Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T03:08:35.912Z Has data issue: false hasContentIssue false

Psychomotor Dance Therapy Intervention (DANCIN) for people with dementia in care homes: a multiple-baseline single-case study

Published online by Cambridge University Press:  02 May 2016

A. Guzmán*
Affiliation:
Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
M. Freeston
Affiliation:
Institute of Neuroscience, Ridley Building, 4th Floor, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, NE1 7RU Psychotherapy Community Services, Northumberland, Tyne and Wear, NHS Foundation Trust
L. Rochester
Affiliation:
Institute of Neuroscience, Institute for Ageing, Clinical Ageing Research Unit, Campus for Ageing & Vitality, Newcastle University, Newcastle-upon-Tyne, NE4 5PL, UK
J. C. Hughes
Affiliation:
PEALS (Policy, Ethics & Life Sciences) Research Centre, Newcastle University, 4th Floor Claremont Bridge, Newcastle-upon-Tyne, NE1 7RU, UK
I. A. James
Affiliation:
Community Services, Akenside Offices, Campus for Ageing and Vitality, Centre of the Health of the Elderly (Formerly Newcastle General Hospital) Northumberland, NHS Foundation Trust, Westgate Road, Newcastle-upon-Tyne, NE4 6BE
*
Correspondence should be addressed to: Dr Azucena Guzmán, Lecturer in Health & Ageing, Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Old Medical Quad, Doorway 6, Edinburgh, EH5 4AG, UK. Phone: +44 (0) 131 651 5162. Email: [email protected].

Abstract

Background:

A Psychomotor DANCe Therapy INtervention (DANCIN) using Latin Ballroom (Danzón) in care homes has previously been shown to enhance well-being for both residents with dementia and staff. The aim of this study was to understand the effect of this approach on the mood and behavior of individual people living with mild to moderate dementia.

Method:

A multiple-baseline single-case study across two care homes and one nursing home with 3–6 weeks baseline, 12-weeks DANCIN (30 minutes/twice-weekly sessions), and 12-weeks follow-up was conducted. Seventeen items from the Dementia Mood Assessment Scale (DMAS) outcome measure were adapted with input from senior staff to match participants’ behavior and mood symptoms. Daily monitoring diaries were collected from trained staff on reporting individualized items for ten residents. Data were analyzed, using a non-parametric statistical method known as Percentage of All Non-Overlapping Data (PAND) which provides Phi effect size (ES). Medication use, falls, and life events were registered.

Results:

Seven residents participated throughout DANCIN whilst three became observers owing to health deterioration. One participant showed adverse effects in three DMAS items. Nine participants, dancers and observers, showed a small to medium magnitude of change (PAND) in 21 DMAS items, indicating a decrease in the frequency of behavior and mood indices which were regarded as problematic; eight items showed no change.

Conclusion:

