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Bloska J, Crabtree S, Wollersberger N, Mitchell O, Coles J, Halsey C, Parry G, Stewart R, Thacker S, Thacker M, Claydon-Mueller L, Winnard Y, McMahon K, Petrowitz C, Smrokowska-Reichmann A, van Doorn B, Baker FA, Blauth L, Bukowska AA, Stensæth K, Tamplin J, Wosch T, Odell-Miller H. Experiences of participant and public involvement in an international randomized controlled trial for people living with dementia and their informal caregivers. Res Involv Engagem 2024; 10:43. [PMID: 38698480 PMCID: PMC11064380 DOI: 10.1186/s40900-024-00574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/18/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND This study was initiated and co-designed by a Participant and Public Involvement (PPI) group attached to HOMESIDE, a randomized controlled trial that investigated music and reading interventions for people living with dementia and their family caregivers across five countries: Australia, Germany, Norway, Poland, and the UK. The aim was to capture experiences of PPI across the five countries, explore the benefits and challenges of PPI in dementia research, and identify contributions made to the study. METHODS We surveyed PPI members and academic researchers who collaborated on the HOMESIDE study. The survey was co-designed through consultation with PPI members and academics, alongside a small scoping literature review. Survey questions covered four topics: (1) expectations for PPI, (2) perceived contributions of PPI to the research study, (3) benefits and challenges of PPI, and (4) recommendations for future PPI in dementia research. RESULTS There were 23 responses, representing 50% of the PPI members (n = 16) and 29% of academics (n = 7). PPI was found to be beneficial to the research and individuals involved. Contributions to the research included supporting recruitment and publicity, advising on the design of participant-facing materials, guiding the design and delivery of the interventions, and identifying cultural differences affecting research delivery. PPI members benefited from building connections, sharing experiences and receiving support, learning about dementia and research, and gaining new unexpected experiences. Academics learned about the realities of living with dementia, which they felt informed and grounded their work. Several challenges were identified, including the need for clear expectations and objectives, inconsistency of PPI members across research stages, limitations of meeting online versus in-person, scheduling difficulties, and language barriers. CONCLUSIONS This study identifies important considerations for implementing PPI within dementia studies and international healthcare research more broadly. Our findings guided the development of five recommendations: (1) involve PPI members as early as possible and throughout the research process; (2) create a space for constructive criticism and feedback; (3) have clear tasks, roles, and expectations for PPI members; (4) involve PPI members with a diverse range of experiences and backgrounds; and (5) embed infrastructure and planning to support PPI.
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Grants
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- the National Health and Medical Research Council, Australia (APP1169867); The Research Council of Norway (project no. 298995); Federal Ministry of Education and Research, Germany (01ED1901); The National Centre for Research and Development, Poland (JPND/04/2019); and Alzheimer's Society, UK (grant no. 462). EU Joint Programme - Neurodegenerative Disease Research
- EU Joint Programme – Neurodegenerative Disease Research
- Anglia Ruskin University
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Affiliation(s)
- Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK.
| | - Sarah Crabtree
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Nina Wollersberger
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Oti Mitchell
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Jenny Coles
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Caroline Halsey
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Geraldine Parry
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Robert Stewart
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Susan Thacker
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Mark Thacker
- Public Contributor, Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Leica Claydon-Mueller
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Yvette Winnard
- School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Australia
| | - Carina Petrowitz
- Institute for Applied Social Sciences, Technical University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | | | - Beatrix van Doorn
- Singing in Elderly Care, Singing Norway, Oslo, Norway
- Public Contributor, Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Felicity A Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Laura Blauth
- Institute of Applied Sciences, University of Physical Education in Kraków, Kraków, Poland
| | - Anna A Bukowska
- Institute of Applied Sciences, University of Physical Education in Kraków, Kraków, Poland
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Australia
| | - Thomas Wosch
- Institute for Applied Social Sciences, Technical University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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2
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Thompson N, Hsu MH, Odell-Miller H, Underwood BR, Wolverson E. Characteristics, outcomes, facilitators and barriers for psychosocial interventions on inpatient mental health dementia wards: a systematic review. BMC Geriatr 2024; 24:364. [PMID: 38654223 PMCID: PMC11040912 DOI: 10.1186/s12877-024-04965-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The National Institute for Health and Care Excellence guidelines state that psychosocial interventions should be the first line of treatment for people with dementia who are experiencing distress behaviours, such as agitation and depression. However, little is known about the characteristics and outcomes of psychosocial interventions or the facilitators and barriers to implementation on inpatient mental health dementia wards which provide care for people with dementia who are often experiencing high levels of distress. METHODS A systematic search was conducted on MEDLINE, CINAHL, PsycINFO, Psychology and Behavioural Sciences Collection, and Scopus in May 2023, following PRISMA guidelines. Reference and citation searches were conducted on included articles. Peer-reviewed literature of any study design, relating to psychosocial interventions in inpatient mental health dementia wards, was included. One author reviewed all articles, with a third of results reviewed independently by a second author. Data were extracted to a bespoke form and synthesised using a narrative review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS Sixteen studies were included in the synthesis, which together included a total of 538 people with dementia. Study methods and quality varied. Psychosocial interventions delivered on wards included music therapy (five studies), multisensory interventions (four studies), multicomponent interventions (two studies), technology-based interventions (two studies), massage interventions (two studies) and physical exercise (one study). Reduction in distress and improvement in wellbeing was demonstrated inconsistently across studies. Delivering interventions in a caring and individualised way responding to patient need facilitated implementation. Lack of staff time and understanding of interventions, as well as high levels of staff turnover, were barriers to implementation. CONCLUSION This review highlights a striking lack of research and therefore evidence base for the use of psychosocial interventions to reduce distress in this vulnerable population, despite current healthcare guidelines. More research is needed to understand which psychosocial interventions can reduce distress and improve wellbeing on inpatient mental health dementia wards, and how interventions should be delivered, to establish clinical and cost effectiveness and minimise staff burden.
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Affiliation(s)
- Naomi Thompson
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK.
