Viewing and making art together: an eight-week gallery-based intervention for people with dementia and their caregivers

Objectives: This is the first known study that sought to understand the experience of an eight-week art-gallery-based intervention offered at two distinctly different galleries for people with mild to moderate dementia and their carers. The study examined impact on social inclusion, carer burden, and quality of life and daily living activities for a person with dementia. Method: A mixed-methods pre-post design using standardised questionnaires and interviews involved 24 participants (12 with dementia) and compared similar interventions at a traditional and a contemporary art gallery. Qualitative data was analysed using thematic analysis. Results: No significant pre-post difference was found between the traditional or contemporary gallery groups on quantitative measures. There was, however, a non-significant trend towards a reduction in carer burden over the course of the intervention for both gallery groups. Thematic analysis revealed well-being benefits from both traditional and contemporary art gallery sites that included positive social impact resulting from feeling more socially included, self-reports of enhanced cognitive capacities for people with dementia, and an improved quality of life. Conclusion: Participants were unanimous in their enjoyment and satisfaction with the programme, despite the lack of significance from standardised measures. Further consideration of art galleries and museums, as non-clinical community resources for dementia care, is warranted. The interventions at both galleries helped to foster social inclusion and social engagement, enhance the caring relationship between the carers and PWD, support the personhood of PWD, and stimulate cognitive processes of attention and concentration

Viewing art on a tablet computer: a wellbeing intervention for people with dementia and their caregivers

Background: Art-based interventions have been shown to be beneficial for the wellbeing of people with dementia and their caregivers. This paper explored whether such interventions can be delivered via a touchscreen tablet device displaying art images. Methods: Twelve pairs of volunteers with dementia and informal caregivers were recruited. A quasi-experimental mixed-methods within-subjects study evaluated the wellbeing impacts of art viewing using visual analogue scales and explored participant experiences with thematic analysis. Findings: Quantitative results showed a significant effect for change in composite wellbeing from session one to session five. Wellbeing subdomains showed impact on wellbeing, which generally increased with number of sessions. Qualitative findings included changes in cognition, behaviour, mood and relationships. These changes tended to be viewed positively. Conclusions: The results suggest touchscreen-based art interventions could yield wellbeing benefits for this population. A larger-scale controlled study would help to determine whether wider dementia care practice implications can be drawn

What factors influence healthcare professionals to refer children and families to paediatric psychology?

Objectives: This study aimed to investigate factors influencing referral of children with physical illness to paediatric psychology. Due to high rates of mental health problems within this population, studies have shown that referral to paediatric psychology should be increased. However, few studies have examined factors shaping healthcare professionals’ referral behaviour. Methods: The current study used the theory of planned behaviour to develop a questionnaire which explores factors influencing the referral of children and families to paediatric psychology. Psychometric properties of the questionnaire were examined. Results: The questionnaire was found to have good reliability and validity. The main constructs of the theory of planned behaviour were useful in predicting intention to refer to paediatric psychology. Specific beliefs about referral were shown to influence intention to refer. Conclusions: Findings suggest that individual attitudes and beliefs can impact healthcare professionals’ referral behaviour, indicating that multidisciplinary interventions and inter-professional education relating to the psychological aspects of illness are required

Effects of a museum-based social-prescription intervention on quantitative measures of psychological wellbeing in older adults

Aims: To assess psychological wellbeing in a novel social prescription intervention for older adults called Museums on Prescription, and to explore the extent of change over time in six self-rated emotions (‘absorbed, ‘active’, ‘cheerful’, ‘encouraged’, ‘enlightened’ and ‘inspired’). Methods: Participants (n=115) aged 65-94 were referred to museum-based programmes comprising 10, weekly sessions, by healthcare and third sector organisations using inclusion criteria (e.g. socially isolated; able to give informed consent; not in employment; not regularly attending social or cultural activities) and exclusion criteria (e.g. unable to travel to the museum; unable to function in a group situation; unlikely to be able to attend all sessions; unable to take part in interviews and complete questionnaires). In a within-participants design, the Museum Wellbeing Measure for Older Adults (MWM-OA) was administered pre-post session at start- mid- and end-programme. Twelve programmes, facilitated by museum staff and volunteers, were conducted in seven museums in central London and across Kent. In addition to the quantitative measures, participants, carers where present, museum staff and researchers kept weekly diaries following guideline questions, and took part in end programme in-depth interviews. Results: Multivariate analyses of variance showed significant participant improvements in all six MWM-OA emotions, pre-post session at start- mid- and end-programme. Two emotions, ‘absorbed’ and ‘enlightened’, increased pre-post session disproportionately to the others; ‘cheerful’ attained the highest pre-post session scores whereas ‘active’ was consistently lowest. Conclusions: Museums can be instrumental in offering museum-based programmes for older adults to improve psychological wellbeing over time. Participants in the study experienced a sense of privilege, valued the opportunity to liaise with curators, visit parts of the museum closed to the public, and handle objects normally behind glass. Participants appreciated opportunities afforded by creative and co-productive activities to acquire learning and skills, and get to know new people in a different context

