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Music therapy for reducing agitation and psychotropic medication in nursing home residents with dementia
Abstracts / European Journal of Integrative Medicine 7S (2015) 1–53
experiences within a recovery-focused group programme called ‘Rebuilding your Life’, co-developed by people with and recovered from CFS/ME and healthcare professionals. Facilitated by an expert trainer in Neuro-Linguistic Programming, the programme uses the examples of people already recovered from CFS/ME as models for successful recovery. It has an ethos of coenquiry between participants (patients and facilitators) as joint and equal collaborators. Methods: A phenomenological exploration of the experiences of 13 group participants; 9 people with CFS/ME, 1 recovered person and 3 facilitators (including researcher/facilitator). Data collection involved: (1) researcher/facilitator keeping a reflective journal (2) participants’ reviews (individual and group) of their experiences in the programme, with an invitation to co-produce resource(s) for others, recording aspects of their own narratives. Data analysis: A heuristic process intertwining participants’ narratives and researcher’s reflections, developing themes through text, metaphor and imagery. Results: Identification of key themes: (1) gaining hope (2) internalising an image of a personal future recovery (3) finding a voice. A poster was co-produced by the group illustrating these themes, both in its making process and its content. Conclusions: This group programme may offer a means to developing a recovery-focused community, through its perpetuating format of those who recover becoming models and voicing narratives to on-going cohorts. This concept has potential in many areas of health provision. http://dx.doi.org/10.1016/j.eujim.2015.09.048 Music therapy for reducing agitation and psychotropic medication in nursing home residents with dementia Hanne Mette Ridder Department of Communication and Psychology, Aalborg University, Kroghstræde 3, Aalborg 9220, Denmark E-mail address: [email protected]. Introduction: Dementia is a neurocognitive disease with a high risk of social isolation and agitation due to loss of cognitive functions. In nursing home residents with dementia, agitation is the most significant symptom causing patient distress and caregiver burden. Agitation is described as abuse or aggressive or inappropriate behaviour. According to a psychosocial model of care, agitation is understood as attempts to communicate psychosocial needs. The prevalence of agitation is predicted by the psychosocial culture of care, and too often symptoms of agitation are treated with psychotropic medication without first trying the efficacy of psychosocial interventions. The aim of this paper is to provide an overview of research on the effectiveness of music therapy on agitation and psychotropic medication. Methods: Review studies investigating non-pharmacological interventions are synthesized and related to recent
19
published RCTs on music therapy, agitation and psychotropic medication. Results: A Cochrane review from 2011 on the effect of music therapy on dementia could not include enough studies for a meta-analysis, however several recent review studies on nonpharmachological interventions point at music therapy as an effective intervention in dementia care. Recent studies show an effect of music therapy on agitation. Conclusions: Psychotropic medication is described as ineffective or harmful, and the overall evidence regarding nonpharmacological interventions in general, and music therapy in specific, is unclear. With regard to recent controlled studies, structured music therapy is concluded to decrease agitation in care home residents with dementia and prevent the prescription of psychotropic medication. http://dx.doi.org/10.1016/j.eujim.2015.09.049 Homeopathic therapy in paediatric atopic diseases: Short and long term outcomes Elio Rossi ∗ , Marco Picchi, Paola Bartoli, Marialessandra Panozzo, Chiara Cervino, Mariella Di Stefano Hospital Campo di Marte ASL 2 Lucca, Homeopatic Clinic, via dell’ospedale, Lucca, Lucca 55100, Italy E-mail address: [email protected] (E. Rossi). Introduction: To study the outcomes of atopic diseases (dermatitis, asthma and allergic rhinitis) in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy), and the long-term outcomes of children suffering from atopic diseases after an approximate 8-year period (range 5–10 years). Methods: An observational longitudinal study was carried out on 857 (24.9%) consecutive paediatric patients, mean age < 14 years, consecutively visited from 1998 until 2014. Children with atopic diseases were 325 (37.9%); with atopic dermatitis were 126 (39%), allergic rhinitis 72 (22%) and asthma 127 (39%). Moreover, a long-term study was conducted with 107 out of 165 paediatric patients, mean age 6.5 years, consecutively visited from 1999 until 2006 for atopic diseases, with at least 5 years of follow-up. The mean age of the patients at re-evaluation was 13.8 years. Patients’ conditions were evaluated on a 5-level ordinal scale (from 0 to 4) both during the first visit and during the follow-up visit about 7.6 years later. Homeopathy effectiveness was evaluated using the Wilcoxon test for paired samples. Results: At least one follow-up visit was performed in 49.5% of children, of whom75.8% had moderate/important improvement or resolution of the diseases. At re-evaluation after 5/10 years complete remission of the symptoms was obtained in 70.1% of the atopic children. Children with two or three atopic diseases at the first visit were completely healed in 52.3% of cases.