- Arts Therapies Services, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK.
| | - Ming-Hung Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
- Arts Therapies Services, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
- Arts Therapies Services, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Emma Wolverson
- Dementia UK, London, UK
- Faculty of Health Sciences, University of Hull, Hull, UK
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Smrokowska-Reichmann A, Janus E, Tamplin J, Odell-Miller H, Stensæth K, Wenborn J, Viken RM, Wosch T, Bukowska AA, Sousa TV, Baker FA. The HOMESIDE Study-A Research Project to Support People Living With Dementia and Their Family Caregivers: Preliminary Report on Reading Intervention. Gerontol Geriatr Med 2024; 10:23337214241239174. [PMID: 38510059 PMCID: PMC10953035 DOI: 10.1177/23337214241239174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/21/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
The behavioral and psychological symptoms of dementia (BPSD) can be challenging for family caregivers to cope with, leading to distress and fatigue. It is therefore important to offer effective strategies to reduce the impact of BPSD. The HOMESIDE randomized controlled trial (RCT) was testing purposefully developed interventions to improve the quality of life and wellbeing of dyads of people with dementia and family caregivers as a result of reduction of BPSD. HOMESIDE RCT was conducted in Australia, Germany, Norway, Poland and the United Kingdom between 2019 and 2022. The study design was a three-arm parallel-group single-blinded, pragmatic RCT with a sample size of 432 dyads. Dyads were randomly allocated to one of three treatment conditions: Music Intervention plus Standard Care; or Reading Intervention plus Standard Care; or Standard Care only. The Reading Intervention (RI) within the HOMESIDE RCT aimed to evoke shared discussion, reminiscence, meaningful shared experiences and consequently enrich everyday life, interaction and the emotional connection between the caregiver (CG) and carereceiver (CR); as well as to enhance activities of daily living and to promote relaxation or stimulation as appropriate. This paper describes the underlying conceptual framework, the content, and delivery of the Reading Intervention within the HOMESIDE RCT.
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Affiliation(s)
| | - Edyta Janus
- University of Physical Education in Kraków, Poland
| | | | | | | | | | | | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Germany
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4
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Baker FA, Pac Soo V, Bloska J, Blauth L, Bukowska AA, Flynn L, Hsu MH, Janus E, Johansson K, Kvamme T, Lautenschlager N, Miller H, Pool J, Smrokowska-Reichmann A, Stensæth K, Teggelove K, Warnke S, Wosch T, Odell-Miller H, Lamb K, Braat S, Sousa TV, Tamplin J. Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial. EClinicalMedicine 2023; 65:102224. [PMID: 38106552 PMCID: PMC10725050 DOI: 10.1016/j.eclinm.2023.102224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/24/2023] [Accepted: 09/05/2023] [Indexed: 12/19/2023] Open
Abstract
Background Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear. Methods We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748. Findings Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred. Interpretation Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms. Funding Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.
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Affiliation(s)
- Felicity Anne Baker
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Vanessa Pac Soo
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Laura Blauth
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Anna A. Bukowska
- Institute of Applied Sciences, University of Physical Education in Krakow, Poland
| | - Libby Flynn
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Ming Hung Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Edyta Janus
- Institute of Applied Sciences, University of Physical Education in Krakow, Poland
| | - Kjersti Johansson
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Tone Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- North Western Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Hayley Miller
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Jonathan Pool
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | | | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Norway
| | - Kate Teggelove
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Sven Warnke
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Thomas Wosch
- Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom
| | - Karen Lamb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Tanara Vieira Sousa
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
| | - Jeanette Tamplin
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia
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Maidhof C, Müller V, Lartillot O, Agres K, Bloska J, Asano R, Odell-Miller H, Fachner J. Intra- and inter-brain coupling and activity dynamics during improvisational music therapy with a person with dementia: an explorative EEG-hyperscanning single case study. Front Psychol 2023; 14:1155732. [PMID: 37842703 PMCID: PMC10570426 DOI: 10.3389/fpsyg.2023.1155732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/06/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Real-life research into the underlying neural dynamics of improvisational music therapy, used with various clinical populations, is largely lacking. This single case study explored within-session differences in musical features and in within- and between-brain coupling between a Person with Dementia (PwD) and a music therapist during a music therapy session. Methods Dual-EEG from a music therapist and a PwD (male, 31 years) was recorded. Note density, pulse clarity and synchronicity were extracted from audio-visual data. Three music therapists identified moments of interest and no interest (MOI/MONI) in two drum improvisations. The Integrative Coupling Index, reflecting time-lagged neural synchronization, and musical features were compared between the MOI and MONI. Results Between-brain coupling of 2 Hz activity was increased during the MOI, showing anteriority of the therapist's neural activity. Within-brain coupling for the PwD was stronger from frontal and central areas during the MOI, but within-brain coupling for the therapist was stronger during MONI. Differences in musical features indicated that both acted musically more similar to one another during the MOI. Conclusion Within-session differences in neural synchronization and musical features highlight the dynamic nature of music therapy. Significance The findings contribute to a better understanding of social and affective processes in the brain and (interactive) musical behaviors during specific moments in a real-life music therapy session. This may provide insights into the role of such moments for relational-therapeutic processes.
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Affiliation(s)
- Clemens Maidhof
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
- Josef Ressel Centre for Personalized Music Therapy, University of Applied Sciences IMC Krems, Krems an der Donau, Austria
| | - Viktor Müller
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Olivier Lartillot
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
| | - Kat Agres
- Yong Siew Toh Conservatory of Music, National University of Singapore, Singapore, Singapore
- Centre for Music and Health, National University of Singapore, Singapore, Singapore
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rie Asano
- Institute of Musicology, University of Cologne, Cologne, Germany
- Advanced Comprehensive Research Organization, Teikyo University, Tokyo, Japan
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jörg Fachner
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
- Josef Ressel Centre for Personalized Music Therapy, University of Applied Sciences IMC Krems, Krems an der Donau, Austria
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6
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Fachner J, Maidhof C, Murtagh D, De Silva D, Pasqualitto F, Fernie P, Panin F, Michell A, Muller-Rodriguez L, Odell-Miller H. Music therapy, neural processing, and craving reduction: an RCT protocol for a mixed methods feasibility study in a Community Substance Misuse Treatment Service. Addict Sci Clin Pract 2023; 18:36. [PMID: 37245018 DOI: 10.1186/s13722-023-00385-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/01/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Music therapy has been shown to be effective for multiple clinical endpoints associated with substance use disorder such as craving reduction, emotion regulation, depression, and anxiety, but there are a lack of studies investigating those effects in UK Community Substance Misuse Treatment Services (CSMTSs). Furthermore, there is a demand for identifying music therapy mechanisms of change and related brain processes for substance use disorder treatment. The present study aims to evaluate the feasibility and acceptability of music therapy and a pre-test, post-test, and in-session measurement battery in a CSMTS. METHODS Fifteen participants, from a community service based in London, will take part in a mixed-methods non-blind randomized-controlled trial. Ten participants will receive six-weekly sessions of music therapy in addition to the standard treatment offered by the CSMTS-five of them will receive individual music therapy and five of them will receive group music therapy-while a further five participants will act as a control group receiving standard treatment only. Satisfaction and acceptability will be evaluated in focus groups with service users and staff members following the final treatment session. Moreover, attendance and completion rates will be monitored throughout the intervention. Subjective and behavioral indexes will be assessed before and after the interventions to explore the effects of music therapy on craving, substance use, symptoms of depression and anxiety, inhibitory control, and will be correlated with associated neurophysiological signatures. In-session analysis of two individual music therapy sessions will serve to explore how music and emotion are processed in the brain within the therapy. The data collected at each step will be included in an intention-to-treat analysis basis. DISCUSSION This study will provide a first report on the feasibility of music therapy as an intervention for participants with substance use disorder engaged within a community service. It will also provide valuable information regarding the implementation of a multifaceted methodology that includes neurophysiological, questionnaire-based, and behavioral assessments in this cohort. Notwithstanding the limitation of a small sample size, the present study will provide novel preliminary data regarding neurophysiological outcomes in participants with substance use disorder that received music therapy. TRIAL REGISTRATION ClinicalTrails.gov, NCT0518061, Registered 6 January 2022, https://clinicaltrials.gov/ct2/show/NCT05180617.
