P- People with dementia
I- Engagement with life like baby dolls
C- Perception of the care staff about doll therapy
O- Reduced symptoms of anxiety, agitation or aggression
Secondary outcomes- Long term care using this intervention
The journal has an impact factor of 2.95. An average impact factor is of 2.88, which means that our journal is a good and trusted source of information. It has been quoted a multiple times in a given year (Vošner, 2016). It is mainly published in Germany, under the tag of Routledge house of publication. It has a high “H-index” of the ranking 23. The high impact factors of the journal proves that it can be used as trusted source of information. It also can be considered as an authentic and valid source of information to be used for considered in our case study (Yuen, 2018). All of the authors in the publication are of accepted manuscript. Their publications have not been submitted or published lese where. The authors attached to the journal are all aligned with Allied academics and refrain from any other subsidiary. The publication is affiliated with science and medical research, therefore, it can be a valid source of information to be used in regards with our analysis.
The title and abstract are good in terms of providing for a clear picture of the study. The tittle is very well in consistent with the study to be conducted. The main aim and objective of the study is to compare a lifelike baby doll intervention for reducing anxiety, agitation, and aggression in older people with dementia in long-term care (LTC), with usual facility care; and explore the perceptions of care staff about doll therapy. The abstract was able to provide an insight about the study in a very schematic manner. It helped in briefing about the same before beginning with the analysis of the article. The literature cited in the current view is apt with the study’s aims and objectives. The literature review is quite vast in comparison to be analyzed with the study. Pilot, mixed-methods, parallel, randomized controlled trial, with follow-up semi-structured interviews, was taken into consideration for this study (Adewuyi, 2018). It is apt choice as there are two groups to be evaluated for.
One is the patient group, suffering from dementia and the other is healthcare professionals, whose perceptions are to be analyzed. The research question is- “whether the use of baby dolls useful in providing a sense of calm and compose to the patients with dementia?” The study was needed to mainly evaluate the benefits of use of this intervention in the patients having dementia, so that it can be used for the patient population for future inferences. The intervention group received a non-facilitated 30-minutes session with the doll, outside their meal routine and rest periods. They received this intervention three times a week (Monday, Wednesday & Friday), for a duration of total three weeks. For a duration of 30 minutes, they were left to interact with the dolls as they pleased.
A total of 5 residents were recruited form the Brisbane Central Business District (Queensland, Australia). The participants had dementia positive status and having a long term care for the same. The managers of these care facilities helped in identifying for the eligible candidates and also helped in making contact with their families. 65 years or older individuals were selected for the study with a documented history of dementia. They also has a history of reported anxiety, agitation and aggression documented within the past four weeks span. Griffith University Human Ethics Committee provided for the ethical approval for the participants to take part in the case study. A written informed consent was obtained from the next of kin of the participants, before commencing with the study (Armstrong, 2017). The facility care staff was also provided with the informed consent before starting with the interview. The trial was also duly registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000662460) (Bergin, 2016).
The participants were made to use the doll along with a hand held camera probe. Recordings were made once at the baseline week, i.e. 1st week and then at the end of 3rd week. The sessions lasted for a duration of 40 minutes. 10 minutes were used before intervention and the 30 minutes were used during the intervention. The observed emotional rating scale was used by an observational RA, always present at the time of intervention. The scale helped in noting for mainly five types of emotions displayed by the candidate over the time frame of 10 minutes (Kamiya, 2017). These emotions included, pleasure, fear/anxiety, sadness and general alertness. A five pointer scale was used to measure emotions, where 1 ¼ never’ to ‘5 ¼ more than 5-minutes’, and when the emotion was not in view, this was also coded as ‘7 ¼ not in view’. Apart from this a Cohen-Mansfield Agitation Inventory-Short Form was used to evaluate for the frequency of display of behavior in the individuals (Mervin, 2018).
