Occupational Therapy and Arts Therapies
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/25
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Item Assistive technology: Occupational therapy assessment and services for people with dementia(SAGE, 2024-05-21) Curnow, Eleanor; Maclean, Fiona; McCormack, BrendanIntroduction: Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation. Method: This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery. Results: Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors. Conclusion: There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology.Item Assistive technology and telecare to maintain independent living at home for people with dementia: The ATTILA RCT(NIHR, 2021-03) Gathercole, Rebecca; Bradley, Rosie; Harper, Emma; Davies, Lucy; Pank, Lynn; Lam, Natalie; Davies, Anna; Talbot, Emma; Hooper, Emma; Winson, Rachel; Scutt, Bethany; Montano, Victoria Ordonez; Nunn, Samantha; Lavelle, Grace; Lariviere, Matthew; Hirani, Shashivadan; Brini, Stefano; Bateman, Andrew; Bentham, Peter; Burns, Alistair; Dunk, Barbara; Forsyth, Kirsty; Fox, Chris; Henderson, Catherine; Knapp, Martin; Leroi, Iracema; Newman, Stanton; O'Brien, John; Poland, Fiona; Woolham, John; Gray, Richard; Howard, RobertAssistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. This trial was set in 12 councils in England with adult social services responsibilities. Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group - control group difference: mean -£909, 95% confidence interval -£5336 to £3345) or in societal costs (intervention group - control group difference: mean -£3545; 95% confidence interval -£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval -0.204 to -0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants' health and social care or societal costs. Quality-adjusted life-years based on participants' EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. Current Controlled Trials ISRCTN86537017.Item Music therapy in Greece and its applications in dementia and end-of-life care(2020-10-17) Tsiris, Giorgos; Kalliodi, ChristinaIn this report we focus on music therapy in Greece and its applications in dementia and end-of-life care. Initially we offer an overview of music therapy in the country and outline key developments in terms of professionalisation, education, research and scholarship. Exploring these developments from a critical perspective, we acknowledge contemporary debates and their implications for the advancement of the field. This exploration offers a platform for understanding the current applications of music therapy in dementia and adult end-of-life care in Greece. We provide examples of recent projects and initiatives alongside broader considerations regarding the status of dementia and end-of-life care. We conclude by offering some perspectives for future potential developments in the field.Item The impact of assistive technology on burden and psychological wellbeing in informal caregivers of people with dementia (ATTILA Study)(Alzheimer's Association, 2020-10-07) Davies, Anna; Brini, Stefano; Hirani, Shashivadan; Gathercole, Rebecca; Forsyth, Kirsty; Henderson, Catherine; Bradley, Rosie; Davies, Lucy; Dunk, Barbara; Harper, Emma; Lam, Natalie; Pank, Lynn; Leroi, Iracema; Woolham, John; Fox, Chris; O'Brien, John; Bateman, Andrew; Poland, Fiona; Bentham, Pete; Burns, Alistar; Gray, Richard; Knapp, Martin; Talbot, Emma; Hooper, Emma; Winson, Rachel; Scutt, Bethany; Ordonez, Victoria; Nunn, Samantha; Lavelle, Grace; Howard, Robert; Newman, StantonINTRODUCTION, Assistive Technology and Telecare (ATT) may alleviate psychological burden in informal caregivers of people with dementia. This study assessed the impact of ATT on informal caregivers’ burden and psychological wellbeing.Item Exploring the needs of people with dementia living at home reported by people with dementia and informal caregivers: A systematic review and meta-analysis(Taylor & Francis, 2019-12-03) Curnow, Eleanor; Rush, Robert; Maciver, Donald; Górska, Sylwia; Forsyth, KirstyObjectives: To provide prevalence estimates of needs of people with dementia living at home, and to determine sources of variation associated with needs for this population.Item Participation as means for adaptation in dementia: A conceptual model(Taylor & Francis, 2019-12-02) Górska, Sylwia; Maciver, Donald; Forsyth, KirstyObjectives: There are a number of conceptual models of dementia, capturing a range of biopsychosocial factors. Few integrate the lived experience of dementia. The aim of this study was to develop a conceptualisation grounded in the first-hand accounts of living with the condition and reflecting its complexity.Item Assessment of need and practice for assistive technology and telecare for people with dementia—The ATTILA (Assistive Technology and Telecare to maintain Independent Living At home for people with dementia) trial(Elsevier, 2019-09-03) Forsyth, Kirsty; Henderson, Catherine; Davis, Lucy; Singh Roy, Anusua; Dunk, Barbara; Curnow, Eleanor; Gathercole, Rebecca; Lam, Natalie; Harper, Emma; Leroi, Iracema; Woolham, John; Fox, Chris; O'Brien, John; Bateman, Andrew; Poland, Fiona; Bentham, Peter; Burns, Alistair; Davies, Anna; Gray, Richard; Bradley, Rosie; Knapp, Martin; Newman, Stanton; McShane, Rupert; Ritchie, Craig; Talbot, Emma; Hooper, Emma; Winson, Rachel; Scutt, Bethany; Ordonez, Victoria; Nunn, Samantha; Lavelle, Grace; Howard, RobertIntroduction The objective of this study was to define current assistive technology and telecare (ATT) practice for people with dementia living at home.Item Living With Dementia: A Meta-synthesis of Qualitative Research on the Lived Experience(Oxford, 2017-01-09) Górska, Sylwia; Forsyth, Kirsty; Maciver, Donald; QMUPurpose of the Study: To identify and examine the published qualitative research evidence relative to the experience of living with dementia. Design and Methods: Metasynthesis was used as the methodological framework to guide data collection and analysis. Results: Three themes were identified. The first theme considered the main condition-related changes experienced by people with dementia (PWD) and showed how these are interlinked and impact upon various areas of people's lives. The second theme indicated that amidst these changes, PWD strive to maintain continuity in their lives by employing various resources and coping strategies. The third theme underlined the role of contextual factors. The reviewed evidence indicates that, the emerging experience of PWD and their potential to adjust to the continuous changes is influenced by access to and quality of both personal and contextual resources which remain in a constant, transactional relationship to each other. Implications: The findings were interpreted and discussed in the context of relevant theoretical frameworks and research evidence. It was considered that current evidence and findings presented in this review can be further explored and expanded upon in a more systematic way through research conducted within the theoretical framework of dynamic systems theory. Further research would be also beneficial to explore the subjective experience of dementia from a participatory perspective. Exploring the application of these theoretical standpoints would contribute to the current state of knowledge and offer both PWD and carers fresh perspective on the nature of change and potential for adaptability in dementia.