout symptoms. RESULTS A total of 240 students participated in this project. Students spent an average of 70.7 minutes interviewing patients. A majority of the students believed MLMS was a good use of time (77%), fostered connection with patients (79%), and was effective in recognizing patients' thoughts and feelings (69%). DISCUSSION To our knowledge, this is one of the first life story interview interventions to be implemented into a required medical school curriculum and outside the VA setting. MLMS may assist students in improving clinical empathy skills and create a structure for medical trainees to better understand their patients.
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Affiliation(s)
- Jeffrey A. Lam
- Bray Humanities Fellow, Warren Alpert Medical School of Brown University
| | - Mara Feingold-Link
- Fellow, Department of Palliative Care, Warren Alpert Medical School of Brown University
| | - Julia Noguchi
- Director of Community Engagement and Scholarship, Doctoring Program, Warren Alpert Medical School of Brown University; Doctor of Public Health Candidate, Department of Community Health Sciences, Boston University School of Public Health
| | - Anne Quinn
- My Life, My Story Volunteer Coordinator, Warren Alpert Medical School of Brown University
| | - Dana Chofay
- Doctoring Program Course Leader and Clinical Assistant Professor of Medicine and Medical Sciences, Warren Alpert Medical School of Brown University
| | - Kate Cahill
- Internal Medicine Clerkship Director, Associate Professor of Medicine and Medical Sciences, and Clinician Educator, Warren Alpert Medical School of Brown University
| | - Steven Rougas
- Doctoring Program Director and Associate Professor of Emergency Medicine and Medical Sciences, Warren Alpert Medical School of Brown University
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Stargatt J, Bhar S, Bhowmik J, Al Mahmud A. Digital Storytelling for Health-Related Outcomes in Older Adults: Systematic Review. J Med Internet Res 2022; 24:e28113. [PMID: 35019845 PMCID: PMC8792772 DOI: 10.2196/28113] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/28/2021] [Accepted: 10/22/2021] [Indexed: 12/30/2022] Open
Abstract
Background Older adults face a unique set of challenges and may experience a range of psychological comorbidities. Digital storytelling is an emerging tool for sharing and recording lived experiences and may have the potential to support well-being but is yet to be systematically reviewed for use among older adults. Objective The aim of this review is to examine the methods for creating digital stories, the health-related outcomes associated with creating digital stories, and the potential for implementing digital storytelling with older adults. Methods We systematically searched electronic databases to identify articles published in English that reported on at least one health-related outcome of digital storytelling for participants aged ≥60 years. Data were extracted and synthesized using qualitative content analysis and summarized in tables. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Results A total of 8 studies were included in the review. Participants were primarily community-dwelling older adults living with dementia, involving family caregivers and professional care staff. Studies have taken various approaches to digital storytelling and reported diverse benefits associated with digital storytelling, including improvements in mood, memory, social engagement, and quality of relationships. Although the potential for implementation was not widely examined, some studies have presented evidence for acceptability and feasibility. Generally, studies were of high quality, despite the absence of comparator groups and confounder analyses. Conclusions The evidence reviewed suggests that despite the various approaches taken, digital storytelling shows promise as an effective approach for supporting well-being in older adults. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019145922; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145922 International Registered Report Identifier (IRRID) RR2-10.2196/15512
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Affiliation(s)
- Jennifer Stargatt
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Sunil Bhar
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Jahar Bhowmik
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Abdullah Al Mahmud
- Centre for Design Innovation, School of Design, Swinburne University of Technology, Hawthorn, Australia
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Davis L, Botting N, Cruice M, Dipper L. A systematic review of language and communication intervention research delivered in groups to older adults living in care homes. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:182-225. [PMID: 34841623 DOI: 10.1111/1460-6984.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The communication skills of older adults living in care homes is an underexplored topic. Ageing can lead to reduced communication ability and activity; and in the care home environment there may also be fewer communication opportunities. This situation is likely to negatively impact well-being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well-being, but no systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. AIMS To identify and evaluate the evidence for behavioural interventions with older adults, delivered in groups in care homes, that specifically included a language or communication activity. To explore the impact of such intervention on the specific domains of language, communication and social interaction. To determine whether behavioural mechanisms of action can be identified. METHODS & PROCEDURES Embase, Medline, Ovid Nursing database, Psych info and CINAHL complete were searched and produced 158 records for screening, of which 22 remained for review. In order to identify and evaluate the quality of the evidence base presented the following research questions were posed: What research has been conducted in this area? What is the methodological quality of the studies identified? How complete is the intervention reporting? How was change measured in the domains of language, communication and social interaction? Is there evidence of efficacy, indicated by statistically significant improvement, in these domains? How did the interventions work? Synthesis tools employed included the PEDro-P Scale, the TIDieR checklist and the ITAX. MAIN CONTRIBUTION A total of 22 studies met the criteria for review. One study used solely language or communication interventions, but the remaining 21 studies used behavioural interventions which incorporated language and communication activities to varying degrees. Studies fell into four broad intervention types: reminiscence or life review; cognitive stimulation; narrative or storytelling; and multi-modality group communication. The majority of studies were of fair methodological quality, with a moderate level of detail provided in treatment reporting. Statistically significant improvement was reported by authors in all four intervention types and across language, communication and social domains. Social interaction, social support and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions. CONCLUSIONS & IMPLICATIONS Despite limitations in the evidence base, there are important positive signs for the beneficial effects of supporting language and communication in care homes. Blinding of assessors, and the accuracy and accessibility of statistical reporting are important areas to address in order to improve the quality of the evidence base. WHAT THIS PAPER ADDS Ageing can lead to reduced communication ability and activity, and in the care home setting there may also be fewer communication opportunities. This situation is likely to negatively impact well-being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well-being. The communication skills of older adults living in care homes is an underexplored topic. No systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. This review reveals important positive signs for the beneficial effects of supporting language and communication in care homes. Social interaction, social support, and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions.
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Affiliation(s)
- Lydia Davis
- Division of Language and Communication Science, School of Health Sciences, University of London, London, UK
| | - Nicola Botting
- Division of Language and Communication Science, School of Health Sciences, University of London, London, UK
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, University of London, London, UK
| | - Lucy Dipper
- Division of Language and Communication Science, School of Health Sciences, University of London, London, UK
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Al-Ghafri BR, Al-Mahrezi A, Chan MF. Effectiveness of life review on depression among elderly: a systematic review and meta-analysis. Pan Afr Med J 2022; 40:168. [PMID: 34970410 PMCID: PMC8683455 DOI: 10.11604/pamj.2021.40.168.30040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction depression is considered one of the most common obstacles to daily life activities and quality of life in the elderly. Evidence is accumulating regarding the effectiveness of reminiscence and life review interventions in reducing depression and raising well-being in the elderly. The aim of this review was to determine the effects of life review interventions on depression outcomes among the elderly. Methods a search of the literature was performed through 11 electronic databases to identify all randomized controlled trials studies that examine life review effects on depression among the elderly. For each study, the effect size (Cohen's d) between groups (life review vs. control) differences in depression scores for post-intervention and follow-up intervention were computed. Results in total, 15 studies were met the inclusion criteria and was evaluated by meta-analysis. Results showed that the life review group has a large effect on reducing depression level than the control group on post-intervention and follow-up. After conducted sensitivity analysis, a moderate effect (effect size=-0.54; 95% CI=-0.71 to -0.36; p<0.05) and small effect (effect size=-0.20; 95% CI=-0.41 to -0.01; p<0.05) were found on post-intervention and follow-up, respectively. Conclusion through this systematic review and meta-analysis, the overall results showed a moderate effect to reducing depression levels among the elderly in the life review group after carrying out post-intervention measurements, while in the follow-up the effect was small. This review indicates that life review intervention is one of the options likely to be of benefit for elderly in primary care settings, but further research can be focused on intervention and follow-up durations to obtain long-term effects.
