Rutgers University - Newark, Newark, New Jersey, USA.
Brigham Young University, Provo, Utah, USA.
Int J Geriatr Psychiatry. 2022 Jan;37(1). doi: 10.1002/gps.5641. Epub 2021 Oct 19.
Research has found that music-based interventions can decrease behavioral and psychological symptoms of dementia or behaviors that challenge (BPSD/BtC). However, how to effectively implement these interventions is unclear. This study synthesizes available evidence regarding implementation strategies and outcomes of music-based interventions for people with dementia at residential long-term care facilities.
Study registered with PROSPERO (registration number: CRD42020194354). We searched the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. Inclusion criteria included articles targeting music-based interventions conducted for people with dementia, studies conducted in residential long-term care facilities, and articles that reported implementation strategies and outcomes of the intervention.
Of the included eight studies, half were studies of music therapy and the other half were on individualized music. 49 implementation strategies were reported. The most frequently reported category of strategies was planning (34.7%), followed by education (24.5%), quality management (24.5%), restructuring (12.2%), and finance (4.1%). No strategies under the category of attending to the policy context were reported. The most frequently reported implementation outcomes were appropriateness (27.3%), followed by adoption (22.7%), fidelity (22.7%), acceptability (9.1%), sustainability (9.1%), and cost (9.1%). No studies measured feasibility or penetration.
Although various effective implementation strategies were identified, we were unable to examine the effectiveness of individual implementation strategies due to the designs of the selected studies. Less attention has been paid to strategies that aim at structural changes of intervention delivery systems. Future studies should investigate facilitators and barriers of implementing music-based interventions especially focusing on structural aspects.
研究发现，基于音乐的干预措施可以减少痴呆症患者的行为和心理症状或具有挑战性的行为（BPSD/BtC）。然而，如何有效地实施这些干预措施尚不清楚。本研究综合了关于音乐干预措施在住宅长期护理机构中对痴呆症患者的实施策略和结果的现有证据。
本研究在 PROSPERO（注册号：CRD42020194354）上进行了注册。我们搜索了以下数据库：PsychInfo、PubMed、MEDLINE、CINAHL 和 The Cochrane Library。纳入标准包括针对痴呆症患者进行的基于音乐的干预措施的文章、在住宅长期护理机构中进行的研究以及报告干预实施策略和结果的文章。
在纳入的八项研究中，有一半是音乐治疗研究，另一半是个性化音乐研究。报告了 49 项实施策略。报告的策略最常见的类别是规划（34.7%），其次是教育（24.5%）、质量管理（24.5%）、重组（12.2%）和财务（4.1%）。没有报告属于关注政策环境类别的策略。报告的最常见实施结果是适当性（27.3%），其次是采用率（22.7%）、保真度（22.7%）、可接受性（9.1%）、可持续性（9.1%）和成本（9.1%）。没有研究测量可行性或渗透性。
尽管确定了各种有效的实施策略，但由于所选研究的设计，我们无法检查个别实施策略的有效性。对旨在改变干预提供系统结构的策略关注较少。未来的研究应调查实施基于音乐的干预措施的促进因素和障碍，特别是关注结构方面。
