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观察音乐疗法在痴呆症中的应用:重复的单案例研究评估幸福感和社交互动。

Observing Music Therapy in Dementia: Repeated Single-case Studies Assessing Well-being and Sociable Interaction.

机构信息

Department of Clinical Psychology, University of Bergen, Bergen, Norway.

NKS Olaviken Gerontopsychiatric Hospital, Bergen, Askøy, Norway.

出版信息

Clin Gerontol. 2022 Jul-Sep;45(4):968-982. doi: 10.1080/07317115.2021.1978121. Epub 2021 Sep 29.

Abstract

OBJECTIVES

This study compared behavioral expressions of momentary well-being and sociable behavior toward significant others during music therapy and regular social interaction.

METHODS

A 10-week active music therapy intervention was provided for people living with dementia and family caregivers. A bi-phasic AB single-case design was replicated for three sessions per dyad and coded using the Observable Well-being in Living with Dementia-Scale (OWLS) and the Verbal and Nonverbal Sociable Interaction Scale-Care Receiver (VNVIS-CR). Effect sizes (Log Response Ratio) were calculated for each session and analyzed with robust cluster meta-analysis.

RESULTS

Eleven dyads were included, and 32 sessions analyzed (2102 observations). Within sessions we found a 48% increase in well-being, and a 32% increase in sociable interaction during music therapy. Heterogeneity was high. Dementia severity predicted an increase in nonverbal sociable interaction (93% for moderate dementia). Depression and time did not predict any change.

CONCLUSION

The potential of music therapy to increase well-being and sociable interactions toward significant others calls for further investigation of heterogeneity and covariates. Single-case designs are demonstrated to be feasible for these investigations.

CLINICAL IMPLICATIONS

Preference-based music therapy may alleviate some of the individual and relational consequences of living with dementia, facilitating positive emotions and connection to significant others.

摘要

目的

本研究比较了音乐治疗和常规社交互动期间瞬间幸福感和对重要他人的社交行为的表现。

方法

为患有痴呆症的患者和家庭护理人员提供了为期 10 周的积极音乐治疗干预。对每对参与者的三个会话重复使用双相 AB 单案例设计,并使用“与痴呆症共存中的观察性幸福感量表”(OWLS)和“口头和非口头社交互动量表-照顾接收者”(VNVIS-CR)进行编码。对每个会话计算效应大小(对数响应比),并使用稳健聚类元分析进行分析。

结果

纳入了 11 对参与者,分析了 32 个会话(2102 次观察)。在会话内,我们发现音乐治疗期间幸福感增加了 48%,社交互动增加了 32%。异质性很高。痴呆症严重程度预测非言语社交互动增加(中度痴呆症为 93%)。抑郁和时间都没有预测任何变化。

结论

音乐治疗增加幸福感和对重要他人的社交互动的潜力需要进一步研究异质性和协变量。单案例设计被证明可用于这些研究。

临床意义

基于偏好的音乐治疗可能减轻与痴呆症共存的个体和关系后果,促进积极的情绪和与重要他人的联系。

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