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Affiliation(s)
- Bushra Rashid Al-Ghafri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Abdulaziz Al-Mahrezi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Chamorro-Garrido A, Ramírez-Fernández E, Ortega-Martínez AR. Autobiographical Memory, Gratitude, Forgiveness and Sense of Humor: An Intervention in Older Adults. Front Psychol 2021; 12:731319. [PMID: 34970181 PMCID: PMC8712764 DOI: 10.3389/fpsyg.2021.731319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/16/2021] [Indexed: 12/02/2022] Open
Abstract
Research has shown that happiness and well-being play a fundamental role in the health of older adults. For this reason, programs based on Positive Psychology seek to improve quality of life, preventing and reducing the appearance of emotional disorders. The objective of this study was to verify whether an intervention based on Autobiographical Memory, Forgiveness, Gratitude, and Sense of humor would increase quality of life in institutionalized older adults. We used a quasi-experimental design with pre- and post-intervention measures and follow-on measures at 3, 6, and 12 months. A total of 111 institutionalized older adults participated in the study and were randomly assigned to one of three groups: experimental (n = 36), placebo (n = 39), and control (n = 36). Measurements were taken of depression, subjective happiness, satisfaction with life, psychological well-being, and specific memories. Program duration was 11 weeks, followed by refresher sessions of the activities that had been conducted. The results showed that the intervention was effective, producing lasting increase in the participating adults' well-being, maintained for the following 12 months, in contrast to the other two groups. In conclusion, the proposed intervention proved to be a novel tool that was effective, easily applied, and able to improve quality of life and emotional disorders in older adults.
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Millett G, Fiocco AJ. A pilot study implementing the JAVA Music Club in residential care: impact on cognition and psychosocial health. Aging Ment Health 2021; 25:1848-1856. [PMID: 32338054 DOI: 10.1080/13607863.2020.1758919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Ninety percent of long-term care (LTC) residents experience some form of cognitive impairment. Social support may benefit cognition by decreasing depressive symptoms and loneliness, which are commonly reported among LTC residents. OBJECTIVE To investigate the effects of the Java Music Club (JMC), a manualized social support program, on cognition and psychosocial health among LTC residents using a pre-post mixed-methods approach. METHODS The JMC was implemented once a week for twelve weeks. Participants (n = 24, 91.7% female) completed cognitive tasks and psychosocial questionnaires before (T1), after (T2), and twelve weeks following (T3) participation in the JMC. Qualitative interviews were conducted at T2 with participants and recreation coordinators. RESULTS Analyses showed decreased loneliness from T1 to T2 (t = 3.31, p = .003) and reductions in depressive symptoms (F = 3.459, p = .043) and subjective memory complaints (F = 3.837, p = .048) from T2 to T3. Participants' qualitative interviews (N = 19) illustrate that the JMC was a positive experience that promoted social engagement. Important group elements included the group facilitator and group composition. Possible process elements included social engagement, the opportunity for reminiscence, and the ability of both social interaction and singing to benefit the residents and lift their 'spirits'. Recreation coordinators (N = 3) reported that the group was unlike currently available group programs and increased socialization between residents. CONCLUSIONS Participation in the JMC may be a promising approach to counter loneliness, depressive symptoms and subjective memory complaints in LTC residents.
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Affiliation(s)
- Geneva Millett
- Department of Psychology, Ryerson University, Toronto, ON, Canada
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Liu Z, Yang F, Lou Y, Zhou W, Tong F. The Effectiveness of Reminiscence Therapy on Alleviating Depressive Symptoms in Older Adults: A Systematic Review. Front Psychol 2021; 12:709853. [PMID: 34484066 PMCID: PMC8415872 DOI: 10.3389/fpsyg.2021.709853] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Depression is one of the most common problems faced by older adults. Reminiscence therapy, defined as using the recall of past events, feelings, and thoughts facilitating pleasure, is one type of psychotherapy that could alleviate depressive feelings among older adults, improve their quality of life, and help them live independently. Reminiscence therapy originated from geriatric psychiatry, and is an effective non-pharmacological intervention that could be structured or unstructured and be conducted individually or in a group. The current systematic review was designed to summarize and review existing evidence on the effect of reminiscence therapy on depression in older adults. Methods: We conducted a systematic review from January 2000 to Mar 2021 using 10 electronic databases in English and Chinese languages, including Medline, Embase, Cinahl, PsychInfo, Cochrane, Web of Science, Google Scholar, Science Direct, CNKI, and WANFANG. We excluded studies that didn't use randomized controlled trials (RCT) from the meta-analysis. The selected studies were scored using the Cochrane Risk of Bias tool. The RevMan 5.0 was used in subgroup analysis depending on how the interventions were classified. Results: We extracted 527 studies based on keyword searches, of which 10 RCTs met inclusion criteria were included in the meta-analysis. The meta-analysis yielded high heterogeneity, and the analyses of significant subgroups showed that reminiscence therapy has a significant effect on relieving depressive symptoms in older adults. Reminiscence therapy benefits older adults with chronic illness and those on antidepressants as well. The effect and cost-effectiveness of group reminiscence therapy were higher than individual reminiscence therapy. And some specific types of group reminiscence therapy have a significant effect on improving depression and secondary outcomes, including life satisfaction. Although the effectiveness of structured and unstructured group reminiscence on depression has no significant differences according to current evidence, the structured therapy is more replicable, generalizable, and user-friendly due to its detailed protocol for new therapists. Furthermore, reminiscence therapy is more effective for older women and older adults with more severe depressive symptoms. Conclusion: Reminiscence therapy significantly increased older adults' remission from depression and quality of life immediately after the intervention. However, the evidence-based protocol and implementation of reminiscence interventions need to be further developed and standardized to facilitate global use. Moreover, it remains unclear on the long-term effect of reminiscence therapy. Based on the limitations of the current study, more rigorous evidence is needed from studies with large sample sizes, RCT design, and longer follow-up periods. Future studies could also explore the effect of different types of reminiscence therapy. Furthermore, qualitative data should be included to better understand older adults' narrative and experiences with reminiscence therapy. Future studies could also investigate the impact of reminiscence therapy on older relatives as a part of outcome measure to explore the efficacious mechanism of reminiscence therapy in alleviating older adults' depressive symptoms.