Despite methodological challenges, the DANCIN model has the potential to facilitate and sustain behavior change and improve mood (e.g. decrease irritability, increase self-esteem) of the residents living with dementia. The study was conducted in two care homes and one nursing home, strengthening the interventions’ validity. Findings suggest DANCIN is appropriate for a larger controlled feasibility study.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramson, J. (2011a). Available at: http://www.brixtonhealth.com/pepi4windows.html (Last accessed 24/Feb/2016).Google Scholar
Abramson, J. (2011b). WINPEPI updated: computer programs for epidemiologists and their teaching potential. Epidemiologic Perspectives & Innovations, 8, 19.CrossRefGoogle ScholarPubMed
Barlow, D. H., Nock, M. K. and Hersen, M. (2009). Single Case Experimental Designs, Strategies for Studying Behaviour Change. Boston: Person Education.Google Scholar
Bertram, G. and Stickley, T. (2007). Young @ Heart, An evaluation of the Young @ Heart Dance Project for Older People. Dance4, University of Nottingham, Available at: www.dance4.co.uk (Last accessed 24/Feb/16).Google Scholar
Blampied, N. M. (1999). A legacy neglected: restating the case for single-case research in cognitive-behaviour therapy. Behaviour Change, 16, 89104.CrossRefGoogle Scholar
Blampied, N. M. (2013a). Single-case research and the scientist-practitioner ideal in applied psychology. In Madden, G. (Ed.), Handbook of Behavior Analysis vol. 1 (pp. 177197). Washington, DC: American Psychological Association.Google Scholar
Blampied, N. M. (2013b). Single-case research and the scientist-practitioner ideal in applied psychology. In Madden, G. (Editor-in-chief), Handbook of Behavior Analysis, vol. 1, (pp. 177197). Washington, DC: American Psychological Association.Google Scholar
Brooker, D., Snape, M., Johnson, E., Ward, D. and Payne, M. (1997). Single case evaluation of the effects of aromatherapy and massage on disturbed behaviour in severe dementia. British Journal of Clinical Psychology, 36, 287296.CrossRefGoogle ScholarPubMed
Burns, M. K. (2012). Meta-analysis of single-case design research: introduction to the special issue. Journal of Behavioural Education, 21, 175184.CrossRefGoogle Scholar
Calmels, D. (2003). ¿Qué es Psicomotricidad? Los Trastornos Psicomotores y la prácticapsicomotriz [What is Psychomotor Practice? Psychomotor Disorders and Practice]. Buenos Aires: Lumen.Google Scholar
Calvo-Merino, B., Jola, C., Glaser, D. E. and Haggard, P. (2008). Towards a sensorimotor aesthetics of performing art. Consciousness and Cognition, 17, 911922.CrossRefGoogle ScholarPubMed
Camacho, M. and Paolillo, G. (2004). Relajación y narración: recursos originales en la práctica del psicomotricista en educación [Relaxation and narration: original resources in the practice of the psychomotor therapist in education]. Revista Iberoamericana de Psicomotricidad y Técnicas Corporales, vol. 15, (pp. 55–73) (In Spanish).Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences, Hillsdale, NJ: Erlbaum Associates.Google Scholar
Davis, M. L. (2008). Self-practice/self-reflection: has it a role in the training and development of experienced cognitive-behavioural therapists? Doctorate Thesis in Clinical Psychology. Newcastle University, England, UK.Google Scholar
Craig, P., Dieppe, P, Macintyre, S., Michie, S., Nazareth, I. and Petticrew, M. C. (2008). Developing and evaluating complex interventions: new guidance. Medical Research Council. Available at: https://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/ (Last accessed 24/Feb/16).Google Scholar
Des Jarlais, D. C., Lyles, C., Crepaz, N. and the TREND Group (2004). Improving the reporting quality of nonrandomized evaluations of behavioural and public health interventions: the TREND statement. American Journal Public Health, 94, 361366.CrossRefGoogle Scholar
Dröes, R. M. (1997). Psychomotor group therapy for demented patients in the nursing home. In Miesen, M. L. B. and Jones, M. M. G. (Eds.), Care-Giving in Dementia Research and Applications. vol. 2 (pp. 95–118) London: Routledge.Google Scholar
Enabling Research in Care Homes (ENRICH) (2015). Available at: http://www.sdcrn.org.uk/resources/enrich-care-home-research (Last accessed: 24/Feb/16).Google Scholar
Faes, M. C., Reelick, M. F., Esselink, R. A. and Olde Rikkert, M. G. (2010). Developing and evaluating complex healthcare interventions in geriatrics: the use of the medical research council framework exemplified on a complex fall prevention intervention. Journal of American Geriatrics Society, 58, 22122221.CrossRefGoogle ScholarPubMed
Flores y Escalante, J. (2006). Salón México, Historia Documental y Gráfica del Danzón en México, México Ballroom Hall, Written and Pictorial History of Danzón in México, 2nd. Ed., México City: Asociación Mexicana de Estudios Fonográficos, A.C. (In Spanish).Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
French Alzheimer's Plan (2008-2012). Available at: http://plan-alzheimer.gouv.fr/measure-no17.html (Last accessed 24/Feb/2016).Google Scholar
