Ray Kendra D, Götell Eva
Planning and Research Department, Menorah Center for Nursing and Rehabilitation, MJHS, Brooklyn, NY, United States.
Ersta Sköndal Bräcke University College, Stockholm, Sweden.
Front Med (Lausanne). 2018 Oct 9;5:287. doi: 10.3389/fmed.2018.00287. eCollection 2018.
Studies have shown music therapy can improve depression symptoms in dementia and the use of music activities show promise to have positive impacts on wellbeing. However, few studies show the influence of a music intervention led by certified nursing assistants (CNAs) trained by music therapists to address depression symptoms and wellbeing in individuals with dementia. Credentialed music therapists (1) administered 2-weeks of music therapy, (2) a 3-days training to CNAs, (3) followed by 2-weeks of music activities, singing and music-with-movement, led by CNAs for 62 nursing home residents with moderate dementia, (4) then measured depression symptoms using the Cornell Scale for Depression. We obtained video consent for 26 of the 62 residents who were video recorded receiving CNA-led music-based caregiving activities. Using the Music in Dementia Scale, over 200 h of video data was observed and raters measured changes in well-being, e.g., levels of enjoyment, mood and engagement in the residents, during the CNA facilitated music activities. A repeated measures ANOVA revealed that mean depression scores differed statistically significantly between time points, ≤ 0.001. Residents' baseline depression symptoms significantly declined following 2 weeks of music therapy, ≤ 0.001, increased during a 2-weeks wash-out period, = 0.389, but appeared to stabilize following the 2-weeks music activity, = 1.00. A video analysis and paired sampled -test demonstrated a significant improvement in wellbeing in residents who engaged in music with movement, = 0.003. Wellbeing improved slightly, but not significantly for residents who participated in the singing intervention, = 0.165. Findings suggest that music therapy can significantly decrease depression symptoms in nursing home residents with dementia. Music activities designed by music therapists and facilitated by CNAs may help sustain the reduction of depression symptoms and improve wellbeing in nursing home residents with moderate to severe dementia.
研究表明，音乐疗法可以改善痴呆症患者的抑郁症状，音乐活动的运用有望对幸福感产生积极影响。然而，很少有研究表明由音乐治疗师培训的认证护理助理（CNA）主导的音乐干预对痴呆症患者的抑郁症状和幸福感的影响。有资质的音乐治疗师对62名中度痴呆的养老院居民进行了以下操作：（1）进行为期两周的音乐治疗；（2）对CNA进行为期三天的培训；（3）随后由CNA主导进行为期两周的音乐活动、唱歌和音乐律动；（4）然后使用康奈尔抑郁量表测量抑郁症状。我们获得了62名居民中26名的视频同意，他们在接受CNA主导的基于音乐的护理活动时被录像。使用痴呆症音乐量表，观察了超过200小时的视频数据，评估者在CNA协助的音乐活动中测量了居民幸福感的变化，例如愉悦程度、情绪和参与度。重复测量方差分析显示，各时间点的平均抑郁评分在统计学上有显著差异，P≤0.001。经过两周的音乐治疗后，居民的基线抑郁症状显著下降，P≤0.001，在为期两周的洗脱期有所增加，P = 0.389，但在为期两周的音乐活动后似乎趋于稳定，P = 1.00。视频分析和配对样本t检验表明，参与音乐律动的居民的幸福感有显著改善，P = 0.003。参与唱歌干预的居民幸福感略有改善，但不显著，P = 0.165。研究结果表明，音乐疗法可以显著降低养老院痴呆症患者的抑郁症状。由音乐治疗师设计并由CNA协助的音乐活动可能有助于维持抑郁症状的减轻，并改善中度至重度痴呆养老院居民的幸福感。
