Research Department of Clinical, Educational and Health Psychology, 4919University College London, London, UK.
School of Human Sciences, Faculty of Education, Health and Human Sciences, 4918University of Greenwich, London, UK.
Dementia (London). 2021 Jul;20(5):1553-1564. doi: 10.1177/1471301220954611. Epub 2020 Sep 7.
Cognitive stimulation therapy (CST) is a brief, non-pharmacological intervention for people with dementia, with an established evidence base for improving cognition and quality of life. It is widely implemented in National Health Service (NHS) settings, but little is known about its naturalistic use. The aim of this survey was to identify and explore inclusion criteria, dose and quality of CST across services in Great Britain (England, Scotland and Wales). All NHS memory clinics and services for people with dementia were contacted and asked to complete a mixed methods online survey on CST delivery in their service. Questions were centred on who provided CST, who received CST, the dose of CST and any outcomes that were routinely measured. A total of 57/186 services responded, giving a response rate of 30.7%. While the majority reported offering CST (87.7%), there was variability in how this was delivered. Differing inclusion criteria included the use of varying cognitive and behavioural outcome measures, and CST was reported as being offered once and twice weekly. Services also differed in how they evaluated the quality of CST and how this evidence was incorporated for future sessions. While there was a low response rate, this survey indicates that there is significant variability in how CST is used in clinical practice, with many trusts not adhering to the evidence base. To ensure that people with dementia are consistently offered evidence-based, high-quality CST across NHS settings, further standardisation of inclusion criteria, dose and outcomes is needed.
认知刺激疗法(CST)是一种针对痴呆症患者的简短、非药物干预措施,具有改善认知和生活质量的既定证据基础。它在国民保健制度(NHS)环境中得到广泛实施,但对其自然使用情况知之甚少。本调查的目的是确定并探讨英国(英格兰、苏格兰和威尔士)各地服务机构中 CST 的纳入标准、剂量和质量。所有 NHS 记忆诊所和痴呆症服务机构都被联系并要求完成一项关于其服务中 CST 提供情况的混合方法在线调查。问题集中在谁提供 CST、谁接受 CST、CST 的剂量以及常规测量的任何结果。共有 57/186 个服务机构做出回应,回应率为 30.7%。虽然大多数机构报告提供 CST(87.7%),但提供方式存在差异。不同的纳入标准包括使用不同的认知和行为结果测量方法,CST 每周提供一次和两次。服务机构在评估 CST 质量的方式以及如何将这些证据纳入未来课程方面也存在差异。尽管回应率较低,但这项调查表明,CST 在临床实践中的使用存在很大差异,许多信托机构没有遵守证据基础。为确保在 NHS 环境中为痴呆症患者提供一致的、基于证据的高质量 CST,需要进一步标准化纳入标准、剂量和结果。