Froggatt, K. and Parker, D. (2010). Care homes and long-term care for people with dementia. In Hughes, J. C., Lloyd-Williams, M. and Sachs, G.A. (Eds.), Supportive Care for the Person with Dementia (pp. 181188). Oxford: Oxford University Press.Google Scholar
Guzmán-García, A., Hughes, J. C., James, I. A. and Rochester, L. (2012a). Dancing as a psychosocial intervention in care homes: a systematic review of the literature. International Journal of Geriatric Psychiatry, 28, 914924.CrossRefGoogle Scholar
Guzmán-García, A., Johannsen, L. and Wing, A. M. (2011). Dance exercise for older adults: a pilot study investigating standing balance following a single lesson of Danzón. American Journal of Dance Therapy, 33, 148156, doi 10.1007/s1046501191146.CrossRefGoogle Scholar
Guzmán-García, A., Mukaetova-Ladinska, E. and James, I. A. (2012b). Introducing a Latin ballroom dance class to people with dementia living in care homes, benefits and concerns: A pilot study. Dementia, 12, 523535.CrossRefGoogle ScholarPubMed
Hokkanen, L., Rantala, L., Remes, A. M., Härkönen, B., Viramo, P. and Winblad, I. (2003). Dance/movement therapeutic methods in management of dementia. Journal of American Geriatrics Society, 51, 576577.CrossRefGoogle ScholarPubMed
Hokkanen, L., Rantala, L., Remes, A. M., Härkönen, B., Viramo, P. and Winblad, I. (2008). Dance and movement therapeutic methods in management of dementia: a randomized, controlled study. Journal of American Geriatrics Society, 56, 771772.CrossRefGoogle ScholarPubMed
Hopman-Rock, M., Staats, P. G. M., Tak, E. and Dröes, R. M. (1999). The effects of a psychomotor activation programme for use in groups of cognitively impaired people in homes for the elderly. International Journal of Geriatric Psychiatry, 14, 633642.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
James, I. A., McClintock, K., Reichelt, K. and Ellingford, J. (2007). Are staff reliable informants? Identifying the triggers to challenging behaviours in dementia. International Journal of Geriatric Psychiatry, 22, 598600.CrossRefGoogle ScholarPubMed
Karpati, F., Giacosa, C., Foster, N. E. V, Penhune, V. B. and Hyde, K. L. (2015). Dance and the brain: a review. Annals of the New York Academy of Sciences. Issue: The Neurosciences and Music, 1337, 140146.CrossRefGoogle ScholarPubMed
Kelly, F. (2014). Bodywork in dementia care: recognising the commonalities of selfhood to facilitate respectful care in institutional settings. Ageing & Society, 118, doi: 10.1017/S0144686X13000093.Google Scholar
Keogh, J. W. L., Kilding, A., Pidgeon, P., Ashley, L. and Gillis, D. (2012). Effects of different weekly frequencies of dance on older adults' functional performance and physical activity patterns. European Journal of Sports and Exercise Science, 1, 1423.Google Scholar
Kratochwill, T. R. et al. (2010). Single-case Designs Technical Documentation. Available at What Works Clearinghouse website: http://ies.ed.gov/ncee/wwc/pdf/wwc_scd.pdf(Last accessed on 24/Feb/16).Google Scholar
Livingston, G. et al. (2014). Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials. British Journal of Psychiatry, 6, 436442.CrossRefGoogle Scholar
Loew, T. H., Tritt, K., Lahmann, C. and Röhricht, F. (2006). Body psychotherapy-scientifically proved? An overview of empirically evaluated body oriented psychological therapies. Psychodyanmische Psychotherapie, 5, 619 (in German).Google Scholar
Lovatt, P. (2011). Dance confidence, age and gender. Personality and Individual Differences, 50, 668672.CrossRefGoogle Scholar
Mental Capacity Act (2005). Research section. Available at: http://www.legislation.gov.uk/ukpga/2005/9/part/1/crossheading/research (Last accessed: 24/Feb/2016).Google Scholar
Michie, S. et al. (2013). The behaviour change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behaviour change interventions. Annuals of Behaviour Analysis, 46, 8195.Google Scholar
Möhler, R., Köpke, S. and Meyer, G. (2015). Criteria for reporting the development and evaluation of complex interventions in healthcare: revised guideline (CReDECI 2). Trials, 16, doi 10.1186/s13063-015-0709-y.CrossRefGoogle ScholarPubMed
Moniz-Cook, E., Stokes, G. and Agar, S. (2003). Difficult behaviour and dementia in nursing homes: five cases of psychosocial intervention. Clinical Psychology and Psychotherapy, 10, 197208.CrossRefGoogle Scholar
Ottenbacher, K. (1997). Introduction to single system designs for neurorehabilitation research. Journal of Neuro Rehabilitation, 11,199206.Google Scholar
Parker, R. I. and Brossart, D. F. (2003). Evaluating single-case research data: a comparison of seven statistical methods. Behavior Therapy, 34, 189211.CrossRefGoogle Scholar
Parker, R. I. and Hagan-Burke, S. (2007a). Single case research results as clinical outcomes. Journal of School Psychology, 45, 637653.CrossRefGoogle Scholar
Parker, R. I. and Hagan-Burke, S. (2007b). Useful effect size interpretations for single case research. Behavior Therapy, 38, 95105.CrossRefGoogle ScholarPubMed
Parker, R. I., Hagan-Burke, S. and Vannest, K. (2007c). Percent of all non-overlapping data (PAND): an alternative to PND, Journal of Special Education, 40, 194204.CrossRefGoogle Scholar