A systematic review and psychometric evaluation of resilience measurement scales for people living with dementia and their carers

Psychometrically sound resilience outcome measures are essential to establish how health and care services or interventions can enhance the resilience of people living with dementia (PLWD) and their carers. This paper systematically reviews the literature to identify studies that administered a resilience measurement scale with PLWD and/or their carers and examines the psychometric properties of these measures. Electronic abstract databases and the internet were searched, and an international network contacted to identify peer-reviewed journal articles. Two authors independently extracted data. They critically reviewed the measurement properties from the available psychometric data in the studies, using a standardised checklist adapted for purpose. Fifty-one studies were included in the final review, which applied nine different resilience measures, eight developed in other populations and one developed for dementia carers in Thailand. None of the measures were developed for use with people living with dementia. The majority of studies (N = 47) focussed on dementia carers, three studies focussed on people living with dementia and one study measured both carers and the person with dementia. All the studies had missing information regarding the psychometric properties of the measures as applied in these two populations. Nineteen studies presented internal consistency data, suggesting seven of the nine measures demonstrate acceptable reliability in these new populations. There was some evidence of construct validity, and twenty-eight studies hypothesised effects a priori (associations with other outcome measure/demographic data/differences in scores between relevant groups) which were partially supported. The other studies were either exploratory or did not specify hypotheses. This limited evidence does not necessarily mean the resilience measure is not suitable, and we encourage future users of resilience measures in these populations to report information to advance knowledge and inform further reviews. All the measures require further psychometric evaluation in both these populations. The conceptual adequacy of the measures as applied in these new populations was questionable. Further research to understand the experience of resilience for people living with dementia and carers could establish the extent current measures -which tend to measure personal strengths -are relevant and comprehensive, or whether further work is required to establish a new resilience outcome measure

Talking lines: A research protocol integrating verbal and visual narratives to understand the experiences of people affected by rarer forms of dementia

People affected by rarer forms of dementia often have a long and difficult experience obtaining a diagnosis and appropriate support, impacting family, employment and social relationships, quality of life and wellbeing. For this population progressive cognitive symptoms affect skills other than memory and disproportionately occur under the age of 65 years, often resulting in misdiagnosis and lack of appropriate care pathways. The objective of this study will be to better understand the subjective experience of the time period from first noticing symptoms to obtaining a formal diagnosis, through to accessing support, and onward to the present time. Through the concurrent use of line drawings and video-recorded interviews we will collect the stories of people living with different rarer dementias and/or family members who are care partners in Canada and the United Kingdom. Narrative and visual analysis will be used in parallel to methodologically explore how line drawing and verbal discourse interact and inform each other to construct knowledge, and how the use of drawing lines might enrich research interviews and increase accessibility of research participation. This novel research approach may also have implications for clinical interviewing, support services, and public engagement. To the best of our knowledge, this is the first study to retrospectively explore over time the experiences of people affected by rarer forms of dementia from initial symptoms—to diagnosis—to accessing support—to the present, using visual and verbal methodologies

What factors influence healthcare professionals to refer children and families to paediatric psychology?

OBJECTIVES: This study aimed to investigate factors influencing referral of children with physical illness to paediatric psychology. Due to high rates of mental health problems within this population, studies have shown that referral to paediatric psychology should be increased. However, few studies have examined factors shaping healthcare professionals' referral behaviour. METHODS: This study used the theory of planned behaviour to develop a questionnaire which explores factors influencing the referral of children and families to paediatric psychology. Psychometric properties of the questionnaire were examined. RESULTS: The questionnaire was found to have good reliability and validity. The main constructs of the theory of planned behaviour were useful in predicting intention to refer to paediatric psychology. Specific beliefs about referral were shown to influence intention to refer. CONCLUSION: Findings suggest that individual attitudes and beliefs can impact healthcare professionals' referral behaviour, indicating that multidisciplinary interventions and inter-professional education relating to the psychological aspects of illness are required