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Affiliation(s)
- Jörg Fachner
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK.
| | - Clemens Maidhof
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Daniel Murtagh
- Innovation & Research Unit, Westminster Drug Project (WDP), London, UK
| | - Devon De Silva
- Innovation & Research Unit, Westminster Drug Project (WDP), London, UK
| | - Filippo Pasqualitto
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Paul Fernie
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Francesca Panin
- School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Andrew Michell
- Clinical Neurophysiology, Addenbrooke's Hospital, Cambridge, UK
| | | | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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7
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Smith L, López Sánchez GF, Shin JI, Soysal P, Pizzol D, Barnett Y, Kostev K, Jacob L, Veronese N, Butler L, Odell-Miller H, Bloska J, Underwood BR, Koyanagi A. Pain and mild cognitive impairment among adults aged 50 years and above residing in low- and middle-income countries. Aging Clin Exp Res 2023:10.1007/s40520-023-02434-7. [PMID: 37227581 DOI: 10.1007/s40520-023-02434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Previous studies on the association between pain and cognitive decline or impairment have yielded mixed results, while studies from low- and middle-income countries (LMICs) or specifically on mild cognitive impairment (MCI) are scarce. Thus, we investigated the association between pain and MCI in LMICs and quantified the extent to which perceived stress, sleep/energy problems, and mobility limitations explain the pain/MCI relationship. METHODS Data analysis of cross-sectional data from six LMICs from the Study on Global Ageing and Adult Health (SAGE) were performed. MCI was based on the National Institute on Aging-Alzheimer's Association criteria. "Overall in the last 30 days, how much of bodily aches or pain did you have?" was the question utilized to assess pain. Associations were examined by multivariable logistic regression analysis and meta-analysis. RESULTS Data on 32,715 individuals aged 50 years and over were analysed [mean (SD) age 62.1 (15.6) years; 51.7% females]. In the overall sample, compared to no pain, mild, moderate, and severe/extreme pain were dose-dependently associated with 1.36 (95% CI = 1.18-1.55), 2.15 (95% CI = 1.77-2.62), and 3.01 (95% CI = 2.36-3.85) times higher odds for MCI, respectively. Mediation analysis showed that perceived stress, sleep/energy problems, and mobility limitations explained 10.4%, 30.6%, and 51.5% of the association between severe/extreme pain and MCI. CONCLUSIONS Among middle-aged to older adults from six LMICs, pain was associated with MCI dose-dependently, and sleep problems and mobility limitations were identified as potential mediators. These findings raise the possibility of pain as a modifiable risk factor for developing MCI.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge , CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge, CB21 5EF, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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McMahon K, McFerran K, Clark IN, Odell-Miller H, Stensæth K, Tamplin J, Baker FA. Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study. Front Med (Lausanne) 2023; 10:1205784. [PMID: 37275362 PMCID: PMC10232877 DOI: 10.3389/fmed.2023.1205784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Katrina McFerran
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N. Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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9
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Pac Soo V, Baker FA, Sousa TV, Odell-Miller H, Stensæth K, Wosch T, Bukowska AA, Tamplin J, Lautenschlager N, Braat S, Lamb KE. Statistical analysis plan for HOMESIDE: a randomised controlled trial for home-based family caregiver-delivered music and reading interventions for people living with dementia. Trials 2023; 24:316. [PMID: 37226214 DOI: 10.1186/s13063-023-07327-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Most people with dementia live in the community, not in residential care. Therefore, quality informal care for them is critical for managing behavioural and psychological symptoms of dementia (BPSD). Music therapy has been shown to reduce BPSD. However, no randomised controlled trial has examined the effects of music interventions delivered by caregivers in home settings. The HOME-based caregiver-delivered music intervention for people living with dementia (HOMESIDE) trial aims to evaluate the effectiveness of a 12-week music intervention in addition to standard care for BPSD. This article describes the statistical analysis plan. METHODS AND ANALYSIS HOMESIDE is a large, pragmatic international three-arm parallel-group randomised controlled trial. Dyads (persons with dementia and caregiver) in Australia, Germany, the UK, Poland and Norway were randomised to receive music and standard care, reading and standard care or standard care alone. The primary outcome is BPSD (proxy) of the person living with dementia, measured using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) at 90 and 180 days post-randomisation. Longitudinal analysis will compare NPI-Q severity between music and standard care versus standard care alone. Secondary outcomes include quality of life and depression (both person with dementia and caregiver), cognition (person with dementia only), distress, resilience, competence and caregiver-patient relationship (caregiver only). Treatment effects will be obtained at 90 and 180 days post-randomisation, where applicable. Safety outcomes (adverse events, hospitalisations, deaths) will be summarised. DISCUSSION This statistical analysis plan provides a detailed methodology for the analysis of HOMESIDE and will improve the validity of the study and reduce the potential for bias. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001799246. Registered on November 05, 2018. CLINICALTRIALS gov NCT03907748. Registered on April 09, 2019.
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Affiliation(s)
- Vanessa Pac Soo
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - Felicity A Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Tanara Vieira Sousa
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Anna A Bukowska
- Institute of Applied Sciences, University of Physical Education, Kraków, Poland
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Austin Health, Melbourne, VIC, Australia
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, VIC, Australia
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Karen E Lamb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Baker FA, Blauth L, Bloska J, Bukowska AA, Flynn L, Hsu MH, Janus E, Johansson K, Odell-Miller H, Miller H, Petrowitz C, Pool J, Stensæth K, Tamplin J, Teggelove K, Wosch T, Sousa TV. Recruitment approaches and profiles of consenting family caregivers and people living with dementia: A recruitment study within a trial. Contemp Clin Trials Commun 2023; 32:101079. [PMID: 36949849 PMCID: PMC10025412 DOI: 10.1016/j.conctc.2023.101079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/04/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
Background While studies have identified strategies that are useful for recruiting people living with dementia, none have focused on psychosocial interventions involving arts therapies, or have examined the profiles of older people living in the community who consent or decline participation, particularly during a global pandemic. We aimed to identify the most effective recruitment strategies according to participant characteristics and transnational differences and develop a profile of consenting and non-consenting participants. Methods Recruitment teams in Australia, Norway, Germany, Poland, and the United Kingdom, recorded participants' source of study awareness and characteristics of consenting and non-consenting participants. Distributions of participants 'consenting to participate' were compared and logistic regressions were used to estimate the odds ratios. Results Consenting female caregivers were disproportionally represented. Study awareness differed between countries but overall, most expressions of interest to participate were derived from referrals from professionals or organisations, or from databases of people wanting to participate in research. Troughs in recruitment rates occurred during Northern Hemisphere summer vacation periods, and during Christmas periods. Conclusions This study found that recruiting for a trial with community-dwelling family caregivers and people living with dementia is challenging, especially during a global pandemic. While spousal caregivers comprised the highest proportion of dyads recruited, overall spousal caregivers were more reluctant to consent to participate than adult child caregivers. More targeted recruitment strategies designed for minority groups are also needed to ensure broader representation in dementia treatment studies.
