期刊论文详细信息
BMC Geriatrics
Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study
Helen Odell-Miller1  Jörg Fachner1  Michael Parker3  Rosamund Flowerdew2  Ming Hung Hsu1 
[1] Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK;Methodist Homes (MHA), Derby, UK;Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
关键词: Dementia;    Neuropsychiatric symptoms;    Caregiving;    Music therapy;   
Others  :  1220019
DOI  :  10.1186/s12877-015-0082-4
 received in 2014-12-23, accepted in 2015-07-06,  发布年份 2015
PDF
【 摘 要 】

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.

【 授权许可】

   
2015 Hsu et al.

【 预 览 】
附件列表
Files Size Format View
20150721022939334.pdf 1107KB PDF download
Fig. 4. 19KB Image download
Fig. 3. 20KB Image download
Fig. 2. 20KB Image download
Fig. 1. 72KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

【 参考文献 】
  • [1]Alzheimer’s Disease International (ADI). World Alzheimer report: Journey of Caring: An analysis of long-term care for dementia. 2013. http://www.alz.co.uk/research/WorldAlzheimerReport2013.pdf. Accessed 1 April 2015.
  • [2]Margallo-Lana M, Swann A, O’Brien J, Fairburn A, Reichelt K, Potkins D, Ballard C: Prevalence and pharmacological management of behavioural and psychological symptoms amongst dementia sufferers living in care environments. Int J Geriatr Psychiatry 2001, 16(1):39-44.
  • [3]Zuidema S, Koopmans R, Verhey F: Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. J Geriatr Psychiatry Neurol 2007, 20(1):41-49.
  • [4]Aalten P, de Vugt ME, Jaspers N, Jolles J, Verhey FRJ: The course of neuropsychiatric symptoms in dementia. Part I: findings from the two-year longitudinal Maasbed study. Int J Geriatr Psychiatry 2005, 20:523-530.
  • [5]Douglas S, James I, Ballard C: Non-pharmacological interventions in dementia. Adv Psychiatr Treat 2004, 10:171-179.
  • [6]Kitwood T: Dementia Reconsidered: The Person Comes First. Open University Press, Buckingham; 1997.
  • [7]Kitwood T, Bredin K: Towards a theory of dementia care: personhood and well-being. Ageing Soc 1992, 12(03):269-287.
  • [8]Bains J, Birks JS, Dening TR: Antidepressants for treating depression in dementia. Cochrane Database Syst Rev 2002, 4:CD003944.
  • [9]Lonergan E, Luxenberg J, Colford J: Haloperidol for agitation in dementia. Cochrane Database Syst Rev 2002, 2:CD002852.
  • [10]Cooper C, Mukadam N, Katona C, Lyketsos CG, Blazer D, Ames D, Rabins P, Brodaty H, de Mendonca LC, Livingston G: Systematic review of the effectiveness of pharmacologic interventions to improve quality of life and well-being in people with dementia. Am J Geriatr Psychiatry 2013, 21(2):73-183.
  • [11]Prudent M, Dramé M, Jolly D, Trenque T, Parjoie R, Mahmoudi R, Lang PO, Somme D, Boyer F, Lanièce I, Gauvain JB, Blancahrd F, Novella JL: Potentially inappropriate use of psychotropic medications in hospitalized elderly patients in France: cross-sectional analysis of the prospective, multicentre SAFEs cohort. Drugs Aging 2008, 25:933-946.
  • [12]Gustafsson M, Karlsson S, Gustafson Y, Loevheim H: Psychotropic drug use among people with dementia – a six-month follow-up study. BMC Pharmacol Toxicol 2013, 14:56. BioMed Central Full Text
  • [13]Department of Health. ‘Living well with dementia, A National Dementia Strategy’. The National Dementia strategy in England. Br J Med Med Res. 2009;338.. http://dx.doi.org/10.1136/bmj.b931 webcite
  • [14]Department of Health: The Use of Antipsychotic Medication for People with Dementia: Time for Action. Department of Health, London; 2009.
  • [15]Odell-Miller H, Sandford S. Update on Music Therapy in the United Kingdom. Voices Resources. 2009. http://testvoices.uib.no/community/?q=country/monthuk_march2009. Accessed 1 April 2015.