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Affiliation(s)
- Zhuo Liu
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Fan Yang
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| | - Yifan Lou
- School of Social Work, Columbia University, New York, NY, United States
| | - Wei Zhou
- Party School of Chongqing Municipal Committee of CPC, ChongQing, China
| | - Feng Tong
- School of International Law and Sociology, Sichuan International Studies University, Chongqing, China
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Oh J. Factors affecting health promoting behavior among older women in Korea: a structural equation model. Health Promot Int 2021; 36:924-932. [PMID: 33236075 DOI: 10.1093/heapro/daaa117] [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] [Indexed: 11/12/2022] Open
Abstract
The purpose of this study was to explain the health promoting behaviors of older women in South Korea using a structural equation model. The health promotion model developed by Pender was used. A survey using self-administered questionnaires was carried out between 2 October 2016 and 26 November 2016, with 252 older women ≥65 years living in Korea. The data were analyzed using structural equation modeling. The fitness parameters of the modified model (χ2 = 227.243, df = 176, χ2/df = 1.29, p = 0.006, root mean square error of approximation = 0.034, goodness of fit index = 0.927, Tucker-Lewis Index = 0.979, comparative fit index = 0.984, normed fit index = 0.933) indicated its suitability as the research model. Perceived benefits of action and social support directly influenced health promoting behavior, and prior related behavior indirectly influenced health promoting behavior. Interventions should aim to directly improve social support and perceived benefits to increase health promoting behaviors.
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Affiliation(s)
- Jihyun Oh
- Department of Nursing, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, South Korea
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Abstract
OBJECTIVES Reminiscence promotes the acceptance of oneself and others, a sense of meaning, and the integration of the present and the past. The currently accepted classification contains eight reminiscence functions grouped in three broader functions: self-positive functions (identity, problem-solving, and death preparation); self-negative functions (bitterness revival, boredom reduction, and intimacy maintenance); and prosocial functions (conversation and teach-inform). The main objective of this study was to investigate how the eight dimensions change over time in a sample of healthy older adults after an intervention based on simple reminiscence and subsequent follow-up. DESIGN Participants were randomly assigned to the treatment or control group. SETTING Participants were evaluated individually before, immediately after, and 3 months after the intervention. PARTICIPANTS Participants included 139 healthy older adults (71 intervention group and 68 control group). INTERVENTION Ten weekly sessions lasting 2 hours each were administered, based on a simple reminiscence program. MEASUREMENTS Participants were assessed with the Reminiscence Functions Scale. RESULTS After the intervention, in the treatment group, there was a significant increase in the self-positive functions of problem-solving and death preparation, and these effects were maintained even at the follow-up; there was a significant reduction in the self-negative functions of bitterness revival and intimacy maintenance; and there was a significant increase in the prosocial function of conversation. CONCLUSIONS When applying an intervention based on reminiscence, it is important to evaluate how it influences these functions because this information can help us to modify the objectives of the intervention and increase its effectiveness.
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Xu D, Simpson VL. Subjective Well-Being, Depression, and Delays in Care Among Older Adults: Dual-Eligible Versus Medicare-Only Beneficiaries. J Appl Gerontol 2021; 41:158-166. [PMID: 33736521 DOI: 10.1177/07334648211000920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to (a) determine the role of subjective well-being and depression in care delays among Medicare beneficiaries and (b) examine whether subjective well-being and depression play a differential role among Medicare-only and dual-eligible beneficiaries. A nationally representative sample of 1,696 older adults participated in the study. Roughly, 22% of participants reported often or sometimes experiencing care delays, with more delays among dual eligibles. We found that higher levels of subjective well-being were significantly related to less frequent care delays. In contrast, higher levels of depression were significantly related to more frequent care delays. Moreover, as depression increased, the predicted probability of delays increased to a greater extent among dual eligibles than Medicare-only beneficiaries. These findings signify the importance of identifying and implementing strategies to enhance subjective well-being and reduce depression in older adults, particularly dual eligibles, to improve access to timely care.
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Saredakis D, Keage HAD, Corlis M, Loetscher T. Virtual reality intervention to improve apathy in residential aged care: protocol for a multisite non-randomised controlled trial. BMJ Open 2021; 11:e046030. [PMID: 33526504 PMCID: PMC7852932 DOI: 10.1136/bmjopen-2020-046030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Apathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Reminiscence therapy is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence use physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders; however, there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to identify changes in apathy after a reminiscence therapy intervention using head-mounted displays (HMDs). METHODS AND ANALYSIS Participants will be allocated to one of three groups; reminiscence therapy using VR; an active control using a laptop computer or physical items and a passive control. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, and secondary outcomes include cognition and depression. Side effects from using HMDs will also be examined in the VR group. Primary and secondary outcomes at baseline and follow-up will be analysed using linear mixed modelling. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of South Australia Human Research Ethics Committee. The results from this study will be disseminated through manuscript publications and national/international conferences. TRIAL REGISTRATION NUMBER ACTRN12619001510134.
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Affiliation(s)
- Dimitrios Saredakis
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Hannah A D Keage
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Megan Corlis
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Tobias Loetscher
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
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Tam W, Poon SN, Mahendran R, Kua EH, Wu XV. The effectiveness of reminiscence-based intervention on improving psychological well-being in cognitively intact older adults: A systematic review and meta-analysis. Int J Nurs Stud 2020; 114:103847. [PMID: 33352435 DOI: 10.1016/j.ijnurstu.2020.103847] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Aging is one of the most important public health issues. The World Health Organization (WHO) expects the number of older adults aged 65 and above to triple from 2010 to 2050. A major challenge would be to consider how functional ability and quality of life could be enhanced in older age. Reminiscence-based interventions are widely reported as having positive effects on psychological outcomes among older adults with dementia, but its effects on cognitively intact older adults have not been clearly evaluated. OBJECTIVES The aim of the current systematic review is to evaluate the existing evidence on the effects of reminiscence-based intervention on psychological outcomes in cognitively intact older adults. REVIEW METHODS Commonly used English databases, including CINAHL, EMBASE, MEDLINE and PsycINFO, were searched from inception till 31 Mar 2020. Studies were included if they examined the effects of reminiscence-based intervention on psychological outcomes among cognitively intact older adults aged 60 and above. Meta-analysis was conducted to synthesise the effects on different psychological outcomes. RESULTS Thirty-one studies involving 1,829 older adults were included. The pooled standardized mean difference for depressive symptoms and life satisfaction were -0.38 (95% CI: -0.69--0.07) and 0.33 (95% CI: 0.14-0.52) respectively. Positive effects were observed on self-esteem, psychological well-being and happiness, though meta-analysis could not be conducted. CONCLUSION Significant reduction of depressive symptoms and improvement of life satisfaction were revealed from the reminiscence-based intervention among cognitively intact older adults. In addition, reminiscence-based intervention has been effective in enhancing self-esteem, and promoting psychological well-being and happiness. Our results suggest that reminiscence-based intervention could be an effective solution to improve psychological well-being among cognitively intact older adults. Such non-pharmacological approach can be recommended for older adults at the community level.