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Affiliation(s)
- Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
- Corresponding author. The University of Melbourne, The Conservatorium of Music, Gate 12, Royal Parade, Parkville, Melbourne, Victoria, 3010, Australia.
| | - Laura Blauth
- Hochschule für Angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Anna A. Bukowska
- Institute for Applied Science, University of Physical Education, Kraków, Poland
| | - Libby Flynn
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ming-Hung Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Edyta Janus
- Institute for Applied Science, University of Physical Education, Kraków, Poland
| | - Kjersti Johansson
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Hayley Miller
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carina Petrowitz
- Hochschule für Angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Jonathan Pool
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Teggelove
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas Wosch
- Hochschule für Angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Tanara Vieira Sousa
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
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11
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Thompson N, Iyemere K, Underwood BR, Odell-Miller H. Investigating the impact of music therapy on two in-patient psychiatric wards for people living with dementia: retrospective observational study. BJPsych Open 2023; 9:e42. [PMID: 36815454 PMCID: PMC9970170 DOI: 10.1192/bjo.2023.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Music therapy can lift mood and reduce agitation for people living with dementia (PwD) in community and residential care settings, potentially reducing the prevalence of distress behaviours. However, less is known about the impact of music therapy on in-patient psychiatric wards for PwD. AIMS To investigate the impact of music therapy on two in-patient psychiatric wards for PwD. METHOD A mixed-methods design was used. Statistical analysis was conducted on incidents involving behaviours reported as 'disruptive and aggressive' in 2020, when music therapy delivery varied because of the COVID-19 pandemic. Semi-structured interviews conducted online with three music therapists and eight ward-based staff were analysed using reflexive thematic analysis. RESULTS Quantitative findings showed a significant reduction in the frequency of behaviours reported as disruptive and aggressive on days with in-person music therapy (every 14 days) than on the same weekday with no or online music therapy (every 3.3 or 3.1 days, respectively). Qualitative findings support this, with music therapy reported by music therapists and staff members to be accessible and meaningful, lifting mood and reducing agitation, with benefits potentially lasting throughout the day and affecting the ward environment. CONCLUSIONS We identified a significant reduction in the occurrence of distress behaviours on days with in-person music therapy when compared with no music therapy. Music therapy was reported to be a valuable intervention, supporting patient mood and reducing agitation. Interventional studies are needed to investigate the impact of music therapy and its optimum mode of delivery.
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Affiliation(s)
- Naomi Thompson
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, UK; and Arts Therapies Service, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
| | - Kimberley Iyemere
- Arts Therapies Service, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
| | - Benjamin R Underwood
- Faculty of Science and Engineering, Anglia Ruskin University, UK; Older People and Adult Community Directorate, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK; and Department of Psychiatry, University of Cambridge, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, UK; and Arts Therapies Service, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, UK
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12
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Stedje K, Kvamme TS, Johansson K, Sousa TV, Odell-Miller H, Stensæth KA, Bukowska AA, Tamplin J, Wosch T, Baker FA. The Influence of Home-Based Music Therapy Interventions on Relationship Quality in Couples Living with Dementia-An Adapted Convergent Mixed Methods Study. Int J Environ Res Public Health 2023; 20:2863. [PMID: 36833562 PMCID: PMC9966062 DOI: 10.3390/ijerph20042863] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/01/2023]
Abstract
Relationship quality is important for well-being and quality of life in couples living with dementia. Home-based music therapy interventions may be conducted with the aim of enhancing relationship quality. However, the effects or influences of such interventions are only briefly investigated in previous studies. This study's aim was to identify how a 12-week home-based music therapy intervention may influence relationship quality in couples living with dementia, through an adapted convergent mixed methods design. In this case, 68 participating couples from the HOMESIDE RCT study, and four individually recruited couples, received the music therapy intervention. Relationship quality for all participants was measured by the standardized Quality of Caregiver-Patient Relationship scale, and qualitative interviews were conducted with the four individually recruited participants at baseline and post intervention. Quantitative analysis indicated no statistically significant intervention effect. However, relationship quality remained stable over the intervention period. The qualitative analysis identified that the music therapy interventions primarily led to positive emotions, closeness, intimacy, and communication between the persons with dementia and their care partners. Intervention influences could also be ambiguous, as sharing music experiences might involve a risk of evoking vulnerabilities or negative emotional responses.
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Affiliation(s)
- Kristi Stedje
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Tone Sæther Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Kjersti Johansson
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Tanara Vieira Sousa
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | | | - Anna A. Bukowska
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Jeanette Tamplin
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Thomas Wosch
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | - Felicity Anne Baker
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
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13
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Stedje K, Kvamme TK, Johansson K, Stensæth KA, Odell-Miller H, Bukowska A, Tamplin J, Wosch T, Baker FA. Influential factors of spousal relationship quality in couples living with dementia - A narrative synthesis systematic review. Dementia (London) 2023; 22:281-302. [PMID: 36317673 PMCID: PMC9773007 DOI: 10.1177/14713012221137280] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIM The aim of this systematic review is to identify factors that influence relationship quality in couples living with dementia. Previous research has shown how maintaining a positive spousal relationship quality is important for quality of life and coping for both the caregiver and the person with dementia. Knowledge of influential factors could contribute to a deeper understanding of the value of a couple-centred clinical practice and research, within the field of dementia. RESEARCH DESIGN AND METHODS Systematic procedures to database search, screening, data extraction and synthesis were followed. Qualitative, quantitative and mixed methods studies were included. A narrative synthesis was conducted through narrative summaries of included studies, thematic analysis and narrative descriptions of factors influencing relationship quality. RESULTS 39 studies were included in the study: 28 qualitative, 8 quantitative and 3 mixed methods. Through the narrative synthesis, 20 factors were identified. The factors were grouped into two overarching themes: The world of us and The world outside of us, and further to six influencing factor categories: (1) Attitudes and strategies, (2) Behaviour and activities, (3) Emotional connectedness, (4) Activities and experiences outside of the home, (5) Social behaviour and roles, and (6) Belonging and safety. DISCUSSION AND CONCLUSION The identified factors influence relationship quality in couples living with dementia on various levels. The findings of this review study should inform clinical, couple-centred dementia care practise and intervention studies, and further research should seek to gain deeper understandings of the individual factors and broader understandings of the correlations between factors.
