Digital Storytelling for Health-Related Outcomes in Older Adults: Systematic Review.

BACKGROUND: Older adults face a unique set of challenges and may experience a range of psychological comorbidities. Digital storytelling is an emerging tool for sharing and recording lived experiences and may have the potential to support well-being but is yet to be systematically reviewed for use among older adults. OBJECTIVE: The aim of this review is to examine the methods for creating digital stories, the health-related outcomes associated with creating digital stories, and the potential for implementing digital storytelling with older adults. METHODS: We systematically searched electronic databases to identify articles published in English that reported on at least one health-related outcome of digital storytelling for participants aged ≥60 years. Data were extracted and synthesized using qualitative content analysis and summarized in tables. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. RESULTS: A total of 8 studies were included in the review. Participants were primarily community-dwelling older adults living with dementia, involving family caregivers and professional care staff. Studies have taken various approaches to digital storytelling and reported diverse benefits associated with digital storytelling, including improvements in mood, memory, social engagement, and quality of relationships. Although the potential for implementation was not widely examined, some studies have presented evidence for acceptability and feasibility. Generally, studies were of high quality, despite the absence of comparator groups and confounder analyses. CONCLUSIONS: The evidence reviewed suggests that despite the various approaches taken, digital storytelling shows promise as an effective approach for supporting well-being in older adults. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42019145922; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145922. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/15512.

Preliminary evidence for the impact of digital life stories about aged care residents on staff knowledge and understanding regarding those residents; A single arm trial.

AIMS AND OBJECTIVES: This study aimed to examine the impact of digital stories about aged care residents on staff knowledge and understanding regarding those residents. BACKGROUND: More than a quarter of a million older Australians live in residential aged care facilities. This living arrangement can inhibit the expression of a person's sense of identity. Without objects and cues that reflect the person's selfhood, it can be difficult for a person to express their uniqueness. Staff may not sufficiently appreciate the resident's individuality and therefore may not be able to customise care for the resident. DESIGN: This study used a single-arm trial design. METHODS: The study was conducted in four residential aged care facilities. Short digital life stories (3-4 min) of eight residents were constructed by student volunteers over 6 months. Participants (n = 53 care staff) completed a self-report measure of their knowledge and understanding of a resident before and after watching the resident's story. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) (see Appendix S1). RESULTS: Pre- and post-test scores of the measure were compared using paired samples t-tests. These scores changed significantly, showing an improvement of knowledge and understanding regarding residents. CONCLUSIONS: Watching digital life stories were associated with improvements in knowledge and understanding by staff, and hence have the potential to foster a greater level of understanding of residents by such staff, and more person-centred care practices within residential aged care facilities. RELEVANCE TO CLINICAL PRACTICE: Digital stories about aged care residents are quick and efficient methods for improving aged care staff members' knowledge and understanding of the residents under their care. With such understanding, staff may be able to better customise care for residents, thereby validating residents' sense of identity and elevating residents' quality of life.

Increasing understanding of environmental modifications using the Virtual Dementia Experience for professional carers of people living with dementia.

Modifications to the environment can have a positive impact on the person living with dementia. The purpose of this study was to examine the effects of a virtual reality (VR) educational workshop on improving understanding of the impact of environments for people living with dementia for carers in residential aged care facilities in Australia. Participants were nonrandomly allocated to one of two conditions: a VR condition which enabled them to take the perspective of a person living with dementia as they navigate a home environment (n = 40), or to a non-VR condition, in which participants received equivalent information in a classroom without the use of VR (n = 56). Participants completed a purpose-built pictorial measure of their understanding of environmental factors that could impact on people with dementia before and after the workshop. Following education, an analysis of covariance revealed that compared to non-VR education, those who received VR education identified a significantly greater number of appropriate environmental modifications, after adjusting for practice test scores. The results from this study demonstrate the utility of VR as a promising tool to improve carers' understanding of the ways in which the environment can be modified to assist people living with dementia.

The Effects of Virtual Reality-Based Education on Empathy and Understanding of the Physical Environment for Dementia Care Workers in Australia: A Controlled Study.

