J Korean Acad Nurs.  2016 Aug;46(4):475-489. 10.4040/jkan.2016.46.4.475.

Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis

• Kim EY
• Hwang SD
• Kim EJ

• KMID: 2424545
• DOI: http://doi.org/10.4040/jkan.2016.46.4.475

Abstract

PURPOSE
This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia.
METHODS
Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program.
RESULTS
Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity (I²=62.8%), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected.
CONCLUSION
Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.

Keyword

Dementia; Behavioral symptoms; Sensory art therapies; Acoustic stimulation; Meta-analysis

MeSH Terms

Acoustic Stimulation
Databases, Factual
Dementia/nursing/physiopathology/*therapy
Humans
Music Therapy
*Problem Behavior
Sensory Art Therapies

Figure

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  Figure 1. Flow diagram of study selection.

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  Figure 2. Forest plots of the effects of stimulation–oriented interventions.

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  Figure 3. Regression plot of session time on treatment effect.

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  Figure 4. Funnel plot of standard error by Hedges’ g.

Reference

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