Multicentre Study About the Effect of Individual Reminiscence Therapy
NCT ID: NCT04047238
Last Updated: 2020-02-18
Study Results
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Basic Information
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COMPLETED
NA
251 participants
INTERVENTIONAL
2019-08-08
2019-12-20
Brief Summary
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Detailed Description
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The absence of effective pharmacological treatment that stops or slows down the development of the disease has aroused interest in non-pharmacological therapies as a complement to pharmacological treatment that may improve the quality of life of people with neurocognitive disorders. One of the most investigated and most traditional non-pharmacological therapy in this field is Reminiscence Therapy (RT).
RT involves discussing past activities, events and experiences, usually with the help of triggers, such as photographs, household objects and other familiar items from the past, music… that is, any object or stimulus that serves to stimulate remembrance. In its application to dementia, RT is based on the fact that the memory impairment of people with dementia means that they are able to recall events from their past life, especially from childhood to early adulthood, but cannot remember more recent facts. It focuses on preserved memories and abilities, promotes communication, and enables the person to connect with his/her past and regain his/her sense of personal identity. Thus, RT can be understood as an intervention on the edge of those of cognitive orientation and emotion-centered, with potential interactive effects on autobiographical memory and psychological well-being.
The investigators can distinguish at least two RT approaches. The first one is the "life review" where participants are guided through meaningful experiences from their biography trying to make sense of their life. This type of RT is more structured and is usually conducted in an individual format. It may imply the construction of "life books". This approach is considered to have an integrative function aimed at achieving a sense of validation, coherence and reconciliation with the person's past. Another approach is the simple reminiscence which involves the stimulation of autobiographical memory during conversations about specific themes of the past (such as holidays, food and drinks, work…) using stimuli that trigger memories. It has been described as an unstructured narrative of autobiographical memories. This reminiscence format can be conducted both individually and in groups and promotes communication between participants who share their memories and stories.
In any of the TR formats it is essential to introduce triggering stimuli (photographs, music, antique objects…) to aid in recall. These triggers may be generic, reflecting common experiences in the lives of people relevant to their age group (for example a textbook may serve to recall the experience during their school stage), or specific, with stimuli related to the individual's own experiences (for example photographs of an important life event such as your wedding day or a trip during your youth).
Regarding the effectiveness of RT, according to a recent Cochrane review, there is some evidence for its positive effects on cognition, QoL, communication, and possibly mood of people with dementia, although benefits are small. Despite the distinction between the two different approaches to RT (simple reminiscence vs. life review), the modality of therapy does not seem to be as important for positive effects as the individual or group format of the sessions and the context in which the intervention is administered (people who live in the community or people who are institutionalized).
According to the results of one review study, RT seems to be able to generate a small benefit on cognitive function immediately after the intervention, although it usually does not persist after a follow-up period. Regarding the administration format, individual RT effects seems slightly superior on cognition both immediately and after a follow-up period. In any case, its effects appear to be comparable to those of other cognitive stimulation therapies.
As for the effect of RT on QoL, a life-review-based individual RT study showed an improvement in Qol-AD. Effects with a group format do not seem consistent, showing little or no effect on QoL, although the key factor may be the application context (community vs. institution), with better results of group RT in institutionalized patients.
Group RT was associated with an effect on communication both after the intervention and at follow-up. This effect was not replicated in individual RT, with uncertain results.
Finally, despite evidence of the effect of RT on mood of older people without dementia, in the case of people with dementia only a small effect on mood was found for those participants. in individual RT.
Therefore, this research proposal aims to evaluate the ability of individual RT using a simple reminiscence format to improve the overall cognitive function, memory, executive function, mood and quality of life (QoL) of people with neurocognitive disorder attending social responses for the elderly.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Intervention Group
Participants who meet the inclusion criteria will be randomly assigned to the intervention group receiving Reminiscence Therapy or to a control group receiving treatment as usual. Participants in the intervention group will participate in two Reminiscence Therapy sessions per week for 3 months besides their treatment as usual. The sessions will be based on the Book of Past and Present and they will follow the same protocol in every participant institution.
Reminiscence Therapy
Intervention group will receive two Reminiscence Therapy sessions per week for 3 months. Reminiscence therapy sessions will last approximately 50 minutes and will be developed according to the following structure:
* Welcome to the patient and reality orientation therapy (7 minutes)
* Conducting the main activity of reminiscence (40 minutes)
* Closure, thank you for the participation and farewell until the next session (3 minutes) Reminiscence therapy sessions will have an individual format and will be conducted by a therapist previously trained in the protocol and the principles of Reminiscence Therapy. The Reminiscence activities of each session will be carried out following the protocol proposed in the Book of Past and Present.