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Affiliation(s)
- Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sum Nok Poon
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Health System, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Academic Development, Duke-NUS Medical School, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University Health System, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Lam J, Aftab A, Lee E, Jeste D. POSITIVE PSYCHIATRY INTERVENTIONS IN GERIATRIC MENTAL HEALTH. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2020; 7:471-488. [PMID: 33643770 PMCID: PMC7904105 DOI: 10.1007/s40501-020-00228-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience. RECENT FINDINGS There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes. SUMMARY The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians' abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.
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Affiliation(s)
- Jeffrey Lam
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Awais Aftab
- Department of Psychiatry, Case Western Reserve University, Cleveland OH
- Northcoast Behavioral Healthcare (Ohio Department of Mental Health and Addiction Services), Northfield, OH
| | - Ellen Lee
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Dilip Jeste
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
- Department of Neurosciences, University of California San Diego, La Jolla, CA
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James KL, Bhar SS. Brief reminiscence intervention improves affect and pessimism in non‐clinical individuals: A pilot study. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kelly L. James
- Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia,
| | - Sunil S. Bhar
- Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia,
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Keisari S, Gesser-Edelsburg A, Yaniv D, Palgi Y. Playback theatre in adult day centers: A creative group intervention for community-dwelling older adults. PLoS One 2020; 15:e0239812. [PMID: 33002024 PMCID: PMC7529427 DOI: 10.1371/journal.pone.0239812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/14/2020] [Indexed: 11/19/2022] Open
Abstract
The literature indicates that theatre and drama-based interventions have the potential to improve older adults' well-being and health. The goal of the current study was to characterize the process of a creative group intervention in adult day centers (ADCs), which integrates playback theatre and life-review principles. Our objective was to provide an evidence-informed framework for drama therapy interventions, which would allow older adults to bring up and explore their life-stories in a dramatic creative process in their own community. A total of 27 participants ranging in age from 63 to 91, took part in one of three playback theatre groups. The playback theatre group intervention comprised 12 weekly sessions. All sessions were videotaped to capture the lived experience of the creative process and were analyzed in post-intervention interviews. In addition, focus group meetings were conducted with 13 ADC staff members to decipher further the effects of the participation as perceived by people outside the groups. Three types of potential transformation were identified in the qualitative analysis: the evolution of life stories, evolution of playfulness, and expansion of social engagement. The results indicate the potential of the integrative framework to serve as a creative intervention in ADC communities, as well as its potential to bring about a personal transformation and expand it to enable a person's social engagement in the community. The findings imply the potential benefits of using playback theatre groups to supplement the routine care provided in ADCs.
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Affiliation(s)
- Shoshi Keisari
- Department of Gerontology, University of Haifa, Haifa, Israel
| | - Anat Gesser-Edelsburg
- School of Public Health and The Health and Risk Communication Research Centre, University of Haifa, Haifa, Israel
| | - Dani Yaniv
- School of Creative Arts Therapies, The Emili Sagol Creative Arts Therapies Research Centre, University of Haifa, Haifa, Israel
| | - Yuval Palgi
- Department of Gerontology, University of Haifa, Haifa, Israel
- The Centre for Research and Study of Aging, University of Haifa, Haifa, Israel
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Shoesmith E, Charura D, Surr C. Acceptability and feasibility study of a six-week person-centred, therapeutic visual art intervention for people with dementia. Arts Health 2020; 13:296-314. [PMID: 32744920 DOI: 10.1080/17533015.2020.1802607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND There has been increasing interest in dementia, the arts and creativity across different disciplines in recent years, with previous literature illustrating the benefits of visual arts for people with dementia. METHOD A mixed-methods, quasi-experimental, pre/post design to assess the feasibility, acceptability and preliminary efficacy of a newly developed therapeutic, person-centred visual art intervention for people with dementia attending a day care centre or residing in an assisted living facility. RESULTS Five themes were identified from the interviews. Two themes reflected the feasibility/acceptability and the perceived impacts of the intervention, and three themes represented perceived successful elements: participant choice, socialisation and mentally stimulating activities. The quantitative data tentatively indicated enhanced social functioning and quality of life scores post-intervention. CONCLUSION These findings indicate that engagement with visual art is effective for people with dementia, and taking into account the factors that impact on feasibility and acceptability will promote future robust evaluation.
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Affiliation(s)
- Emily Shoesmith
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
| | - Divine Charura
- Psychological Therapies and Mental Health, Leeds Beckett University, Leeds, UK
| | - Claire Surr
- Centre for Dementia Research, Leeds Beckett University, Leeds, UK
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Aw S, Koh GCH, Tan CS, Wong ML, Vrijhoef HJM, Harding SC, Ann B Geronimo M, Hildon ZJL. Promoting BioPsychoSocial health of older adults using a Community for Successful Ageing program (ComSA) in Singapore: A mixed-methods evaluation. Soc Sci Med 2020; 258:113104. [PMID: 32559575 DOI: 10.1016/j.socscimed.2020.113104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/04/2020] [Accepted: 05/31/2020] [Indexed: 11/15/2022]
Abstract
BioPsychoSocial health promotion is increasingly emphasized for Successful Ageing. Few programs are known to target BioPsychoSocial health of older adults and their community. The Community for Successful Ageing: Community Development program (ComSA CD) was developed in Singapore for this purpose. This study assessed program effects on BioPsychoSocial health and civic engagement behaviours of participants. ComSA CD offered self-care healthy lifestyle education (Bio-physical), guided autobiography (Psychological) and a civic engagement component which galvanized participants to solve community issues (Social). Recruitment occurred through self-care or guided autobiography; following which participants were funnelled into the civic engagement component. A mixed-methods quasi-experimental evaluation was conducted, using a pre-post one-year survey (N=232) with those exposed and unexposed (rejected) to ComSA CD. Using a generalized linear model, associations between post one-year BioPsychoSocial outcomes and exposure group were quantified using percentage change, adjusting for baseline outcome and group differences. Concurrently, program effects were explored through six focus groups with program implementers and participants using thematic analysis. The program had multiple positive effects. Participants recruited via self-care also taking part in civic engagement reported 31% higher frequency of self-care (95% CI=21% to 68%) post one-year compared to unexposed participants. Qualitative findings illustrated how the civic engagement component stimulated agency of participants to push for neighborhood changes and civic engagement initiatives. The quantitative survey highlighted that this effect was strongest among those funnelled from guided-autobiography (92% higher frequency of civic engagement at post one-year than unexposed; 95%CI=41% to 178%) compared to those funnelled from self-care (53% higher than unexposed, 95%CI=17% to 114%). It was found qualitatively that guided-autobiography enabled more meaningful bonding and communication than the self-care component, explaining quantitative effects on social support only present among guided autobiography participants (36% higher than unexposed; 95%CI=11% to 68%). Findings highlighted the importance of improving group dynamics for collective action.