Parker, R. I. and Vannest, K. J. (2012). Bottom up analysis of single-case research designs. Journal of Behavioral Education. 17, 254265.CrossRefGoogle Scholar
Parker, R. I., Vannest, K. J. and Davis, J. L. (2011). Nine Non-overlap techniques for calculating an effect size in single case research. Behaviour Modification, 35, 303322.CrossRefGoogle Scholar
Pezzullo, J. C. (2010). Two-way Contingency Table Analysis. Online Resource for calculating Phi coefficient. Available at: http://statpages.org/ctab2x2.html (Last accessed 24/Feb/2016).Google Scholar
Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. T. and Prina, M. (2015). Alzheimer's Disease International (ADI). London: 2015. Available at: http://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf (Last accessed: 24/Feb/16).Google Scholar
Probst, M., Knapen, J., Poot, G. and Vancampfort, D. (2010). Psychomotor therapy & psychiatry: what's in a name?. The Open Complementary Medicine Journal, 2, 105113.CrossRefGoogle Scholar
Ravelin, T. T., Isola, A. A. and Kylmä, J. J. (2013) Dance performance as a method of intervention as experienced by older persons with dementia. International Journal Older People Nursing, 8, 1018.CrossRefGoogle ScholarPubMed
Rösler, A. et al. (2002). Skill learning in patients with moderate Alzheimer's disease: a prospective pilot-study of waltz-lessons. International Journal of Geriatric Psychiatry, 17, 11551156.CrossRefGoogle ScholarPubMed
Rosnow, R. and Rosenthal, R. (1989). Statistical procedures and the justification of knowledge in psychological science. American Psychologist, 44, 12761284.CrossRefGoogle Scholar
Schneider, N., Goldstein, H. and Parker, R. (2008). Social skills interventions for children with autism: a meta-analytic application of percentage of all non-overlapping data (PAND). Evidence-based Communication Assessment & Intervention, 2, 152162.CrossRefGoogle Scholar
Scotland's National Dementia Strategy 2013–2016. Available at: http://www.gov.scot/Resource/0042/00423472.pdf (Last accessed 24/Feb/16).Google Scholar
Silva Lima, M. M. and Pedreira Vieira, A. (2007). Ballroom dance as therapy for the elderly in Brazil. American Journal of Dance Therapy, 29, 129260.CrossRefGoogle Scholar
Spector, A. et al. (2003). A randomised controlled trial investigating the effectiveness of an evidence-based cognitive stimulation therapy programme for people with dementia. British Journal of Psychiatry, 183, 248254.CrossRefGoogle Scholar
Sunderland, T., Alterman, I. S., Yount, D., James, R. N. and Hill, L. (1988). A new scale for the assessment of depressed mood in demented patients. American Journal of Psychiatry, 145, 955959.Google ScholarPubMed
Sunderland, T. and Minichiello, M. (1996). Dementia mood assessment scale. International Psychogeriatrics, 8, 329331.CrossRefGoogle ScholarPubMed
Sung, H. C., Lee, W. L., Li, T. L. and Watson, R. (2012). A group music intervention using percussion instruments with familiar music to reduce anxiety and agitation of institutionalized older adults with dementia. International Journal of Geriatric Psychiatry, 27, 621627.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Williams, T. F. and Mayewski, R. (1986). Fall Risk for elderly patients based on number of chronic disabilities. American Journal of Medicine, 80, 429434.CrossRefGoogle ScholarPubMed
Tupinier, G. (2009) Ainsi dansaient [Dancing this way]. Paris: Getu Dance Edition (in French).Google Scholar
van Haeften-van Dijk, A. M., van Weert, J. C. M. and Dröes, R. M. (2014). Implementing living room theatre activities for people with dementia on nursing home wards: a process evaluation study. Aging & Mental Health, 19, 536547, doi: 10.1080/13607863.2014.955459.CrossRefGoogle ScholarPubMed
Vernooj-Dassen, M. and Moniz-Cook, E. (2014). Raising the standard of applied dementia care research: addressing the implementation error. Aging & Mental Health, doi: 10.1080/13607863.2014.899977.CrossRefGoogle Scholar
Wallon, H. (1932). Syndromes d’ insufficance psycho-motrice et types psycho-moteurs. Enfance, 12, 240251. (in French).CrossRefGoogle Scholar
Supplementary material: PDF

Guzmán supplementary material S1

Supplementary Figure

Download Guzmán supplementary material S1(PDF)
PDF 193.9 KB
Supplementary material: PDF

Guzmán supplementary material S2

Supplementary Figure

Download Guzmán supplementary material S2(PDF)
PDF 280.7 KB
Supplementary material: PDF

Guzmán supplementary material S3

Supplementary Table

Download Guzmán supplementary material S3(PDF)
PDF 206.8 KB
Supplementary material: PDF

Guzmán supplementary material S4

Supplementary Table

Download Guzmán supplementary material S4(PDF)
PDF 229.2 KB
Supplementary material: PDF

Guzmán supplementary material S5

Supplementary Table

Download Guzmán supplementary material S5(PDF)
PDF 179.5 KB
Supplementary material: PDF

Guzmán supplementary material S6

Supplementary Table

Download Guzmán supplementary material S6(PDF)
PDF 277.5 KB
Supplementary material: PDF

Guzmán supplementary material S7

Supplementary Table

Download Guzmán supplementary material S7(PDF)
PDF 277.2 KB