Control Group
Participants assigned to the control group will maintain their usual treatment in the institution, participating in the activities previously assigned to their individual care plan.
No interventions assigned to this group
Interventions
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Reminiscence Therapy
Intervention group will receive two Reminiscence Therapy sessions per week for 3 months. Reminiscence therapy sessions will last approximately 50 minutes and will be developed according to the following structure:
* Welcome to the patient and reality orientation therapy (7 minutes)
* Conducting the main activity of reminiscence (40 minutes)
* Closure, thank you for the participation and farewell until the next session (3 minutes) Reminiscence therapy sessions will have an individual format and will be conducted by a therapist previously trained in the protocol and the principles of Reminiscence Therapy. The Reminiscence activities of each session will be carried out following the protocol proposed in the Book of Past and Present.
Eligibility Criteria
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Inclusion Criteria
* To have delivered the informed consent of the project, duly completed and signed, after prior information
* Capacity to communicate and understand.
* Possibility of gathering information about the participant's life history through their relatives or habitual caregivers, using the socio-familiar questionnaire design for that purpose.
* Being 65 years of age or older.
* Being a native Portuguese speaker.
* Regularly attend a social response institution that provides services for the elderly.
Exclusion Criteria
* Serious sensory and physical limitations that prevent the participation in the sessions.
* Severe disconnection with the environment and very limited attention span.
* Presence of severe neuropsychiatric symptoms, such as hyperactivity, psychosis, severe depressive and anxiety symptoms and apathy, that prevent participation in the sessions or presence of uncontrolled delirium.
* Traumatic life history or marked by negative events relevant to the person that discourage the participation in the Reminiscence Therapy sessions.
* History of negative reactions during previous Reminiscence Therapy sessions or similar activities.
65 Years
ALL
No
Sponsors
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Rsocialform - Geriatria, Lda
OTHER
Responsible Party
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Principal Investigators
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Susana I Justo Henriques, PhD
Role: PRINCIPAL_INVESTIGATOR
Cediara and University of de Santiago de Compostela
Enrique Pérez Sáez, PhD
Role: PRINCIPAL_INVESTIGATOR
CRE Alzheimer and University of Salamanca
João L Alves Apóstolo, PhD
Role: PRINCIPAL_INVESTIGATOR
Nursing School of Coimbra
Locations
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Cediara - Assoc. Sol. Social de Ribeira de Fráguas
Albergaria-a-Velha, Aveiro District, Portugal
Rsocialform - Geriatria, Lda.
Mealhada, Aveiro District, Portugal
Santa Casa Da Misericórdia de Ovar
Ovar, Aveiro District, Portugal
Lar D. Pedro V
Praia da Vitória, Azores, Portugal
Delicate Age Lda.
Portimão, Faro District, Portugal
APARSIN - Assoc. Port. de Apoio e Reabilitação Sénior de Intervenção Neurológica
Elvas, Portalegre District, Portugal
Santa Casa Da Misericordia de Almada - Centro São Lázaro
Almada, Setúbal District, Portugal
Centro Social Vale Do Homem
Braga, , Portugal
Santa Casa Da Misericórdia de Vila Verde
Braga, , Portugal
Centro Zulmira Pereira Simões
Braga, , Portugal
Santa Casa Da Misericórdia de Castelo Branco
Castelo Branco, , Portugal
Santa Casa Da Misericórdia de Vila Velha de Ródão
Castelo Branco, , Portugal
Centro Social Paroquial Dornelas
Guarda, , Portugal
Primavida Residência Sénior Amor
Leiria, , Portugal
Santa Casa Da Misericórdia de Alcobaça
Leiria, , Portugal
Santa Casa Da Misericórdia Do Alvorge
Leiria, , Portugal
Associação Alzheimer Portugal
Lisbon, , Portugal
Irmãs Hospitaleiras - Casa de Saúde Da Idanha
Lisbon, , Portugal
Centro Social de Tolosa
Portalegre, , Portugal
Centro Social Paroquial Recarei
Porto, , Portugal
Associação de Solidariedade Social S. Tiago de Rebordões
Porto, , Portugal
Santa Casa Da Misericordia de Coruche
Santarém, , Portugal
Santa Casa Da Misericórdia de Melgaço
Viana do Castelo, , Portugal
Santa Casa Da Misericórdia de Vouzela
Viseu, , Portugal
Pesqueiramiga- Associação de Solidariedade Social
Viseu, , Portugal
Countries
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References
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Other Identifiers
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01082019
Identifier Type: -
Identifier Source: org_study_id
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