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Affiliation(s)
- Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Gerald C H Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Hubertus J M Vrijhoef
- Department of Patient and Care, Maastricht University Medical Centre, the Netherlands; Panaxea b.v., Amsterdam, the Netherlands
| | | | | | - Zoe J L Hildon
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Jeffers SL, Hill R, Krumholz MF, Winston-Proctor C. Themes of Gerotranscendence in Narrative Identity Within Structured Life Review. GEROPSYCH 2020. [DOI: 10.1024/1662-9647/a000235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Narrative identity is a person’s internalized and evolving life story. It provides a person with some degree of unity and purpose over the life course. It is shaped by the themes, plots, and images available within an individual’s culture. Research in narrative gerontology finds that positive themes within narrative identity in late life are sparse because of a pervading “narrative of decline,” which may contribute to prevalence of late life depression. Structured Life Review (SLR) is an effective intervention to manage depressive symptoms in older adults. It relies on clinician-guided storytelling and themes drawn from Erikson’s developmental stages to foster positive narrative identity. In this theoretical review, the authors explore gerotranscendence-related themes to inform narrative identity through SLR, the goal being to advance the argument that gerotranscendence can adaptively navigate negative narrative themes. It should be considered within clinical narrative practice to improve psychological well-being for older adults.
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Affiliation(s)
| | - Ricco Hill
- Department of Psychology, Howard University, Washington, DC, USA
| | - Miriam F. Krumholz
- Department of Neurology, Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, NY, USA
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Menn L, Corsten S, Lauer N, Wallace SJ. The Effectiveness of Biographical Approaches in Long-Term Care: A Systematic Review. THE GERONTOLOGIST 2020; 60:e309-e328. [PMID: 31175820 DOI: 10.1093/geront/gnz074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults in long-term residential aged care experience loneliness and reduced quality of life (QoL). Biographical approaches use the recall of the past events to increase self-efficacy, promote acceptance, and improve QoL. The aim of the systematic review was to examine the effectiveness of biographical approaches in improving the QoL of older adults in long-term residential aged care. RESEARCH DESIGN AND METHODS This systematic review was conducted in accordance with PRISMA guidelines, using databases Medline, CINAHL, and the Cochrane Library. A 2-phase search strategy was used to identify research literature relating to the use of biographical interventions. Narrative analysis was used to synthesize results. RESULTS Twenty-one studies met inclusion criteria for this review, comprising both group and individual interventions. The findings were inconsistent. Subjective elements of QoL of older adults improved in a narrow majority of the studies. Of a total of 21 outcomes investigated in group interventions, 11 resulted in significant improvements in QoL. The 16 outcomes of the individual interventions resulted in 10 significant improvements. The most significant influence was observed in life satisfaction. Group reminiscence also had a particularly strong influence on self-esteem. DISCUSSION AND IMPLICATIONS Although benefits were observed, it remains unclear why some interventions led to improvements in subjective elements of QoL and others did not. Exploration of the participant perspective through qualitative data collection and more detailed description of interventions in future studies could lead to a better understanding of the treatment components that are related to improved outcomes for older adults.
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Affiliation(s)
- Lara Menn
- Department for Health Care and Nursing, Catholic University of Applied Sciences, Mainz, Germany
| | - Sabine Corsten
- Department for Health Care and Nursing, Catholic University of Applied Sciences, Mainz, Germany
| | - Norina Lauer
- Department for Social & Health Care Sciences, OTH Regensburg-Technical University of Applied Sciences, Germany
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Zimmermann S, Forstmeier S. From fragments to identity: reminiscence, life review and well-being of holocaust survivors. An integrative review. Aging Ment Health 2020; 24:525-549. [PMID: 30522330 DOI: 10.1080/13607863.2018.1525608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Survivors of the Holocaust have reached an age during which it is common for them to look back on their lives. Previous research has shown that reminiscence can take on either adaptive ('self-positive') or detrimental ('self-negative') forms, which in turn are differently linked to psychological well-being. Thus, the question of "why" and "how" Holocaust survivors recall their autobiographical memories may hold important information about the underlying coping processes at play. This review aims to give insight into the current state of research on these questions.Method: A systematic literature search was conducted, looking for articles reporting quantitative and qualitative research on reminiscence and narrative styles, life review and well-being of Holocaust survivors. A methodological quality assessment was undertaken.Results: 23 articles met the criteria for inclusion. These articles focused either on reminiscence functions or on content and structure of life narratives. Such autobiographical reports were shaped by the experience of Holocaust. However, actual well-being was particularly determined by positive life events. Studies found evidence for resilience and ongoing effort to integrate the past into a coherent review. The link between reminiscence and health remains stable even after massive trauma. Contextual influences (such as culture) and age are discussed as possible covariates.Conclusions: The results show that Holocaust survivors are able to use reminiscence in a functional way, though they are increasingly more vulnerable as they reach very old age. The link between past suffering and present well-being gets stronger with age. Other stressful life experiences after the Holocaust must be considered as exacerbating factors. This review also presents the implications for therapy and open research questions are discussed.
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Hesse M, Forstmeier S, Ates G, Radbruch L. Patients' priorities in a reminiscence and legacy intervention in palliative care. Palliat Care Soc Pract 2020; 13:2632352419892629. [PMID: 32215373 PMCID: PMC7065501 DOI: 10.1177/2632352419892629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/06/2019] [Indexed: 12/04/2022] Open
Abstract
Background: Reminiscence is used in a range of different interventions in palliative
care, for example, Dignity Therapy or Life Review. However, literature has
focused mainly on the methodology, and little has been published on
patients’ priorities and primary concerns. Objective: This study looks at themes emerging in a reminiscence intervention with
patients confronted with a life-limiting disease. Interviews were audiotaped
and transcribed verbatim. Transcripts were analysed using thematic
analysis. Setting/subjects: Seventeen patients who were receiving palliative care at the University
Hospital Bonn participated in interviews reviewing parts or phases of their
lives. Results: Patients expressed satisfaction and a sense of well-being with the
intervention. Major themes emerging in the interviews were the factors
involved in the development and expression of personality, such as
character-forming influences, self-image, self-awareness, and philosophy of
life. Talking about personality was entangled with influences from growing
up, qualification/job, partner/spouse, children, resources, twists of
fate/crossroads, and coping. Conclusion: The topics emerging from the interviews differed from the scope of guiding
questions in common reminiscence methods like Life Review or Dignity
Therapy. The underlying motivation of patients seemed to be the search for
identity and continuity in one’s life.