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Affiliation(s)
- Kristi Stedje
- Kristi Stedje, Music therapy, Norwegian Academy of music, Slemdalsveien 11, Oslo 0363, Norway.
| | | | | | | | | | - Anna Bukowska
- 74803Akademia Wychowania Fizycznego im Bronislawa Czecha, Krakow, Poland
| | | | - Thomas Wosch
- 38954University of Applied Sciences Würzburg-Schweinfurt, Germany
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14
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Odell-Miller H, Blauth L, Bloska J, Bukowska AA, Clark IN, Crabtree S, Engen RB, Knardal S, Kvamme TK, McMahon K, Petrowitz C, Smrokowska-Reichmann A, Stensæth K, Tamplin J, Wosch T, Wollersberger N, Baker FA. The HOMESIDE Music Intervention: A Training Protocol for Family Carers of People Living with Dementia. Eur J Investig Health Psychol Educ 2022; 12:1812-1832. [PMID: 36547028 PMCID: PMC9778265 DOI: 10.3390/ejihpe12120127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads.
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Affiliation(s)
- Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
- Correspondence:
| | - Laura Blauth
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Anna A. Bukowska
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Imogen N. Clark
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Sarah Crabtree
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Runa B. Engen
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Solgunn Knardal
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Tone K. Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Kate McMahon
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Carina Petrowitz
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | | | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
| | - Jeanette Tamplin
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Thomas Wosch
- Music Therapy Lab, Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, 97072 Würzburg, Germany
| | - Nina Wollersberger
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Felicity A. Baker
- Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, VIC 3010, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, 0369 Oslo, Norway
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15
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Jones K, Odell-Miller H. A theoretical framework for the use of music therapy in the treatment of selective mutism in young children: Multiple case study research. Nordic Journal of Music Therapy 2022. [DOI: 10.1080/08098131.2022.2028886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kate Jones
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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16
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Baker F, Odell-Miller H, Wosch T, Stensaeth K, Bukowska A, Clark I. HOMESIDE-A home-based family caregiver-delivered music and reading intervention for people living with dementia: A randomised controlled trial. Alzheimers Dement 2022. [PMID: 34971264 DOI: 10.1002/alz.049983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no studies have examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project addresses the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia and CGs. METHODS An international three-arm parallel-group randomised controlled trial has so far randomised 130 of the target 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads are randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of people with dementia (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes examine relationship quality between CG and people with dementia, depression, resilience, competence, QoL for CG and QoL for people with dementia. Outcomes are collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia captures economic data across the life of the intervention and at 6-month follow-up. Our presentation will briefly outline the study protocol and describe the caregiver training protocol and interventions in detail with video footage illustrating how the intervention looks in practice.
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Affiliation(s)
| | | | - Thomas Wosch
- University of Applied Sciences Würzburg-Schweinfurt, Wurzburg, Germany
| | | | - Anna Bukowska
- University of Physical Education in Krakow, Krakow, Poland
| | - Imogen Clark
- The University of Melbourne, Melbourne, VIC, Australia
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Smith L, Bloska J, Jacob L, Barnett Y, Butler L, Trott M, Odell-Miller H, Veronese N, Kostev K, Bettac EL, Godier-McBard L, Koyanagi A. Is loneliness associated with mild cognitive impairment in low- and middle-income countries? Int J Geriatr Psychiatry 2021; 36:1345-1353. [PMID: 33606886 DOI: 10.1002/gps.5524] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/14/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Loneliness may be a risk factor for mild cognitive impairment but studies on this topic are scarce, particularly from low- and middle-income countries (LMICs). Therefore, the aim of the present study was to investigate the association between loneliness and mild cognitive impairment (MCI) in six LMICs (China, Ghana, India, Mexico, Russia and South Africa). METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. RESULTS The final analytical sample consisted of 19,092 and 13,623 individuals aged 50-64 years (middle-aged adults) and ≥65 years (older adults), respectively. Among the middle-aged, overall, loneliness was associated with a non-significant 1.43 (95% confidence interval [CI] = 0.93-2.21) times higher odds for MCI although significant associations were observed in China (OR = 1.51; 95%CI = 1.08-2.09) and South Africa (OR = 3.87; 95%CI = 1.72-8.71). As for older adults, overall, there was a significant association between loneliness and MCI (OR = 1.52; 95%CI = 1.12-2.07). CONCLUSION In this large representative sample of middle-aged and older adults from multiple LMICs, findings suggest that loneliness is associated with MCI. It may be prudent to consider reducing loneliness in low-economic settings to aid in the prevention of MCI and ultimately dementia.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, France
| | | | - Laurie Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Mike Trott
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, Geriatric Unit, University of Palermo, Palermo, Italy
| | - Karel Kostev
- Philipps University of Marburg, Marburg, Germany
| | - Erica L Bettac
- Department of Psychology, Washnington State University Vancouver, Vancouver, Washington, USA
| | - Lauren Godier-McBard
- Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Baker FA, Pool J, Johansson K, Wosch T, Bukowska AA, Kulis A, Blauth L, Stensæth K, Clark IN, Odell-Miller H. Strategies for Recruiting People With Dementia to Music Therapy Studies: Systematic Review. J Music Ther 2021; 58:373-407. [PMID: 34173662 DOI: 10.1093/jmt/thab010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Positive effects of music therapy for people with dementia and their family carers are reported in a growing number of studies. However, small sample sizes or low recruitment rates often limit the success of these research studies. More adequately powered evidence-based studies are needed to impact policy and funding in dementia care. This systematic review examined recruitment strategies in music therapy clinical trials involving people living with dementia and/or their family carers. Eligible studies described enrolment, consent, accrual, or recruitment methods as well as recruitment or consent rates. Thirty studies with a total of 1,192 participants were included. Recruitment and conversion rates in residential aged care facilities (RACFs) (14 studies) were substantially higher than in community-based studies (16 studies). Whereas studies in RACFs most commonly recruited participants through staff approaching residents face-to-face or conversing with residents' legal guardians, community-based studies utilized a vast array of strategies, including staff referral, demonstrations/information sessions by researchers, advertisements, and direct contact with residents. Recruitment rates are likely to be higher when recruiters have an existing relationship with potential participants and when an independent third-party dementia organization is involved. Randomized controlled trials led to equally or greater recruitment conversion rates than other designs. Findings suggest that recruitment in dementia trials is complex, challenging, and needs thorough planning and consideration to be time- and cost-effective. Future studies should include reporting of recruitment strategies, enrolment rates, and related aspects so that researchers can better design recruitment strategies and estimate resources needed to reach the target sample size.