Estimates of Critical Power and Anaerobic Work Capacity from a Single, All-Out Test of Less than 3-Min

The purpose of this study was to determine if Critical Power (CP) and Anaerobic Work Capacity (AWC) could be estimated from a single, all-out test of less than 3-min. Twenty-eight subjects (mean ± SD: age 23.3 ± 3.3 years, body mass 71.6 ± 16 kg) performed an incremental cycle ergometer test to exhaustion to determine peak oxygen consumption rate and heart rate peak. The 3-min all-out test was used to determine the criterion and six estimated values of CP and AWC. The criterion critical power (CP180) and anaerobic work capacity (AWC180) values were determined from the 3-min all-out test and were expressed as 30-s averages (155-180-s). The six estimated CP and AWC values were calculated from 30-s averages at decreasing 10-s intervals from 145 to 170-s (CP170 and AWC170), 135 to 160-s (CP160 and AWC160), 125 to 150-s (CP150 and AWC150), 115 to 140-s (CP140 and AWC140), 105 to 130-s (CP130 and AWC130), and 95 to 120-s (CP120 and AWC120). Mean differences, total error, constant error, standard error of the estimate, and correlations were used to compare the criterion to the estimated CP and AWC values. The results of the present study indicated that 150-s was the shortest test duration that resulted in non-significant differences between the criterion (CP180 and AWC180) and estimated CP (CP150) and AWC (AWC150) values. The subsequent validation analyses showed that there were close agreements for the estimated CP150 and AWC150 versus the criterion (CP180 and AWC180) values. Therefore, the current findings indicated that estimates of CP and AWC were not affected by shortening the test by 30-s. Reducing the length of the test to 2.5 minutes provides a less strenuous, yet valid protocol for estimating CP and AWC

‘The oxygen of shared experience’: exploring social support processes within peer support groups for carers of people with non-memory-led and inherited dementias

Objectives: To explore support processes and behaviours taking place during online peer support groups for family carers of people living with rare, non-memory-led and inherited dementias (PLWRD). Methods: Twenty-five family carers of PLWRD participated in a series of ongoing online peer supportgroups on the theme of ‘Independence and Identity’. Transcripts from 16 sessions were analysed using qualitative directed content analysis with a coding framework informed by Cutrona & Suhr’s (2004) Social Support Behaviour Code (SSBC). Results: Most of the social support behaviours outlined in the SSBC were identified within the sessions, along with two novel social support categories – ‘Experiential Support’ and ‘Community Support’ – and novel support behaviours including ‘Advocacy and Collective Action’ and ‘Uses Humour’. The SSBC code ‘Relationship’ appeared to be of central importance. Conclusions: This study sheds light on the unique challenges of the caring context for those affected by non-memory-led and inherited dementias and the significant contributions carers can offer to, and receive from, peers in similar situations. It highlights the importance of services which recognise the value of the informational and emotional expertise of carers of PLWRD and encourages the continued development and delivery of tailored support for these populations

Validation of the physical working capacity at the fatigue threshold treadmill test

The purposes of the present study were twofold: 1) to determine the physical working capacity at the fatigue threshold (PWCFT) during an incremental treadmill test, and 2) to examine the validity of this fatigue threshold through constant-velocity runs to exhaustion at 90, 100, and 110% of the estimated PWCFT. Twelve aerobically-trained males (mean age±SD=24.6±5.4 years, running volume=69.9±46.0 km·wk-1, n=9) and females (22.3±2.3 years, 45.6±4.6 km·wk-1, n=3) volunteered to perform a treadmill test to exhaustion with electromyographic (EMG) signals recorded from the m. vastus lateralis on four separate visits. The First visit required each subject to complete an incremental treadmill test to exhaustion for determination of their PWCFT. During the second, third, and fourth visit, the subjects completed a treadmill run to exhaustion at a constant velocity that corresponded to 90, 100, or 110% of their PWCFT in random order. The linear regression analyses indicated there were no significant (p>.05) changes in muscle activation (i.e. EMG amplitude) across time to exhaustion during the constant velocity runs at 90% (60.00±0.00 min) and 100% (48.86±14.59 min) PWCFT, but significant (p<.05) increases occurred at 110% PWCFT (19.44±10.26 min). Thus, the findings of the present study indicated that the PWCFT treadmill test was able to accurately estimate the fastest running velocity that could be maintained for an extended period of time without evidence of neuromuscular fatigue