  • [16]World Federation of Music Therapy. Announcing WFMT’s NEW Definition of Music Therapy. 2011. http://www.wfmt.info/2011/05/01/announcing-wfmts-new-definition-of-music-therapy/. Accessed 1 April 2015.
  • [17]Health Care Professions Council. Standards of Proficiency: Arts Therapists. 2013. http://www.hpc-uk.org/assets/documents/100004FBStandards_of_Proficiency_Arts_Therapists.pdf. Accessed 1 April 2015.
  • [18]Health Care Professions Council. Standards of Education and Training. 2014. http://www.hpc-uk.org/assets/documents/10000BCF46345Educ-Train-SOPA5_v2.pdf. Accessed 1 April 2015.
  • [19]National Institute for Health and Care Excellence. NICE guidelines 42: Dementia. 2006. http://pathways.nice.org.uk/pathways/dementia. Accessed 1 April 2015.
  • [20]Brotons M: An Overview of the Music Therapy Literature Relating to Elderly People. In Music Therapy in Dementia Care. Edited by Aldridge D. Jessica Kingsley Publishers, London; 2000:33-62.
  • [21]Brotons M, Pickett-Cooper P: The effects of music therapy intervention on agitation behaviors of Alzheimer’s disease patients. J Music Ther 1996, 33:2-18.
  • [22]Koger SM, Chapin K, Brotons M: Is music therapy an effective intervention for dementia? A meta-analytic review of literature. J Music Ther 1999, 36:2-15.
  • [23]Livingston G, Johnston K, Katona C, Paton J, Lyketsos CG: Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. Am J Psychiatry 2005, 162(11):1996-2021.
  • [24]McDermott O, Crellin N, Ridder HM, Orrell M: Music therapy in dementia: a narrative synthesis systematic review. Int J Geriatr Psychiatry 2012, 28(8):781-794.
  • [25]Raglio A, Bellelli G, Mazzola P, Bellandi D, Giovagnoli AR, Farina E, Trabucchi M: Music, music therapy and dementia: a review of literature and the recommendations of the Italian Psychogeriatric Association. Maturitas 2012, 72(4):305-310.
  • [26]Ueda T, Suzukamo Y, Sato M, Izumi S-I: Effects of music therapy on behavioural and psychological symptoms of dementia: a systematic review and meta-analysis. Ageing Res Rev 2013, 12(2):628-641.
  • [27]Guetin S, Charras K, Berard A, Arbus C, Berthelon P, Blanc F, Blayac JP, Bonte F, Bouceffa JP, Clement S, Ducourneau G, Gzil F, Laeng N, Lecourt E, Ledoux S, Platel H, Thomas-Anterion C, Touchon J, Vrait FX, Leger J-M: An overview of the use of music therapy in the context of Alzheimer’s disease: a report of a French expert group. Dementia 2013, 12(5):619-634.
  • [28]Lord T, Garner E: Effects of music on Alzheimer patients. Percept Mot Skills 1993, 76:451-455.
  • [29]Cohen-Mansfield J, Werner P: Management of verbally disruptive behaviors in nursing home residents. J Gerontol A Biol Sci Med Sci 1997, 52:369-377.
  • [30]Denney A: Quiet music. An intervention for mealtime agitation? J Gerontol Nurs 1997, 23(7):16-23.
  • [31]Ragneskog H, Kihlgren M, Karlsson I, Norberg A: Dinner music for demented Patients analysis of video-recorded observations. Clin Nurs Res 1996, 5(3):262-277.
  • [32]Remington R: Calming music and hand massage with agitated elderly. Nurs Res 2002, 51(5):317-323.
  • [33]Gerdner L: Effects of individualized versus classical “relaxation” music on the frequency of agitation in elderly persons with Alzheimer’s disease and related disorders. Int Psychogeriatr 2000, 12:49-65.
  • [34]Clark ME, Lipe AW, Bilbrey M: Use of music to decrease aggressive behaviors in people with dementia. J Gerontol Nurs 1998, 24(7):10-7.
  • [35]Sung H, Chang S, Lee W, Lee M: The effects of group music with movement intervention on agitated behaviours of institutionalized elders with dementia in Taiwan. Complement Ther Med 2006, 14(2):113-119.
  • [36]Svansdottir HB, Snaedal J: Music therapy in moderate and severe dementia of Alzheimer’s type: a case–control study. Int Psychogeriatr 2006, 18(4):613-621.