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Affiliation(s)
- Michaela Hesse
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | - Gülay Ates
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany; Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany
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Nadir experiences and ego-integrity: types of narrative enactment. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractComing to terms with negative life experiences is a way of reaching ego-integrity in mature age, a development task belonging to the last phase of Erikson's theory of psycho-social development. This study explores fundamental tensions between negative life experiences and ego-integrity through the lens of narrative enactment, i.e. by looking at how nadir experiences are constructed in the narratives of study participants. From 166 potential participants, we selected life-story narratives of 42 highly ego-integrated older adults based on a self-rated ego-integrity scale. Data were analysed using the narrative approach, where ageing is perceived as autobiographical work and narrativity is viewed as enactment of the constitutive event of ‘trouble’. Our results suggest a subtle classification of five distinct types of narrative enactment: ‘it turned out well’, ‘I managed to cope with it’, ‘validation with respect to future development’, ‘acquisition of a new attitude’ and, finally, ‘justification of a hard decision’. Each of these enactment types is defined by a particular configuration of narrative categories: agency in a negative event, agency in a positive resolution, reflexivity and construction of moral identity. Our results highlight the meaning of processing and reconstruction of negative life experiences and the various narrative pathways this process can follow in highly ego-integrated older adults.
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Miyawaki CE, Brohard C, Chen NW, Rubin A, Willoughby S. Can Family Caregivers Provide Life Review to Reduce Depression in Older Adults With Dementia? J Gerontol Nurs 2020; 46:41-48. [PMID: 31978238 DOI: 10.3928/00989134-20200108-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 10/17/2019] [Indexed: 11/20/2022]
Abstract
Life review (LR) therapy has received considerable support as an effective treatment for depression among older adults. Researchers believe that providing LR does not require extensive training and can be done by family members who are not psychiatric professionals. If so, then training family caregivers to provide LR is a potential strategy for alleviating the shortage of resources for treating depression among the growing population of older adults experiencing depression. A pilot study that explored the feasibility of that strategy had mixed results. Seventeen (89%) of 19 caregiver-care recipient dyads completed the current study, and caregivers provided the LR with self-reported fidelity. However, there was lack of statistically significant improvement in this convenience sample. Implications are provided for future assessments of this strategy with a larger study of caregiver and care recipient dyads. [Journal of Gerontological Nursing, 46(2), 41-48.].
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Westerhof GJ, Slatman S. In search of the best evidence for life review therapy to reduce depressive symptoms in older adults: A meta-analysis of randomized controlled trials. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/cpsp.12301] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Åström E, Rönnlund M, Adolfsson R, Grazia Carelli M. Depressive symptoms and time perspective in older adults: associations beyond personality and negative life events. Aging Ment Health 2019; 23:1674-1683. [PMID: 30450950 DOI: 10.1080/13607863.2018.1506743] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: To examine the extent to which time perspective, an individual's habitual way of relating to the past, the present, and the future time frames, accounts for variations in self-reported depressive symptoms among older adults. Method: Four hundred two participants (60-90 years) completed the Center for Epidemiological Studies Depression scale (CES-D) and the Swedish Zimbardo Time perspective Inventory (S-ZTPI). The influence of personality as reflected by the Temperament and Character Inventory (TCI) and self-reported negative life events (NLEs) were controlled for in hierarchic regression analyses. Results: The six S-ZTPI dimensions accounted for 24.5% of the variance in CES-D scores beyond age and gender. Half of the variance remained when the TCI factors and NLEs were controlled for. Past Negative, Future Negative, and Past Positive (inverse association) were the significant unique predictors. Significant age interactions were observed for two S-ZTPI dimensions, with a diminished association to depressive symptoms for Future Negative and a magnified association for Present Fatalistic with higher age. Conclusions: The results demonstrate a substantial relation between facets of time perspective and depressive symptoms in old age. They also indicate an age-related shift in the relative importance from concerns about of the future (Future Negative) to the present (Present Fatalistic) with increased age. In young old-age, when the future is more 'open', future worries (Future Negative) may be a more frequent source of distress. In late senescence, perceived threats to autonomy (e.g. physical health problems and cognitive deficits), as reflected by higher scores on Present Fatalistic, may instead have more bearing on mood state.
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Affiliation(s)
| | | | - Rolf Adolfsson
- Department of Clinical Sciences, Division of Psychiatry, Umeå University , Umeå , Sweden
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Life review therapy for older adults with depressive symptoms in general practice: results of a pilot evaluation. Int Psychogeriatr 2019; 31:1801-1808. [PMID: 31032754 DOI: 10.1017/s1041610219000218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE General practices play an important role in the detection and treatment of depressive symptoms in older adults. An adapted version of the indicated preventive life review therapy group intervention called Looking for Meaning (LFM) was developed for general practice and a pilot evaluation was conducted. DESIGN A pretest-posttest design was used. One week before and one week after the intervention participants filled out questionnaires. SETTING In six general practices in the Netherlands the adapted intervention was given. PARTICIPANTS Inclusion criteria were > 60 years and a score of 5 or higher on the Center for Epidemiological Studies Depression Scale (CES-D). INTERVENTION The length and number of LFM sessions were shortened and the intervention was given by one mental health care nurse practitioner (MHCNP). MEASUREMENTS The impact on mental health was analyzed by depressive symptoms (CES-D) as the primary outcome and anxiety symptoms (HADS-A), psychological well-being (PGCMS) and mastery (PMS) as secondary outcomes. An evaluative questionnaire was included to evaluate the feasibility and acceptability. RESULTS Most participants were satisfied with the adaptations of the number (72%) and length (72%) of sessions. The overall sample showed a significant decrease in depressive symptoms after the intervention. No impact was found on psychological well-being, anxiety symptoms and mastery. CONCLUSIONS The intervention is feasible and acceptable for older adults with depressive symptoms and has an impact on their depressive symptoms.
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Aw S, Koh GCH, Tan CS, Wong ML, Vrijhoef HJM, Harding SC, Geronimo MAB, Hildon ZJL. Exploring the implementation of the Community for Successful Ageing (ComSA)program in Singapore: lessons learnt on program delivery for improving BioPsychoSocial health. BMC Geriatr 2019; 19:263. [PMID: 31664899 PMCID: PMC6820954 DOI: 10.1186/s12877-019-1271-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Community for Successful Ageing (ComSA) program has implemented overlapping BioPsychoSocial (BPS) components as part of a Community Development (CD) grassroots and volunteer-led initiative. Implementation of such multi-component programming is influenced by known program characteristics including novelty, complexity and observability as well as related organizational factors. As such, we explored ComSA CD's implementation from the organizational perspective, seeking to inform program improvements. METHODS We conducted four focus groups with program staff, partners and trainers (total N = 21 participants). Findings were analysed using an interpretative approach and synthesized into a line of argument informing lessons learnt. RESULTS An implementation framework was identified. It is guided by considering the influence of known program characteristics across major themes, representing three core implementation stages. These and supporting sub-themes are elaborated in turn: 1) Creating commitment toward the program was challenged by novelty and at times a lack of shared understanding of ComSA CD, particularly relating to the S component. Overall, cohesion within organizational contexts and having a strong rapport with the community (ability to engage) were needed to persuade volunteers and participants to commit to the program. 2) Coordination and resource allocation were influenced by the complexity of interconnecting BPS components - requiring aligning communication between partners and adapting the BPS sequence, given the separated management structure of program trainers. Efficiency of resource utilization was constrained by the ability to pool and match resources given the limited manpower and community partners who worked-in-silo due to a KPI-centric culture. 3) Collaborative program monitoring and appraisal increased observability of the program's benefits, but depended on partners' prior commitment. Despite appreciating its holistic BPS programming, dropout rate was used as a way to gauge program success, which has limited interpretability. Occasional uncertainty about the program value contributed to concerns about duplicating existing ageing programs, particularly those related to the B component. CONCLUSION Lessons learnt for improving BPS programming include (1) eliciting better participants' buy-in and shared program vision, (2) increasing adaptability of BPS sequence and building a culture of shared values for working together (3) and developing comprehensive monitoring systems for program appraisal.