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Affiliation(s)
- Felicity A Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jonathan Pool
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Kjersti Johansson
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Anna A Bukowska
- Institute of Applied Science, University of Physical Education, Kraków, Poland
| | - Aleksandra Kulis
- Institute of Applied Science, University of Physical Education, Kraków, Poland
| | - Laura Blauth
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Imogen N Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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Baker FA, Bloska J, Braat S, Bukowska A, Clark I, Hsu MH, Kvamme T, Lautenschlager N, Lee YEC, Smrokowska-Reichmann A, Sousa TV, Stensaeth KA, Tamplin J, Wosch T, Odell-Miller H. HOMESIDE: home-based family caregiver-delivered music and reading interventions for people living with dementia: protocol of a randomised controlled trial. BMJ Open 2019; 9:e031332. [PMID: 31748300 PMCID: PMC6886975 DOI: 10.1136/bmjopen-2019-031332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no randomised study has examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project aims to address the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia (PwD) and CGs. METHODS AND ANALYSIS A large international three-arm parallel-group randomised controlled trial will recruit a sample of 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads will be randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of PwD (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes will examine relationship quality between CG and PwD, depression, resilience, competence, QoL for CG and QoL for PwD. Outcomes will be collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia will be used to collect economic data across the life of the intervention and at 6-month follow-up. We hypothesise that the music programme plus SC will generate better results than SC alone (primary comparison) and the reading programme plus SC (secondary comparison). ETHICS AND DISSEMINATION Ethical approval has been obtained for all countries. Results will be presented at national and international conferences and published in scientific journals and disseminated to consumer and caregiver representatives and the community. TRIAL REGISTRATION NUMBERS ACTRN12618001799246p; NCT03907748.
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Affiliation(s)
- Felicity Anne Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Sabine Braat
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Bukowska
- Department of Occupational Therapy, University of Physical Education, Kraków, Poland
| | - Imogen Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | - Ming H Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Tone Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Nicola Lautenschlager
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Young-Eun Claire Lee
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | | | - Tanara Vieira Sousa
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Karette A Stensaeth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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Gold C, Eickholt J, Assmus J, Stige B, Wake JD, Baker FA, Tamplin J, Clark I, Lee YEC, Jacobsen SL, Ridder HMO, Kreutz G, Muthesius D, Wosch T, Ceccato E, Raglio A, Ruggeri M, Vink A, Zuidema S, Odell-Miller H, Orrell M, Schneider J, Kubiak C, Romeo R, Geretsegger M. Music Interventions for Dementia and Depression in ELderly care (MIDDEL): protocol and statistical analysis plan for a multinational cluster-randomised trial. BMJ Open 2019; 9:e023436. [PMID: 30928926 PMCID: PMC6475205 DOI: 10.1136/bmjopen-2018-023436] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION In older adults, dementia and depression are associated with individual distress and high societal costs. Music interventions such as group music therapy (GMT) and recreational choir singing (RCS) have shown promising effects, but their comparative effectiveness across clinical subgroups is unknown. This trial aims to determine effectiveness of GMT, RCS and their combination for care home residents and to examine heterogeneity of treatment effects across subgroups. METHODS AND ANALYSIS This large, pragmatic, multinational cluster-randomised controlled trial with a 2×2 factorial design will compare the effects of GMT, RCS, both or neither, for care home residents aged 65 years or older with dementia and depressive symptoms. We will randomise 100 care home units with ≥1000 residents in total across eight countries. Each intervention will be offered for 6 months (3 months 2 times/week followed by 3 months 1 time/week), with extension allowed if locally available. The primary outcome will be the change in the Montgomery-Åsberg Depression Rating Scale score at 6 months. Secondary outcomes will include depressive symptoms, cognitive functioning, neuropsychiatric symptoms, psychotropic drug use, caregiver burden, quality of life, mortality and costs over at least 12 months. The study has 90% power to detect main effects and is also powered to determine interaction effects with gender, severity and socioeconomic status. ETHICS AND DISSEMINATION Ethical approval has been obtained for one country and will be obtained for all countries. Results will be presented at national and international conferences and published in scientific journals. TRIAL REGISTRATION NUMBERS NCT03496675; Pre-results, ACTRN12618000156280.
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Affiliation(s)
- Christian Gold
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Jasmin Eickholt
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Jörg Assmus
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Brynjulf Stige
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | | | - Felicity Anne Baker
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Imogen Clark
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Young-Eun Claire Lee
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | | | | | - Gunter Kreutz
- Department of Music, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | | | - Thomas Wosch
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Enrico Ceccato
- Department of Mental Health, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Mirella Ruggeri
- Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Annemiek Vink
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Music therapy Department, Academy of Music, ArtEZ University of the Arts, Enschede, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Helen Odell-Miller
- The Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Justine Schneider
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Christine Kubiak
- European Clinical Research Infrastructure Network (ECRIN), Paris, France
| | - Renee Romeo
- King’s Health Economics, King’s College London, London, UK
| | - Monika Geretsegger
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