  • [37]Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Villani D, Trabucchi M: Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Dis Assoc Disord 2008, 22(2):158-162.
  • [38]Raglio A, Oasi O, Gianotti M, Manzoni V, Bolis S, Ubezio MC, Gentile S, Villani D, Stramba-Badiale M: Effects of music therapy on psychological symptoms and heart rate variability in patients with dementia. A pilot study. Curr Aging Sci 2010, 3:242-246.
  • [39]Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio M, Gentile S, Villani D, Trabucchi M: Efficacy of music therapy treatment based on cycles of sessions: a randomised controlled trial. Aging Ment Health 2010, 14:900-904.
  • [40]Ledger A, Baker F: An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer’s disease. Aging Ment Health 2007, 11(3):330-338.
  • [41]Clair A, Ebberts A: The effects of music therapy on interactions between family caregivers and their care receivers with late stage dementia. J Music Ther 1997, 34:148-164.
  • [42]Kumar AM, Tims F, Cruess DG, Mintzer MJ, Ironson G, Loewenstein D, Cattan R, Fernandez JB, Eisdorfer C, Kumar M: Music therapy increases serum melatonin levels in patients with Alzheimer’s disease. Altern Ther Health Med 1999, 5(6):49-57.
  • [43]Okada K, Kurita A, Takase B, Otsuka T, Kodani E, Kusama Y, Atarashi H, Mizuno K: Effects of music therapy on autonomic nervous system activity, incidence of heart failure events, and plasma cytokine and catecholamine levels in elderly patients with cerebrovascular disease and dementia. Int Heart J 2009, 50(1):95-110.
  • [44]Suzuki M, Kanamori M, Watanabe M, Nagasawa S, Kojima E, Ooshiro H, Nakahara D: Behavioral and endocrinological evaluation of music therapy for elderly patients with dementia. Nurs Health Sci 2004, 6:11-18.
  • [45]Takahashi T, Matsushita H: Long-term effects of music therapy on elderly with moderate/severe dementia. J Music Ther 2006, 43:317-333.
  • [46]Ashida S: The effect of reminiscence music therapy sessions on changes in depressive symptoms in elderly persons with dementia. J Music Ther 2000, 37:170-182.
  • [47]Ridder HM, Wigram T, Ottesen AM: A pilot study on the effects of music therapy on frontotemporal dementia—developing a research protocol. Nordic J Music Ther 2009, 18(2):103-132.
  • [48]Vink AC, Zuidersma M, Boersma F, Jonge P, Zuidema SU, Slaets JPJ: The effect of music therapy compared with general recreational activities in reducing agitation in people with dementia: a randomised controlled trial. Int J Geriatr Psychiatry 2013, 28(10):1031-1038.
  • [49]Schall A, Haberstroh J, Pantel J. Time series analysis of individual music therapy in dementia. GeroPsych. 2015; [http://dx.doi.org/10.1024/1662-9647/a000123] Accessed 14 July 2015.
  • [50]Solé C, Mercadal-Brotons M, Galati A, De Castro M: Effects of group music therapy on quality of life, affect, and participation in people with varying levels of dementia. J Music Ther 2014, 51(1):103-125.
  • [51]Vink AC, Bruinsma MS, Scholten RJPM: Music therapy for people with dementia. Cochrane Database Syst Rev 2003, 4:CD003477.
  • [52]Ridder HMO, Stige B, Qvale LG, Gold C: Individual music therapy for agitation in dementia: an exploratory randomized controlled trial. Aging Ment Health 2013, 17(6):67-678.
  • [53]Lawrence V, Fossey J, Ballard C, Moniz-Cook E, Murray J: Improving quality of life for people with dementia in care homes: making psychosocial interventions work. Br J Psychiatry 2012, 201:344-351.
  • [54]Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337.
  • [55]Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for the design and evaluation of complex interventions to improve health. BMJ 2000, 321(7262):694-6.
  • [56]Reisberg B, Ferris SH, de Leon MJ, Crook T: The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982, 139:1136-1139.
  • [57]Odell-Miller H: Approaches to Music in Psychiatry with Specific Emphasis upon a Research Project with the Elderly Mentally Ill. In The Art and Science of Music Therapy: A Handbook. Edited by Wigram T, Saperston B, West R. Harwood Academic, London, Toronto; 1995:83-111.
