Making Connections Thru Music: A Group Music Therapy-Based Intervention for Persons with Dementia

项目摘要/摘要 世界各地的医疗体系，包括美国国内，长期以来都缺乏训练有素的人才 照顾者(世卫组织，2016；Jones，Liu，Murfield，&Moyle，2020)。美国医疗保健协会(2019)指出 “一段时间以来，医疗保健系统一直缺乏训练有素的护理员来担当关键角色。”这种稀缺性 直接影响全美45,800个长期护理(LTC)社区(Harris-Kojetin等人，2016)。 在人员短缺的同时，超过一半的LTC居民患有某种形式的痴呆症(阿尔茨海默氏症协会， 2019年)。这两个问题造成了严重的公共卫生问题，因为痴呆症与各种行为有关 表情，如攻击性、焦虑和激动(Cummings，1997)。痴呆的行为表现可以是 通过使用量身定制的心理社会干预和沟通支持成功管理(Vernooij-Dassen et 等人，2010年；法齐奥等人，2018年)。不幸的是，现有的工作人员短缺使这种干预的便利化具有挑战性。 一种有效且经常被忽视的改善人员短缺的方法涉及到利用退休人员 促进对痴呆症患者(PWD)的干预。基于对音乐的近乎普遍的热爱和 作为一项前景看好的试点研究，将在这项技术研究中开发和测试的产品将建立在 首席调查员。通过音乐(MCTM)建立联系，这是一种迫切需要的产品，将使退休 志愿者促进以证据为基础的音乐和与残疾患者的讨论干预。MCTM旨在改进 参与，提高生活质量，减少PWD的行为表达。干预措施将包括两个主要部分 组成部分：(1)为志愿者提供全面的在线培训课程，该课程将提供痴呆症的一般概述， 展示有效的沟通策略以配合残障人士，并指导义工有效地促进MCTM 会话，以及(2)包含结构化的MCTM干预协议和工具包的应用程序，这将是 志愿者为MCTM提供便利。MCTM将面向LTC社区进行营销。 第一阶段的具体目标 这项为期12个月的第一期工程有以下具体目标： ·目标1：改进和扩大MCTM培训材料/课程和MCTM干预措施本身。 ·目标2：制作两个MCTM原型培训模块。 ·目标3：制作一款基于MCTM平板电脑的应用程序原型。 ·目标4：组织重点小组，审查原型培训单元和APP的可行性和可接受性。 第二阶段的具体目标为期24个月的第二阶段有以下具体目标。 ·目标1：最后确定MCTM在线培训课程。 ·目标2：完全开发基于MCTM平板电脑的应用程序。 ·目标3：对MCTM干预进行一次忠诚度试验。 在Fidelity试验中，我们将检查员工和志愿者对干预的依从性、参与度/影响程度 通过志愿者和工作人员主导的MCTM会议，以及自我报告残疾人对MCTM的满意度。

PROJECT SUMMARY/ABSTRACT Healthcare systems around the world, including within the United States, have long-established shortages of trained caregivers (WHO, 2016; Jones, Liu, Murfield, & Moyle, 2020). The American Health Care Association (2019) states that “the health care system has experienced a shortage of trained caregivers for critical roles for some time.” This scarcity directly impacts the 45,800 Long-Term Care (LTC) communities throughout the U.S. (Harris-Kojetin et al, 2016). Concurrent with this staff shortage, more than half of LTC residents have some form of dementia (Alzheimer’s Association, 2019). These two issues create a serious public health concern, since dementia is associated with a variety of behavioral expressions, such as aggression, anxiety, and agitation (Cummings, 1997). Behavioral expressions of dementia can be successfully managed with the use of tailored, psychosocial interventions and communication support (Vernooij-Dassen et al., 2010; Fazio et al., 2018). Unfortunately, existing staff shortages make the facilitation of such interventions challenging. One powerful and often-overlooked approach to ameliorating staffing shortages involves the utilization of retired volunteers to facilitate interventions for persons with dementia (PWD). Based on the nearly universal love of music and a promising pilot study, the product to be developed and tested in this STTR will build upon the combined prior work of the Principal Investigators. Making Connections Thru Music (MCTM), an urgently needed product, will enable retired volunteers to facilitate an evidence-based music and discussion intervention with PWD. MCTM aims to improve engagement, enhance quality of life, and reduce behavioral expressions in PWD. The intervention will consist of two main components: (1) a comprehensive online training course for volunteers, which will provide a general overview of dementia, demonstrate effective communication strategies to use with PWD, and instruct volunteers to effectively facilitate MCTM sessions, and (2) an app containing a structured MCTM intervention protocol and toolkit, which will be the means by which volunteers facilitate MCTM. MCTM will be marketed to LTC communities. PHASE 1 SPECIFIC AIMS The 12-month Phase I project has the following Specific Aims: · Aim 1: Improve and expand upon the MCTM training materials / curriculum and the MCTM intervention itself. · Aim 2: Produce two MCTM prototype training modules. · Aim 3: Produce a prototype of a MCTM tablet-based app. · Aim 4: Conduct focus groups to examine feasibility and acceptability of the prototype training modules and app. PHASE II SPECIFIC AIMS The 24-month Phase II has the following Specific Aims. · Aim 1: Finalize the MCTM online training course. · Aim 2: Complete development of the MCTM tablet-based app. · Aim 3: Conduct a Fidelity Trial of the MCTM intervention. In the Fidelity Trial, we will examine staff and volunteer adherence to the intervention, engagement/affect levels produced by volunteer- and staff-led MCTM sessions, and self-reported PWD satisfaction with MCTM.