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Odell-Miller H. Response to Justine Schneider’s article ‘Music therapy and dementia care practice in the United Kingdom: A British Association for Music Therapy membership survey’. British Journal of Music Therapy 2018. [DOI: 10.1177/1359457518805995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Crawford MJ, Gold C, Odell-Miller H, Thana L, Faber S, Assmus J, Bieleninik Ł, Geretsegger M, Grant C, Maratos A, Sandford S, Claringbold A, McConachie H, Maskey M, Mössler KA, Ramchandani P, Hassiotis A. International multicentre randomised controlled trial of improvisational music therapy for children with autism spectrum disorder: TIME-A study. Health Technol Assess 2018; 21:1-40. [PMID: 29061222 DOI: 10.3310/hta21590] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Preliminary studies have indicated that music therapy may benefit children with autism spectrum disorders (ASD). OBJECTIVES To examine the effects of improvisational music therapy (IMT) on social affect and responsiveness of children with ASD. DESIGN International, multicentre, three-arm, single-masked randomised controlled trial, including a National Institute for Health Research (NIHR)-funded centre that recruited in London and the east of England. Randomisation was via a remote service using permuted blocks, stratified by study site. SETTING Schools and private, voluntary and state-funded health-care services. PARTICIPANTS Children aged between 4 and 7 years with a confirmed diagnosis of ASD and a parent or guardian who provided written informed consent. We excluded children with serious sensory disorder and those who had received music therapy within the past 12 months. INTERVENTIONS All parents and children received enhanced standard care (ESC), which involved three 60-minute sessions of advice and support in addition to treatment as usual. In addition, they were randomised to either one (low-frequency) or three (high-frequency) sessions of IMT per week, or to ESC alone, over 5 months in a ratio of 1 : 1 : 2. MAIN OUTCOME MEASURES The primary outcome was measured using the social affect score derived from the Autism Diagnostic Observation Schedule (ADOS) at 5 months: higher scores indicated greater impairment. Secondary outcomes included social affect at 12 months and parent-rated social responsiveness at 5 and 12 months (higher scores indicated greater impairment). RESULTS A total of 364 participants were randomised between 2011 and 2015. A total of 182 children were allocated to IMT (90 to high-frequency sessions and 92 to low-frequency sessions), and 182 were allocated to ESC alone. A total of 314 (86.3%) of the total sample were followed up at 5 months [165 (90.7%) in the intervention group and 149 (81.9%) in the control group]. Among those randomised to IMT, 171 (94.0%) received it. From baseline to 5 months, mean scores of ADOS social affect decreased from 14.1 to 13.3 in music therapy and from 13.5 to 12.4 in standard care [mean difference: music therapy vs. standard care = 0.06, 95% confidence interval (CI) -0.70 to 0.81], with no significant difference in improvement. There were also no differences in the parent-rated social responsiveness score, which decreased from 96.0 to 89.2 in the music therapy group and from 96.1 to 93.3 in the standard care group over this period (mean difference: music therapy vs. standard care = -3.32, 95% CI -7.56 to 0.91). There were seven admissions to hospital that were unrelated to the study interventions in the two IMT arms compared with 10 unrelated admissions in the ESC group. CONCLUSIONS Adding IMT to the treatment received by children with ASD did not improve social affect or parent-assessed social responsiveness. FUTURE WORK Other methods for delivering music-focused interventions for children with ASD should be explored. TRIAL REGISTRATION Current Controlled Trials ISRCTN78923965. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 59. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | - Christian Gold
- The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Helen Odell-Miller
- Music for Health Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Lavanya Thana
- Centre for Psychiatry, Imperial College London, London, UK
| | - Sarah Faber
- Music for Health Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Jörg Assmus
- The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Łucja Bieleninik
- The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Monika Geretsegger
- The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
| | - Claire Grant
- Central and North West London NHS Foundation Trust, London, UK
| | - Anna Maratos
- Central and North West London NHS Foundation Trust, London, UK
| | - Stephan Sandford
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Morag Maskey
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Karin Antonia Mössler
- The Grieg Academy Music Therapy Research Centre, Uni Research Health, Bergen, Norway
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Bieleninik Ł, Geretsegger M, Mössler K, Assmus J, Thompson G, Gattino G, Elefant C, Gottfried T, Igliozzi R, Muratori F, Suvini F, Kim J, Crawford MJ, Odell-Miller H, Oldfield A, Casey Ó, Finnemann J, Carpente J, Park AL, Grossi E, Gold C. Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder: The TIME-A Randomized Clinical Trial. JAMA 2017; 318:525-535. [PMID: 28787504 PMCID: PMC5817481 DOI: 10.1001/jama.2017.9478] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/05/2017] [Indexed: 02/05/2023]
Abstract
Importance Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents' concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child's focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, -0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration isrctn.org Identifier: ISRCTN78923965.
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Affiliation(s)
- Łucja Bieleninik
- GAMUT—The Grieg Academy Music Therapy Research Centre, Uni Research Health, Uni Research, Bergen, Norway
| | - Monika Geretsegger
- GAMUT—The Grieg Academy Music Therapy Research Centre, Uni Research Health, Uni Research, Bergen, Norway
| | - Karin Mössler
- GAMUT—The Grieg Academy Music Therapy Research Centre, Uni Research Health, Uni Research, Bergen, Norway
| | - Jörg Assmus
- GAMUT—The Grieg Academy Music Therapy Research Centre, Uni Research Health, Uni Research, Bergen, Norway
| | - Grace Thompson
- Melbourne Conservatorium of Music, University of Melbourne, Melbourne, Australia
| | - Gustavo Gattino
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
- Postgraduate Program in Child and Adolescent Health, Faculty of Medicine, Rio Grande do Sul Federal University, Porto Alegre, Brazil
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Tali Gottfried
- Music Therapy Program, David-Yelin College, Jerusalem, Israel
| | | | - Filippo Muratori
- IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Jinah Kim
- Jeonju University, Jeonju, South Korea
| | - Mike J. Crawford
- Centre for Psychiatry, Imperial College London, London, United Kingdom
| | | | | | - Órla Casey
- Anglia Ruskin University, Cambridge, United Kingdom
| | - Johanna Finnemann
- Anglia Ruskin University, Cambridge, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - John Carpente
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, New York
| | - A-La Park
- Personal Social Services Research Unit, LSE Health and Social Care, The London School of Economics and Political Science, London, United Kingdom
| | - Enzo Grossi
- Villa Santa Maria Institute, Tavernerio, Italy
| | - Christian Gold
- GAMUT—The Grieg Academy Music Therapy Research Centre, Uni Research Health, Uni Research, Bergen, Norway
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Street AJ, Magee WL, Bateman A, Parker M, Odell-Miller H, Fachner J. Home-based neurologic music therapy for arm hemiparesis following stroke: results from a pilot, feasibility randomized controlled trial. Clin Rehabil 2017. [PMID: 28643570 PMCID: PMC5751852 DOI: 10.1177/0269215517717060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke. Design: A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Setting: Participants’ homes across Cambridgeshire, UK. Subjects: Eleven people with stroke and arm hemiparesis, 3–60 months post stroke, following discharge from community rehabilitation. Interventions: Each participant engaged in therapeutic instrumental music performance in 12 individual clinical contacts, twice weekly for six weeks. Main measures: Feasibility was estimated by recruitment from three community stroke teams over a 12-month period, attrition rates, completion of treatment and successful data collection. Structured interviews were conducted pre and post intervention to establish participant tolerance and preference. Action Research Arm Test and Nine-hole Peg Test data were collected at weeks 1, 6, 9, 15 and 18, pre and post intervention by a blinded assessor. Results: A total of 11 of 14 invited participants were recruited (intervention n = 6, waitlist n = 5). In total, 10 completed treatment and data collection. Conclusion: It cannot be concluded whether a larger trial would be feasible due to unavailable data regarding a number of eligible patients screened. Adherence to treatment, retention and interview responses might suggest that the intervention was motivating for participants. Trial registration: ClinicalTrials.gov identifier NCT 02310438.