  • [58]Panksepp J: Affective Neuroscience: A Conceptual Framework for the Neurobiological Study of Emotions. In International Reviews of Emotion Research. Edited by Strongman K. Wiley, Chichester, UK; 1991:59-99.
  • [59]Sander D: Models of Emotion: The Affective Neuroscience Approach. In The Cambridge Handbook of Human Affective Neuroscience. Edited by Armony J, Vuilleumier P. Cambridge University Press, New York; 2013:5-53.
  • [60]Koelsch S: Emotion and Music. In The Cambridge Handbook of Human Affective Neuroscience. Edited by Armony J, Vuilleumier P. Cambridge University Press, New York; 2013:286-303.
  • [61]Brueck C, Kreifelts B, Ethofer T, Wildgruber D: Emotional Voices: The Tone of (true) Feelings. In The Cambridge Handbook of Human Affective Neuroscience. Edited by Armony J, Vuilleumier P. Cambridge University, New York; 2013:265-285.
  • [62]Atkinson AP: Bodily Expressions of Emotion: Visual Cues and Neural Mechanisms. In The Cambridge Handbook of Human Affective Neuroscience. Edited by Armony J, Vuilleumier P. Cambridge University Press, New York; 2013:198-222.
  • [63]George N: The Facial Expressions of Emotions. In The Cambridge Handbook of Human Affective Neuroscience. Edited by Armony J, Vuilleumier P. Cambridge University Press, New York; 2013:171-197.
  • [64]Vernooij-Dassen M, Vasse E, Zuidema S, Cohen-Mansfield J, Moyle W: Psychosocial interventions for dementia patients in long-term care. Int Psychogeriatr 2010, 22:1121-1128.
  • [65]Dugmore O, Orrell M, Spector A. Qualitative studies of psychosocial interventions for dementia: a systematic review. Aging Ment Health. 2015. [DOI: 10.1080/13607863.2015.1011079].
  • [66]Wood S, Cummings JL, Hsu MA, Barclay T, Wheatley MV, Yarema KT, Schnelle JF: The use of the Neuropsychiatric Inventory in nursing home residents, characterization and measurement. Am J Geriatr Psychiatry 2000, 8:75-83.
  • [67]Aalten P, Verhey FR, Boziki M, Bullock R, Byrne EJ, Camus V, Robert PH: Neuropsychiatric syndromes in dementia. Results from the European Alzheimer Disease Consortium: part I. Dement Geriatr Cogn Disord 2007, 24(6):457-463.
  • [68]Ballard C, O’Brien JT, Reichelt K, Perry E: Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double blind, placebo-controlled trial with Melissa. J Clin Psychiatry 2002, 63(7):553-558.
  • [69]Brooker D, Surr C: Dementia-care mapping (DCM): initial validation of DCM 8 in UK field trials. Int J Geriatr Psychiatry 2006, 21:1018-1025.
  • [70]Brooker D, Duce L: Well-being and activity in dementia: a comparison of group reminiscence therapy, structured goal-directed group activity, and unstructured time. Aging Ment Health 2000, 4:354-358.
  • [71]Gigliotti CM, Jarrott SE, Yorgason J: Harvesting health: effects of three types of horticultural therapy activities for persons with dementia. Dementia 2004, 3:161-170.
  • [72]DeCoster J. Spreadsheet for converting effect size measures. 2012. http://www.stat-help.com/spreadsheets/Converting%20effect%20sizes%202012-06-19.xls. Accessed 1 April 2015.
  • [73]Ochsner KN, Gross JJ: The cognitive control of emotion. Trends Cogn Sci 2005, 9(5):242-249.
  • [74]Damasio AR: Descartes’ error: Emotion, reason and the human brain. GP Putnam’s Sons, New York; 1994.
  • [75]Damasio AR, Everitt BJ, Bishop D: The somatic marker hypothesis and the possible functions of the prefrontal cortex [and discussion]. Philos Trans R Soc London [Biol] 1996, 351(1346):1413-1420.
  • [76]Kuske B, Hanns S, Luck T, Angermeyer MC, Behrens J, Riedel-Heller SG: Nursing home staff training in dementia care: a systematic review of evaluated programs. Int Psychogeriatr 2007, 19(05):818-841.
  • [77]Landsberger HA: Hawthorne Revisited. Cornell University, Ithaca, New York; 1958.
  文献评价指标  
  下载次数:33次 浏览次数:4次