experiences within a recovery-focused group programme called ‘Rebuilding your Life’, co-developed by people with and recovered from CFS/ME and healthcare professionals. Facilitated by an expert trainer in Neuro-Linguistic Programming, the programme uses the examples of people already recovered from CFS/ME as models for successful recovery. It has an ethos of coenquiry between participants (patients and facilitators) as joint and equal collaborators. Methods: A phenomenological exploration of the experiences of 13 group participants; 9 people with CFS/ME, 1 recovered person and 3 facilitators (including researcher/facilitator). Data collection involved: (1) researcher/facilitator keeping a reflective journal (2) participants’ reviews (individual and group) of their experiences in the programme, with an invitation to co-produce resource(s) for others, recording aspects of their own narratives. Data analysis: A heuristic process intertwining participants’ narratives and researcher’s reflections, developing themes through text, metaphor and imagery. Results: Identification of key themes: (1) gaining hope (2) internalising an image of a personal future recovery (3) finding a voice. A poster was co-produced by the group illustrating these themes, both in its making process and its content. Conclusions: This group programme may offer a means to developing a recovery-focused community, through its perpetuating format of those who recover becoming models and voicing narratives to on-going cohorts. This concept has potential in many areas of health provision. http://dx.doi.org/10.1016/j.eujim.2015.09.048 Music therapy for reducing agitation and psychotropic medication in nursing home residents with dementia Hanne Mette Ridder Department of Communication and Psychology, Aalborg University, Kroghstræde 3, Aalborg 9220, Denmark E-mail address: [email protected]. Introduction: Dementia is a neurocognitive disease with a high risk of social isolation and agitation due to loss of cognitive functions. In nursing home residents with dementia, agitation is the most significant symptom causing patient distress and caregiver burden. Agitation is described as abuse or aggressive or inappropriate behaviour. According to a psychosocial model of care, agitation is understood as attempts to communicate psychosocial needs. The prevalence of agitation is predicted by the psychosocial culture of care, and too often symptoms of agitation are treated with psychotropic medication without first trying the efficacy of psychosocial interventions. The aim of this paper is to provide an overview of research on the effectiveness of music therapy on agitation and psychotropic medication. Methods: Review studies investigating non-pharmacological interventions are synthesized and related to recent
19
published RCTs on music therapy, agitation and psychotropic medication. Results: A Cochrane review from 2011 on the effect of music therapy on dementia could not include enough studies for a meta-analysis, however several recent review studies on nonpharmachological interventions point at music therapy as an effective intervention in dementia care. Recent studies show an effect of music therapy on agitation. Conclusions: Psychotropic medication is described as ineffective or harmful, and the overall evidence regarding nonpharmacological interventions in general, and music therapy in specific, is unclear. With regard to recent controlled studies, structured music therapy is concluded to decrease agitation in care home residents with dementia and prevent the prescription of psychotropic medication. http://dx.doi.org/10.1016/j.eujim.2015.09.049 Homeopathic therapy in paediatric atopic diseases: Short and long term outcomes Elio Rossi ∗ , Marco Picchi, Paola Bartoli, Marialessandra Panozzo, Chiara Cervino, Mariella Di Stefano Hospital Campo di Marte ASL 2 Lucca, Homeopatic Clinic, via dell’ospedale, Lucca, Lucca 55100, Italy E-mail address: [email protected] (E. Rossi). Introduction: To study the outcomes of atopic diseases (dermatitis, asthma and allergic rhinitis) in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy), and the long-term outcomes of children suffering from atopic diseases after an approximate 8-year period (range 5–10 years). Methods: An observational longitudinal study was carried out on 857 (24.9%) consecutive paediatric patients, mean age < 14 years, consecutively visited from 1998 until 2014. Children with atopic diseases were 325 (37.9%); with atopic dermatitis were 126 (39%), allergic rhinitis 72 (22%) and asthma 127 (39%). Moreover, a long-term study was conducted with 107 out of 165 paediatric patients, mean age 6.5 years, consecutively visited from 1999 until 2006 for atopic diseases, with at least 5 years of follow-up. The mean age of the patients at re-evaluation was 13.8 years. Patients’ conditions were evaluated on a 5-level ordinal scale (from 0 to 4) both during the first visit and during the follow-up visit about 7.6 years later. Homeopathy effectiveness was evaluated using the Wilcoxon test for paired samples. Results: At least one follow-up visit was performed in 49.5% of children, of whom75.8% had moderate/important improvement or resolution of the diseases. At re-evaluation after 5/10 years complete remission of the symptoms was obtained in 70.1% of the atopic children. Children with two or three atopic diseases at the first visit were completely healed in 52.3% of cases.