Hillebrand Mareike C, Weise Lisette, Wilz Gabriele
Department of Counseling and Clinical Intervention, Institute of Psychology, Friedrich-Schiller-University Jena, Jena, Germany.
Int J Geriatr Psychiatry. 2023 Mar;38(3):e5893. doi: 10.1002/gps.5893.
Evidence suggests that individualized music listening (IML) can effectively reduce the behavioral and psychological symptoms of dementia (BPSD). So far, however, studies have been primarily based on questionnaire measures of BPSD completed by proxy. We therefore investigate effects of IML on BPSD based on systematic observation. We address the methodological limitations of previous observational studies by using a validated instrument, time-based sampling, and longitudinal analytical methods.
We compared BPSD of nursing home residents with dementia in an IML intervention group (IG; n = 44) and a control group (CG; n = 46) in a randomized controlled trial (DRKS00013793; ISRCTN59052178). Trained raters observed 18 BPSD in 15 four-minute intervals before, during and after an IML session. We used t-tests to compare BPSD in the IG and CG before, during and after the session and piecewise latent curve modelling to compare BPSD trajectories across 1 hour.
BPSD were observed less frequently in the IG than in the CG during, but not before or after the session. Likewise, whereas the CG experienced a stable trajectory of BPSD, the IG experienced a u-shaped trajectory characterized by stability before the session, a decrease during the session, and increase after the session. There was significant interindividual variability in baseline BPSD and in the pre- and post-session slopes.
Our results provide additional evidence that IML effectively reduces BPSD, although the effect is short-lived. As IML rarely has negative side effects, is highly accepted and easily implemented, IML should be integrated into the everyday care routines for people with dementia.
German Clinical Trials Register DRKS00013793; ISRCTN registry, ISRCTN59052178.
有证据表明，个性化音乐聆听（IML）可有效减轻痴呆症的行为和心理症状（BPSD）。然而，到目前为止，研究主要基于由他人代填的BPSD问卷测量。因此，我们基于系统观察来研究IML对BPSD的影响。我们通过使用经过验证的工具、基于时间的抽样方法和纵向分析方法，解决了以往观察性研究的方法学局限性。
在一项随机对照试验（DRKS00013793；ISRCTN59052178）中，我们比较了IML干预组（IG；n = 44）和对照组（CG；n = 46）中患有痴呆症的养老院居民的BPSD。经过培训的评估人员在IML疗程之前、期间和之后的15个四分钟时间段内观察了18项BPSD。我们使用t检验比较疗程之前、期间和之后IG和CG中的BPSD，并使用分段潜在曲线模型比较1小时内的BPSD轨迹。
在疗程期间，IG中观察到的BPSD频率低于CG，但在疗程之前和之后并非如此。同样，CG的BPSD轨迹稳定，而IG的轨迹呈U形，其特征是疗程前稳定、疗程中下降、疗程后上升。基线BPSD以及疗程前后斜率存在显著的个体间差异。
我们的结果提供了额外的证据，证明IML可有效减轻BPSD，尽管效果是短暂的。由于IML很少有负面副作用，易于接受且易于实施，因此应将IML纳入痴呆症患者的日常护理程序中。
德国临床试验注册中心DRKS00013793；ISRCTN注册中心，ISRCTN59052178。
