The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes.
The Impact of Music and Memory on Resident Level Outcomes in California Nursing Homes.
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DOI：
10.1016/j.jamda.2020.01.103
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发表时间：
2020-08
影响因子：
7.6
通讯作者：
Taylor S
中科院分区：
文献类型：
--
作者：
Bakerjian D;Bettega K;Cachu AM;Azzis L;Taylor S
研究非药物干预措施音乐和记忆 (M&M) 对居住在疗养院 (NH) 中患有痴呆症和/或行为问题的居民的影响。这是一项前瞻性、混合方法队列研究。总共有 265 个加州 NH 的 4107 名居民参与，他们在 3 年的研究期间至少报告了两次数据。我们采用了季度滚动注册流程；参与者通过在线调查提供基线和季度数据，其中包括从最小数据集中选择的居民水平数据（精神药物使用、认知、行为、情绪、疼痛和跌倒）、M&M 计划的经验以及居民对音乐的使用。如果 NH 获得 Medicare 和 Medicaid 认证，并且有 15 名居民被诊断患有痴呆症或认知障碍或表现出明显的行为症状，则符合资格。 M&M 与精神药物使用的减少、行为的减少和情绪的改善有关。每季度使用抗精神病药物的几率下降约 11%，抗焦虑药物下降 17%，抗抑郁药物下降 9%。随着时间的推移，攻击性行为、抑郁症状、疼痛和跌倒也显着下降。居民表现出攻击性行为的几率每季度下降 20%，抑郁症状下降 16%，报告疼痛下降 17%，跌倒下降 8%。这是迄今为止最大规模的 M&M 研究。我们发现使用 M&M 的居民在临床和统计上显着减少了精神药物的使用并改善了行为。尽管该研究总体上显示出积极的结果，但缺乏对照组是一个重大限制，无法确定参与的居民与非参与者相比经历了多少改善。未来的研究应包括对照组，以便就 M&M 计划的有效性得出更好的结论。
To study the effects of a nonpharmacologic intervention, Music and Memory (M&M), on residents with dementia and/or behavioral problems living in nursing homes (NHs). This was a prospective, mixed-methods cohort study. In total, 4107 residents in 265 California NHs and that reported data at least twice during the 3-year study period were enrolled. We used a quarterly rolling enrollment process; participants provided data at baseline and quarterly via an online survey that included select resident level data from the Minimum Data Set (psychotropic drug use, cognition, behaviors, mood, pain, and falls), experience with the M&M program, and resident use of music. NHs were eligible if they were Medicare- and Medicaid-certified and had 15 residents with a diagnosis of dementia or cognitive impairment or exhibited significant behavioral symptoms. M&M was associated with reductions in psychotropic medication use, reduced behaviors, and improved mood. The odds of antipsychotic use declined by about 11%, of antianxiety medications by 17%, and antidepressants by 9% per quarter. Aggressive behaviors, depressive symptoms, pain, and falls also declined significantly over time. The odds of residents exhibiting aggressive behaviors declined by 20% per quarter, depressive symptoms by 16%, reported pain by 17%, and falls by 8%. This is the largest study of M&M to date. We found clinically and statistically significant reductions in psychotropic medications and improved behaviors in residents using M&M. Although the study showed positive results overall, the lack of a control group was a significant limitation that precluded determining how much more improvement participating residents experienced compared with nonparticipants. Future studies should include a control group so that better conclusions can be drawn regarding the effectiveness of the M&M program.
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DOI：
10.1136/bmj.d4551
发表时间：
2011-08-02
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Coupland C;Dhiman P;Morriss R;Arthur A;Barton G;Hippisley-Cox J
通讯作者：
Hippisley-Cox J
影响因子：
4
作者：
Sanchez, Alba;Maseda, Ana;Carlos Millan-Calenti, Jose
通讯作者：
Carlos Millan-Calenti, Jose
DOI：
10.1016/j.jamda.2012.06.004
发表时间：
2012-09-01
影响因子：
7.6
作者：
Saliba, Debra;Buchanan, Joan;Chodosh, Joshua
通讯作者：
Chodosh, Joshua
影响因子：
3
作者：
Thomas KS;Dosa D;Wysocki A;Mor V
通讯作者：
Mor V
DOI：
10.1016/j.jamda.2012.06.003
发表时间：
2012-09-01
影响因子：
7.6
作者：
Saliba, Debra;DiFilippo, Suzanne;Streim, Joel
通讯作者：
Streim, Joel