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Affiliation(s)
| | - Wendy L Magee
- 2 Music Therapy Program, Temple University, Philadelphia, PA, USA
| | - Andrew Bateman
- 3 Department of Psychiatry, University of Cambridge, Cambridge, UK.,4 Collaborations for Leadership in Applied Health Research and Care (CLAHRC) Cambridgeshire and Peterborough NHS Trust, National Institute for Health Research (NIHR), London, UK.,5 Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK.,6 Cambridgeshire Community Services NHS Trust, St Ives, UK
| | - Michael Parker
- 7 Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
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Ettenberger M, Rojas Cárdenas C, Parker M, Odell-Miller H. Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia – A mixed-methods study. Nordic Journal of Music Therapy 2016. [DOI: 10.1080/08098131.2016.1205650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Møller AS, Odell-Miller H, Wigram T. Indications in Music Therapy: Evidence from Assessment That Can Identify the Expectations of Music Therapy as a Treatment for Autistic Spectrum Disorder (ASD); Meeting the Challenge of Evidence Based Practice. British Journal of Music Therapy 2016. [DOI: 10.1177/135945750201600104] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
When children with Autistic Spectrum Disorder (ASD) are assessed in music therapy, significant strengths, potentials and resources emerge that may remain hidden in other, more formalised assessments. Therefore, it is becoming more necessary to develop a systematic method of describing this responsiveness, in order to define the expectations of therapy. Music therapy is a particularly important intervention for children with ASD to engage and nurture their capacity for flexibility, creativity, variability and tolerance of change, in order to balance the more structured and behaviourally driven education that is currently popular. The potential of treatment can be defined within the context of meeting healthcare needs. A case study will illustrate a model for defining ‘expectations of therapy’, by drawing on one child's awakened capacity for interaction through shared, improvised music-making. This article includes a long appendix providing an evidence-based review and recommendations regarding assessment and referral criteria based on current research and clinical evidence.
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Abstract
This paper describes music therapy within a community mental health setting for adults using a care programme approach in England. It describes the setting, and emphasises the importance of multidisciplinary teamwork in order to enable music therapy to be effective. It provides some statistics and descriptive clinical information which demonstrate the efficacy of music therapy for adults with long-term mental health problems, and argues that music therapy should be apriority for this client group. To support these points of view, the article includes a case study showing a psychoanalytically informed approach in music therapy. This paper was given as a keynote address at the 1994 Australian Conference of Music Therapy.
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Odell-Miller H. The role, function and identity of music therapists in the 21st century, including new research and thinking from a UK perspective. British Journal of Music Therapy 2016. [DOI: 10.1177/1359457516639549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article examines the identity of music therapy and music therapists, focussing upon the United Kingdom as a case study, but also considering international trends. Milestones in the history of music therapy in postwar United Kingdom and professional development in the 21st century are discussed, drawing upon research and clinical practice. Research outcomes across different specialities indicate that music therapy should be widely available to many populations, such as for people with dementia, autism, stroke and mental health problems and so on. These advancements mean that music therapists need to be clear about their role and identity in both doing the work and communicating about it. The article celebrates advances in research, thinking and provision and emphasis collaboration across multidisciplinary groups through an overview of different identities.
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Street AJ, Magee WL, Odell-Miller H, Bateman A, Fachner JC. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage-a feasibility study protocol. Front Hum Neurosci 2015; 9:480. [PMID: 26441586 PMCID: PMC4585041 DOI: 10.3389/fnhum.2015.00480] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/17/2015] [Indexed: 11/13/2022] Open
Abstract
Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.
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Affiliation(s)
- Alexander J Street
- Music and Performing Arts, Music for Health Research Centre, Anglia Ruskin University Cambridge, UK
| | - Wendy L Magee
- Music Therapy Program, Boyer College of Music and Dance, Temple University Philadelphia, PA, USA
| | - Helen Odell-Miller
- Music and Performing Arts, Music for Health Research Centre, Anglia Ruskin University Cambridge, UK
| | - Andrew Bateman
- Department of Psychiatry, University of Cambridge Cambridge, UK ; National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care, Cambridgeshire and Peterborough NHS Trust Cambridge, UK ; Oliver Zangwill Centre for Neuropsychological Rehabilitation Ely, UK ; Cambridgeshire Community Services NHS Trust St Ives, UK
| | - Jorg C Fachner
- Music and Performing Arts, Music for Health Research Centre, Anglia Ruskin University Cambridge, UK
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Hsu MH, Flowerdew R, Parker M, Fachner J, Odell-Miller H. Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study. BMC Geriatr 2015; 15:84. [PMID: 26183582 PMCID: PMC4506459 DOI: 10.1186/s12877-015-0082-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/06/2015] [Indexed: 11/12/2022] Open
Abstract
Background Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients’ care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. Methods 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents’ symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers’ feedback through semi-structured interviews, programme evaluations and track records of the study. Results The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (−0.74, 95 % CI: [−1.15 to −0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. Conclusion The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. Trial registration Clinicaltrials.gov, number NCT01744600.
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Affiliation(s)
- Ming Hung Hsu
- Methodist Homes (MHA), Derby, UK. .,Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | | | - Michael Parker
- Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK.
| | - Jörg Fachner
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | - Helen Odell-Miller
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
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Hsu MH, Flowerdew R, Parker M, Fachner J, Odell-Miller H. Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study. BMC Geriatr 2015. [PMID: 26183582 DOI: 10.1186/s12877‐015‐0082‐4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients' care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes. METHODS 17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents' symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers' feedback through semi-structured interviews, programme evaluations and track records of the study. RESULTS The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (-0.74, 95 % CI: [-1.15 to -0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme. CONCLUSION The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size. TRIAL REGISTRATION Clinicaltrials.gov, number NCT01744600.
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Affiliation(s)
- Ming Hung Hsu
- Methodist Homes (MHA), Derby, UK. .,Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | | | - Michael Parker
- Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK.
| | - Jörg Fachner
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
| | - Helen Odell-Miller
- Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK.
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Shipley A, Odell-Miller H. The Role of Music Therapy for Anxious Adolescent School Refusers: The Importance of Identity. British Journal of Music Therapy 2012. [DOI: 10.1177/135945751202600105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The specific role of music therapy for anxious adolescent school refusers is considered with particular emphasis upon identity and the self. Literature is examined covering areas of education theory, school refusal, psychoanalytically informed thinking, and music therapy. Two case studies with adolescents receiving music therapy at a large general hospital are discussed, and these illustrate new ways of thinking about music therapy and school refusal. The parallel processes between the student music therapist and her adolescent clients are discussed. Concepts of identity and paradox are explored, concluding that these multi-layered paradoxes can be experienced musically. They often manifest as a constantly changing balance between moments of chaos and calm, risk and safety, exploration and retreat. The case studies describe in-depth work where resistance and anxiety are addressed within the musical improvisations between therapist and adolescents in individual therapy. The authors point to the gap in knowledge in this specific field, and build on previous work, linking theoretical thinking to casework.
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Odell-Miller H, Hughes P, Westacott M. An investigation into the effectiveness of the arts therapies for adults with continuing mental health problems. Psychother Res 2006. [DOI: 10.1080/10503300500268342] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Odell-Miller H. Book Review: Music for Life: Aspects of Creative Music Therapy with Adult Clients. British Journal of Music Therapy 1996. [DOI: 10.1177/135945759601000207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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