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Affiliation(s)
- Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549, Singapore.
| | - Gerald C H Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-03G, Singapore, 117549, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Hubertus J M Vrijhoef
- Department of Patient and Care, Maastricht University Medical Centre, P.Debyelaan, 25, 6229 HX, Masstricht, The Netherlands.,Department of Family Medicine, Vrije Universiteit Brussel, Brussel, Belgium
| | - Susana Concordo Harding
- Tsao Foundation, 298 Tiong Bahru Road, #15-01/06 Central Plaza, Singapore, 168730, Singapore
| | - Mary Ann B Geronimo
- Tsao Foundation, 298 Tiong Bahru Road, #15-01/06 Central Plaza, Singapore, 168730, Singapore
| | - Zoe J L Hildon
- Bloomberg School of Public Health, The John Hopkins University, 111 Market Place, Suite 310, Baltimore, Maryland, 21202, USA.,London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, Department of Global Health and Development, Keppel street, London, WC1E 7HT, UK.,Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore, Singapore
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Aw S, Koh GCH, Tan CS, Wong ML, Vrijhoef HJM, Harding SC, Geronimo MAB, Hildon ZJL. Theory and Design of the Community for successful ageing (ComSA) program in Singapore: connecting BioPsychoSocial health and quality of life experiences of older adults. BMC Geriatr 2019; 19:254. [PMID: 31594545 PMCID: PMC6784337 DOI: 10.1186/s12877-019-1277-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 09/10/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite the emphasis on holistic health promotion in community programs for older people, few studies explicitly consider how BioPsychoSocial (BPS) health elements are interconnected and function to improve Quality of Life (QoL). The Community for Successful Ageing (ComSA) program in Singapore focuses on Community Development (CD) initiatives for older people, accounting for BPS theory in its design and content. Biological (B) health is conceived as physiological and cognitive functioning and related biological self-care; Psychological (P) health as feelings of life satisfaction, and Social health (S) as perceived social support and civic engagement. Furthermore, three overlapping sub-constructs are theorized to connect these elements. Namely Bio-Psychological (BP) health in terms of self-perceptions of ageing; the Psycho-Social (PS) aspects of interpersonal communication; and the Socio-Communal (SC) health in terms of civic engagement. BPS health is conceived as distinct from QoL, defined as composed of control, autonomy, self-realisation and pleasure (measured by CASP-19) of the older person. We examined 1) interconnections of BPS constructs and related sub-constructs and 2) their associations with QoL to inform a practical, applied program theory. METHODS A baseline survey (n = 321) of program participants (Mean = 70 years, SD = 8.73). All continuous variables were binarized as 'high' if the scores were above the median. Multivariate logistic regression was used to assess 1) the adjusted effect of each BPS construct on CASP-19, and 2) the odds of scoring high on one BPS construct with the odds of scoring high on a related sub-construct (e.g. B and BP health). RESULTS The strongest relationship with QoL was markedly with BP self-perceptions of ageing (OR = 4.07, 95%CI = 2.21-7.49), followed by P life satisfaction (OR = 3.66, 95%CI = 2.04-6.57), PS interpersonal communication (OR = 2.42, 95%CI = 1.23-4.77), SC civic engagement (OR = 1.94, 95%CI = 1.05-3.57), and S social support (OR = 1.89, 95%CI = 1.06-3.38). Core B, P and S health were closely associated with their sub-constructs. CONCLUSION ComSA CD is tightly coupled to its proposed program theory. It offers classes to improve B self-care and BP self-perceptions of ageing, group-based guided autobiography to improve P life-satisfaction and PS interpersonal communication, and community initiatives that encourage seniors to solve community issues. This holistic approach is likely to enhance ageing experiences and QoL.
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Affiliation(s)
- Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549 Singapore
| | - Gerald C. H. Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549 Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549 Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549 Singapore
| | - Hubertus J. M. Vrijhoef
- Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Family Medicine, Vrije Universiteit Brussel, Brussel, Belgium
| | | | | | - Zoe J. L. Hildon
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549 Singapore
- Bloomberg School of Public Health, The John Hopkins University, Maryland, USA
- Faculty of Public Health and Policy, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel street, London, WC1E 7HT UK
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Hesse M, Forstmeier S, Cuhls H, Radbruch L. Volunteers in a biography project with palliative care patients - a feasibility study. BMC Palliat Care 2019; 18:79. [PMID: 31590633 PMCID: PMC6781359 DOI: 10.1186/s12904-019-0463-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
Background Increasing the quality of life with short interventions for vulnerable patients is one of the objectives of palliative care. Biographical approaches are used in a range of different interventions which may require considerable resources of staff time and energy. This study evaluated the feasibility of training hospice volunteers in biographical interviews of patients confronted with a life-limiting disease. For the purpose of this study, we evaluated resources such as time needed for training, coordination and supervision, outcome such as completion of the intervention in appropriate time and risks such as causing distress in patients or volunteers as major determinants of feasibility. Methods Nine volunteers from a hospice service attended an advanced training with an introduction to palliative care, biography work, interview techniques, transcribing and writing. Volunteers interviewed a patient and developed a written narrative from the interview. Volunteers completed a questionnaire before training and were interviewed at the end of the project. The interviews were audiotaped, transcribed, and evaluated using descriptive and qualitative content analysis. Results Patients provided positive feedback from the intervention. Volunteers felt that their involvement was personally rewarding and were moved by the courage and confidence of the patients. There were no systematic problems or negative experiences reported neither by volunteers nor by patients. Conclusions We found the use of volunteers for biography work with patients in palliative care feasible and effective in this study. Volunteers needed supervision and ongoing support in providing this intervention.
