Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of Porto University, Porto, Portugal.
Geriatrics & Mental Health Group, CINTESIS - Center for Health Technologies and Services Research, Porto, Portugal.
Int J Geriatr Psychiatry. 2021 Nov;36(11):1664-1690. doi: 10.1002/gps.5568. Epub 2021 Jun 7.
Dementia care is a major public health issue worldwide. The management of behavioral and psychological symptoms (BPSD) is one of the hardest challenges in this context. Non-pharmacological strategies, like music-based interventions (Mbi), seem promising options, being considered low-risk, widely available and inclusive. This scoping review aimed at mapping all Mbi used in dementia care, targeting BPSD, and debriefing its components, structure and rationale. Music therapy and other therapeutic music activities were included.
The Arksey and O'Malley framework, Cochrane recommendations and PRISMA checklist were followed. Embase, PubMed, PsycINFO, ASSIA and Humanities Index were searched from first records until the 31 of March 2020. Snowballing process and screening of relevant journals were also undertaken. A panel of experts critically guided the evidence synthesis.
Overall, 103 studies (34 RCT; 12 NRT; 40 Before/After studies and 17 Case Studies) met inclusion criteria. Basic elements of the Mbi, the rationale supporting its development and hypothesis tested were mostly underreported, thus hampering cross-study comparisons and generalizations. Despite this, available evidence indicates that: it is feasible to deliver Mbi to PwD at very different stages and in different settings - from community to the acute setting - even for non-music therapists; positive or neutral effects in BPSD are often reported but not without exception; individualization seems a critical factor mediating Mbi effects.
Detailed intervention and research reporting are essential to interpretation, replication and translation into practice. Ten years after the publication of specific reporting guidelines, this goal is not yet fully achieved in music in dementia care.
痴呆症护理是全球范围内的一个主要公共卫生问题。在这种情况下，管理行为和心理症状（BPSD）是最具挑战性的问题之一。非药物策略，如基于音乐的干预措施（MBI），似乎是很有前途的选择，被认为是低风险、广泛可用且包容性强的选择。本范围综述旨在绘制用于痴呆症护理、针对 BPSD 的所有 MBI，并详细说明其组成部分、结构和原理。包括音乐治疗和其他治疗性音乐活动。
遵循了 Arksey 和 O'Malley 框架、Cochrane 建议和 PRISMA 清单。从第一个记录开始，在 2020 年 3 月 31 日之前，对 Embase、PubMed、PsycINFO、ASSIA 和人文索引进行了搜索。还进行了滚雪球过程和相关期刊的筛选。一个专家小组对证据综合进行了批判性指导。
总体而言，有 103 项研究（34 项 RCT；12 项非随机对照试验；40 项前后对照研究和 17 项案例研究）符合纳入标准。MBI 的基本要素、支持其发展和假设检验的基本原理大多没有得到报告，因此阻碍了跨研究比较和推广。尽管如此，现有证据表明：即使对于非音乐治疗师，也可以在非常不同的阶段和不同的环境中向 PwD 提供 MBI-从社区到急性环境；经常报告 BPSD 有积极或中性的效果，但并非没有例外；个性化似乎是介导 MBI 效果的关键因素。
详细的干预和研究报告对于解释、复制和转化为实践至关重要。在特定报告指南发布 10 年后，这一目标在音乐治疗痴呆症护理方面尚未完全实现。
