The use of digital-touch screen technology in reminiscence work with people with dementia in Jordanian care homes: a feasibility study

Abstract

Background: Dementia is progressive degenerative illness is synonymous with cognitive and behavioural decline. Dementia cannot be cured. However, several pharmacological and nonpharmacological approaches can be used to address the symptoms of dementia. Reminiscence therapy (RT) is a non-pharmacological intervention utilising of written, oral, or both accounts of historical events to improve psychological well-being utilising of written, oral, or both accounts of historical events evoke the long-term memories of the people with dementia (PwD), and improve psychological well-being. Using digital-touch screen technology to deliver RT content is new in the care home activities. The digital RT application contains a wide range of stimuli to prompt reminiscence amongst PwD in the care homes. This is the first study to evaluate the feasibility and acceptability of using digital-touch screen technology to deliver RT for PwD in Jordanian care homes. Aims: The primary aim of this study was to explore the feasibility and acceptability of a digital RT intervention for PwD. The secondary aim was to determine the likelihood of changes in outcome measures including cognitive function, communication, depression, anxiety, and quality of life (QoL). Methods: Concurrent mixed methods research was conducted in two care homes in Jordan using outcome measures and semi-structured interviews for data collection. A single group pre-post-intervention quantitative study was conducted with 60 residents with dementia using the Arabic Version of Saint-Louis-University-Mental-Status (SLUMS) for memory; Older People's Quality of Life questionnaire (OPQoL) brief-13 for QoL; Arabic version of Hospital Anxiety and Depression Scale (HADS) for anxiety and depression; and Holden Communication Scale for persons with dementia (HCS) for communication. Qualitative semi-structured interviews were conducted with 14 residents with dementia and seven care home staff purposively sampled from both care homes to explore the feasibility and acceptability of a digital RT intervention for PwD. Quantitative data was analysed to determine whether certain outcomes are sensitive to change after completion of the digital RT intervention. Thematic analysis was used to analyse the qualitative data using Nvivo. Statistical Package for the Social Science Version 25.0 (IBM SPSS 25.0) was used to analyse quantitative measures. Results: The recruitment process and response rate, retention rate and adherence to the intervention indicated the feasibility of the research processes. The response rate was 100%. There was a loss to follow up at post-intervention (25%). For adherence, the median of session attendance for those who received the intervention was 80%. No adverse health impacts were observed as a consequence of taking part, although emotional distress was reported on five occasions by participants who subsequently withdrew from the study. Thematic analysis of the interview data revealed four themes relating to the necessary features of a digital RT application to be used successfully with the PwD. These included being easy to use, having a facilitative environment, having interesting content and having a positive impact in QoL that participants recognise. The resident participants perceived several positive changes including enhancing communication and cognitive abilities, enhancing relationships, and positive changes in psychological and emotional aspects after completion of the digital RT intervention which led to improving their QoL. There was a positive, statistically significant and clinically relevant difference on all outcome measures from pre to post-intervention: means of cognitive ability (3.7; SD=2.4; t (45) =10.43; p=0.000), communication (6.2; SD= 4.2; t (45) = -9.9, p=0.000), anxiety (4.4; SD= 2.9; t (45) = -10.1, p=.000), depression (3.7; SD= 2.6; t (45) = -9.6; p=.000), and QoL (6.2; SD= 4.8; t (45) =8.6; p=0.000). Conclusion: Using digital-touch screen technology to deliver RT may be feasible and acceptable among PwD and their staff in care homes in Jordan. The statistically significant changes in outcome measures demonstrate that a digital RT intervention may be a promising intervention for PwD in care homes to improve their cognition, communication, QoL, depression, and anxiety for residents PwD. This thesis offers exciting avenues of future research, including a definitive trial to evaluate the efficacy and long-term effectiveness of the digital RT for PwD. However, the digital RT and research processes in their current form require simple adaptations to optimise their potential efficacy