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      Individual music therapy for managing neuropsychiatric symptoms for people with dementia and their carers: a cluster randomised controlled feasibility study

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          Abstract

          Background

          Previous research highlights the importance of staff involvement in psychosocial interventions targeting neuropsychiatric symptoms of dementia. Music therapy has shown potential effects, but it is not clear how this intervention can be programmed to involve care staff within the delivery of patients’ care. This study reports initial feasibility and outcomes from a five month music therapy programme including weekly individual active music therapy for people with dementia and weekly post-therapy video presentations for their carers in care homes.

          Methods

          17 care home residents and 10 care staff were randomised to the music therapy intervention group or standard care control group. The cluster randomised, controlled trial included baseline, 3-month, 5-month and post-intervention 7-month measures of residents’ symptoms and well-being. Carer-resident interactions were also assessed. Feasibility was based on carers’ feedback through semi-structured interviews, programme evaluations and track records of the study.

          Results

          The music therapy programme appeared to be a practicable and acceptable intervention for care home residents and staff in managing dementia symptoms. Recruitment and retention data indicated feasibility but also challenges. Preliminary outcomes indicated differences in symptoms (13.42, 95 % CI: [4.78 to 22.07; p = 0.006]) and in levels of wellbeing (−0.74, 95 % CI: [−1.15 to −0.33; p = 0.003]) between the two groups, indicating that residents receiving music therapy improved. Staff in the intervention group reported enhanced caregiving techniques as a result of the programme.

          Conclusion

          The data supports the value of developing a music therapy programme involving weekly active individual music therapy sessions and music therapist-carer communication. The intervention is feasible with modifications in a more rigorous evaluation of a larger sample size.

          Trial registration

          Clinicaltrials.gov, number NCT01744600.

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          Most cited references91

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          Developing and evaluating complex interventions: the new Medical Research Council guidance

          Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance
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            The cognitive control of emotion.

            The capacity to control emotion is important for human adaptation. Questions about the neural bases of emotion regulation have recently taken on new importance, as functional imaging studies in humans have permitted direct investigation of control strategies that draw upon higher cognitive processes difficult to study in nonhumans. Such studies have examined (1) controlling attention to, and (2) cognitively changing the meaning of, emotionally evocative stimuli. These two forms of emotion regulation depend upon interactions between prefrontal and cingulate control systems and cortical and subcortical emotion-generative systems. Taken together, the results suggest a functional architecture for the cognitive control of emotion that dovetails with findings from other human and nonhuman research on emotion.
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              The Global Deterioration Scale for assessment of primary degenerative dementia

              (1982)
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                Author and article information

                Contributors
                ming.hunghsu@mha.org.uk
                ros.flowerdew@mha.org.uk
                michael.parker@anglia.ac.uk
                jorg.fachner@anglia.ac.uk
                helen.odell-miller@anglia.ac.uk
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                18 July 2015
                18 July 2015
                2015
                : 15
                : 84
                Affiliations
                [ ]Methodist Homes (MHA), Derby, UK
                [ ]Department of Music and Performing Arts, Anglia Ruskin University, Cambridge, UK
                [ ]Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
                Article
                82
                10.1186/s12877-015-0082-4
                4506459
                26183582
                1c764092-f0a8-423b-a904-4b0891a2f90e
                © Hsu et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 December 2014
                : 6 July 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Geriatric medicine
                music therapy,caregiving,neuropsychiatric symptoms,dementia
                Geriatric medicine
                music therapy, caregiving, neuropsychiatric symptoms, dementia

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