Daykin Norma, Parry Barbara, Ball Kerry, Walters David, Henry Ann, Platten Bronwyn, Hayden Rachel
University of Winchester, UK.
Hampshire Hospitals NHS Foundation Trust, UK.
Dementia (London). 2018 Aug;17(6):686-701. doi: 10.1177/1471301217739722. Epub 2017 Nov 3.
Background Improving the quality of care for people with dementia in general hospitals is a key priority. Creative activities including music have been examined for their potential role in enhancing quality of life for people with dementia, although relatively few studies have evaluated their use in acute hospital settings. Methods A mixed methods study examined the effects of a ten week period of weekly music sessions on the wellbeing of patients with dementia and on the ward environment in an acute elderly care service in a UK hospital. Potential effects of the music project on the ward environment were examined by comparing descriptive quantitative ward level data for two equivalent time periods, one with music and one with no music. The impact of the activity on participants' wellbeing was assessed using observational data as well as semi-structured interviews and focus groups with patients, visitors, the musician and staff. Results Ward level data were available for 85 patients with a dementia diagnosis who had stayed on the wards during the study periods. Comparison between the two periods showed a number of differences between the music and the non-music time periods, including a reduction in prescription of antipsychotic drugs. However, many factors could have contributed to the differences in the ward environment. Observational data revealed nuanced responses to music and suggested that participants generally enjoyed the activity. The impacts of music making were mediated strongly by staff responses and hospital organisation. Conclusion Data from this limited pilot study suggest that music is a useful intervention for enhancing patient and staff experiences and improving care in acute dementia care environments. The suggestion that use of anti-psychotic drugs may be reduced when music is present warrants further research.
背景 提高综合医院中痴呆症患者的护理质量是一项关键优先事项。包括音乐在内的创造性活动已被研究其在提高痴呆症患者生活质量方面的潜在作用，尽管相对较少的研究评估了它们在急性医院环境中的应用。方法 一项混合方法研究考察了在英国一家医院的急性老年护理服务中，为期十周的每周一次音乐课程对痴呆症患者幸福感和病房环境的影响。通过比较两个等效时间段（一个有音乐，一个没有音乐）的描述性定量病房层面数据，研究音乐项目对病房环境的潜在影响。使用观察数据以及对患者、访客、音乐家和工作人员的半结构化访谈和焦点小组来评估该活动对参与者幸福感的影响。结果 在研究期间，有85名被诊断患有痴呆症的患者曾入住病房，可获取其病房层面数据。两个时间段的比较显示，有音乐和无音乐时间段之间存在一些差异，包括抗精神病药物处方的减少。然而，许多因素可能导致了病房环境的差异。观察数据揭示了对音乐的细微反应，并表明参与者总体上喜欢这项活动。音乐制作的影响在很大程度上受到工作人员反应和医院组织的调节。结论 这项有限的试点研究数据表明，音乐是一种有用的干预措施，可增强患者和工作人员的体验，并改善急性痴呆症护理环境中的护理。有音乐时抗精神病药物使用可能减少这一建议值得进一步研究。