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Affiliation(s)
- Michaela Hesse
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Str. 25, D- 53127, Bonn, Germany.
| | - Simon Forstmeier
- Department of Psychology, University Siegen, Adolf-Reichwein-Str. 2a, D- 57076, Siegen, Germany
| | - Henning Cuhls
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Str. 25, D- 53127, Bonn, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Sigmund-Freud-Str. 25, D- 53127, Bonn, Germany.,Department of Palliative Medicine, Malteser Hospital Seliger Gerhard Bonn / Rhein-Sieg, Von-Hompesch-Str. 1, D- 53123, Bonn, Germany
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Zamorano Llena C. Looking Very Old Age in the Eye: A Nuanced Approach to the Fourth Age in Contemporary Irish Fiction: A Case Study. THE GERONTOLOGIST 2019; 59:956-963. [PMID: 29688420 DOI: 10.1093/geront/gny035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Associations of young-old age with successful aging have contributed to relegating negatively perceived aspects of aging to very old age. This has prompted the formation of the social imaginary of the fourth age. Re-examinations of the fourth age foreground the diversity of aging experiences among the oldest old. In this sense, literature is in a privileged position to contribute individual narratives of aging to this field. The main aim of this article is to analyze Irish writer Jennifer Johnston's later fiction and how particularly two of her later fictional works contribute a nuanced re-examination of the fourth age through the narrativization of individual aging experiences of the oldest old in the contemporary Irish context. RESEARCH DESIGN AND METHODS The work of sociologists and social theorists on re-examinations of the fourth age functions as the framework to analyze the selected fictional texts. RESULTS The analysis of the oldest old characters in Truth or Fiction and Naming the Stars shows the contribution of literary texts to rethinking the fourth age as a time characterized by the inextricable combination of gains and losses, with emphasis on the diversity of the aging experiences of the oldest old and on the importance of sociocultural influence on individual aging. DISCUSSION AND IMPLICATIONS Combining longitudinal analyses with case studies, such as the ones suggested by these fictional texts, can provide a more accurate knowledge of the experience of advanced old age and the fourth age.
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Ingersoll-Dayton B, Kropf N, Campbell R, Parker M. A systematic review of dyadic approaches to reminiscence and life review among older adults. Aging Ment Health 2019; 23:1074-1085. [PMID: 30596457 DOI: 10.1080/13607863.2018.1555696] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This paper describes a systematic review of quantitative and qualitative studies that examine the effectiveness of dyadic approaches to life review and reminiscence. Methods: The search process began with 1,056 potentially eligible articles and, after a multi-step screening process, led to 20 full-text articles for review. Results: The resulting studies (ten quantitative, nine qualitative, and one mixed-method) comprised six different kinds of dyadic approaches. There are a combination of benefits and problems associated with dyadic life review and reminiscence approaches. Conclusions: This review provides initial understanding of the impact of life review and reminiscence when care recipients and caregivers participate in the intervention together. Future clinical studies on dyadic approaches to life review and reminiscence should provide clearer descriptions of their protocols, include more consistent measures (incorporating in-the-moment measures), and involve populations of healthy older adults and their partners as well as those with cognitive impairment. The inclusion of qualitative studies helps interpret the diverse results reported in the quantitative studies and highlights key themes related to participating in dyadic interventions.
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Affiliation(s)
| | - Nancy Kropf
- b Georgia State University , Atlanta , GA , USA
| | - Ruth Campbell
- c Turner Geriatric Clinic, Medical Center , University of Michigan , Ann Arbor , MI , USA
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50
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Franz S, Schulz B, Wang H, Gottschalk S, Grüter F, Friedrich J, Glaesener JJ, Bock F, Schott C, Müller R, Schultes K, Landmann G, Gerner HJ, Dietz V, Treede RD, Weidner N. Management of pain in individuals with spinal cord injury: Guideline of the German-Speaking Medical Society for Spinal Cord Injury. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2019; 17:Doc05. [PMID: 31354397 PMCID: PMC6637293 DOI: 10.3205/000271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Indexed: 12/19/2022]
Abstract
Introduction: Pain is a prominent complication in spinal cord injury (SCI). It can either occur as a direct or as an indirect consequence of SCI and it often heavily influences the quality of life of affected individuals. In SCI, nociceptive and neuropathic pain can equally emerge at the same time above or below the level of injury. Thus, classification and grading of pain is frequently difficult. Effective treatment of SCI-related pain in general and of neuropathic pain in particular is challenging. Current treatment options are sparse and their evidence is considered to be limited. Considering these aspects, a clinical practice guideline was developed as basis for an optimized, comprehensive and standardized pain management in SCI-related pain. Methods: The German-Speaking Medical Society for Spinal Cord Injury (Deutschsprachige Medizinische Gesellschaft für Paraplegiologie – DMGP) developed a clinical practice guideline that received consensus from seven further German-speaking medical societies and one patient organization. The evidence base from clinical trials and meta-analyses was summarized and subjected to a structured consensus-process in accordance with the regulations of the Association of Scientific Medical Societies in Germany (AWMF) and the methodological requirements of the “German instrument for methodological guideline appraisal”. Results: This consensus-based guideline (S2k classification according to the AWMF guidance manual and rules) resulted in seven on-topic statements and 17 specific recommendations relevant to the classification, assessment and therapy of pain directly or indirectly caused by SCI. Recommended therapeutic approaches comprise pharmacological (e.g. nonsteroidal anti-inflammatory drugs or anticonvulsants) and non-pharmacological (e.g. physical activity or psychotherapeutic techniques) strategies for both nociceptive and neuropathic pain. Discussion: Assessment of SCI-related pain is standardized and respective methods in terms of examination, classification and grading of pain are already in use and validated in German language. In contrast, valid, evidence-based and efficient therapeutic options are limited and ask for further clinical studies, ideally randomized controlled trials and meta-analyses.
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Affiliation(s)
- Steffen Franz
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Barbara Schulz
- BG Klinikum Bergmannstrost, Abteilung Medizinische Psychologie, Spezielle Traumatherapie (DeGPT), Hypnotherapie und Hypnose (DGH), Halle, Germany
| | - Haili Wang
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Gottschalk
- Zentralklinik Bad Berka GmbH, Querschnittgelähmten-Zentrum/Klinik für Paraplegiologie und Neuro-Urologie, Bad Berka, Germany
| | - Florian Grüter
- Kliniken Beelitz GmbH, Neurologische Rehabilitationsklinik, Beelitz-Heilstätten, Germany
| | | | | | | | - Cordelia Schott
- Orthopädische Privatpraxis Schott (OPS), Im Medizinischen Zentrum Essen, Germany
| | | | - Kevin Schultes
- Fördergemeinschaft der Querschnittgelähmten in Deutschland e.V., Lobbach, Germany
| | - Gunther Landmann
- Center for Pain Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Hans Jürgen Gerner
- Fördergemeinschaft der Querschnittgelähmten in Deutschland e.V., Lobbach, Germany
| | - Volker Dietz
- Spinal Cord Injury Center, University Hospital Balgrist, Zurich, Switzerland
| | - Rolf-Detlef Treede
- Chair of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Heidelberg University, Mannheim, Germany
| | - Norbert Weidner
- Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
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