The behavior display noted for reflection of any signs of agitation and aggression in the individuals. At the baseline the RAs helped in collecting the demographic data of each participant. This was done by making use of a Mini Mental State Examination for collection of the behavioral state of the participants in the study (Creavin, 2016). The project manager conducted the nine questions interview in the end of the intervention. These questions helped in exploring the perception of the staff regarding implementation of doll therapy for the dementia patients. The data collection included, collecting for gender, length, position, length of employment in the facility and the duration of working hours in the aged care facilities.
The baseline statistical data was computed for all of the resident’s personal data. Effects of both short-term and long-term effects, i.e. for both 1 week intervention and 3 weeks interventions. The data was analyzed with the help of MANOVA test and the significant observational difference was observed in the study (Stukalin, 2019). The data was also analyzed by the means of IBM SPSS statistic version 25.0. 20 percentage of the whole data was extracted and entered at the time of each assessment, when the raw data was filled for the paper work.
The use of intervention of the doll therapy was not able to produce significant results in the participants. The intervention also did not prove to reduce the signs of anxiety, agitation and aggression in the individuals that significantly. The primary outcomes, i.e. for the first week and the secondary outcomes i.e. for the 3rd week were tested for the significance factor. The overall results were not that significant, however, there was a significant group-by-time interaction observed for the measure of pleasure in the group. The group that was provided with the doll intervention reflected upon having a higher sense of pleasure as compared to their counterparts (Mitchell, 2019). The staff included in the study also felt that the intervention was helpful for the residents and that it can be useful in providing the patients having dementia, with emotional comfort and a calming effect. It can also be used as a part of purposeful activity for these individuals. The limitations however, surfaced as the dolls being useful only some of the time and for some particular individuals only.
The therapy using doll can be helpful for some of the patients. It can provide them with a joyful and purposeful engagement. The use of doll therapy and its effects on the psychosocial interventions for older individuals with dementia is still under covers. The results have been overall positive but there is a dire need of future researches to be concluded to understand the implications and effects of the therapy from an individualized perspective. The circumstances from which the residents can benefit the most are to be analyzes as well. This also has to be dully referred from an individual perspective and how well it can suit the person based on his behavioral display as well.
There is a relevant finding that the doll therapy intervention in people with dementia can be very helpful in providing them with the therapeutic gains, needed for managing their clinical status. Using this therapy cannot be deemed as exactly right but it can be helpful in providing relief with the patient’s current symptoms. This can be used in nursing care to draft a patient-centered approach required by the patient and thus, they can be managed in accordance with their current healthcare needs. This can be helpful for the nurses to manage the care of such patients if the nurses include some of the common practices in evaluating for drafting a patient-centered care model (Cornelison, 2019). They can commit to the role by the means of professional competence, by identifying the patients that might benefit from this interventional largely. Engagement with the dolls used as a therapeutic model can only be effective if the nurses will be facilitating the process. This can also be attained by the means of providing for a care environment to the individuals suffering from dementia.
The nurses can help in building a strong organizational environment, by helping in promoting these activities of engagement through the setting and in larger masses. As there is a limited evidence on the effectiveness of the therapy a larger group of population can be engaged in the process to provide for visibly significant results. This can also be helpful in nursing care, to be included as a part of innovative approach model to treat the patients suffering from dementia (Ng, 2017). The nurses will be also be helpful in developing a person-centered care model for the individuals suffering from dementia. This will be helpful for the nurses to not only identify the vulnerable patients requiring aid, but will also be helpful in providing for the therapeutic avenues for the patient population. These care models will also be helpful in delivering nursing care based on shared-decision making process and will thus, be an effective method of providing an appropriate care management to the patient.
This methodology can also be helpful for the nurses to identify the weak areas for the particular patients to be worked upon (Julian, 2020). These areas can be considered as the areas that can be focused to be worked upon in an effective manner. This can thus, be very helpful in supporting and facilitating the patients in their activities of daily living. This intervention can be helpful in promoting increased and active interaction of the patient and the nursing staff on daily basis. The engagement can be meaningful in providing the patient with not only a good therapeutic intervention, but also to assist in fetching improved patient care outcomes as well as satisfaction in the patients (Cantarella, 2018). This will help in promoting the continuity of care provided to the patient and will also allow the nurses to be able to connect with the patient with a greater efficacy.
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