BACKGROUND: There is support for the effectiveness of virtual reality (VR) technology in dementia education. However, it is not yet known if VR is a useful tool for improving empathy and understanding of dementia care environments among dementia care workers. OBJECTIVE: This study compared learning outcomes of VR versus non-VR (control) workshops for dementia care workers of different ages and English-speaking backgrounds. METHODS: Dementia care workers enrolled in workshops on dementia care principles. Once participants were enrolled, workshops were assigned at random to deliver non-VR or VR-based education. Participants (N = 114, 91.8%female, mean age = 46.4; SD = 13.2; n = 60VR condition, 54control condition) completed self-report measures of empathy towards people living with dementia, understanding of dementia care environments, dementia knowledge, and attitudes towards dementia at pre- and post-workshop. RESULTS: Significant pre-post main effects were observed for empathy, understanding of dementia care environments, and attitudes. Interaction effects were not found; improvements in outcomes were similar between conditions. However, interaction effects were observed for subgroups. Empathy improved significantly more in the VR condition for older participants. Understanding of dementia care environments improved more in the VR condition for younger and non-English-speaking background participants. CONCLUSION: Using VR may not augment teaching outcomes for all learners. VR may differentially assist leaners of different ages and English-speaking backgrounds. More research is needed to understand for which variables and for whom VR is a useful teaching tool.

Implementing Digital Storytelling for Health-Related Outcomes in Older Adults: Protocol for a Systematic Review.

BACKGROUND: The number of older adults is increasing rapidly worldwide. Older adults face a unique set of challenges and may experience a range of psychological comorbidities. Advances in multimedia technology have allowed for digital storytelling to be utilized as an intervention for health-related outcomes. OBJECTIVE: The primary aim of the proposed systematic review is to examine the reported health-related outcomes for older adults engaged in digital storytelling. The review also aims to examine the methods associated with digital storytelling, characteristics of digital story products, and implementational considerations. METHODS: This protocol adheres to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will systematically search selected electronic databases to identify studies that meet our eligibility criteria. From the included studies, data will be extracted and synthesized using a narrative approach and summarized in tables. The methodological quality of the included studies will be assessed using the Mixed Methods Appraisal Tool. RESULTS: Systematic searches, data extraction and analysis, and writing of the systematic review are expected to be completed by the end of 2019. CONCLUSIONS: The proposed systematic review will summarize the existing studies using digital storytelling to improve health-related outcomes for older adults. Results from this review will provide an evidence base for the development of digital storytelling interventions that are effective and implementable with older adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/15512.

Computer-based cognitive interventions for mild cognitive impairment and dementia in older adults: protocol for a systematic review of published studies and meta-analysis.

BACKGROUND: A growing number of older adults experience mild cognitive impairment (MCI) and dementia. Recent technological advances allow for traditional cognitive interventions to be administered via computers and other devices. The aim of the proposed systematic review and meta-analyses is to determine the efficacy of computerised cognitive interventions for MCI and dementia in older adults. METHODS: We will systematically search electronic databases and reference lists to identify randomised controlled trials. We will include studies that examine the use of computer-based cognitive interventions for adults aged over 60 with MCI or dementia. Primarily outcomes are global and domain-specific cognitive function. Secondary outcomes are attitudes (usability, understandability, acceptability of the intervention), mood and quality of life. Risk of bias will be assessed. Finally, the summary effect sizes will be reported. DISCUSSION: This systematic review will summarise existing high-quality primary studies on computerised-cognitive interventions for MCI and dementia. Results from this review will provide the basis for future research in developing computer-based interventions for this population. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016050236.

Cognitive Behavioral Therapy for Older Adults With Anxiety and Cognitive Impairment: Adaptations and Illustrative Case Study.

Anxiety is a prevalent condition in older adults with neurocognitive disorders such as dementia. Interventions based on cognitive behavioral therapy (CBT) appear to be an emerging area of treatment innovation for treating anxiety in older adults with cognitive impairment. Drawing on the empirical literature on CBT for late-life anxiety and recent trials of CBT for anxiety in persons with mild-to-moderate dementia, this article provides an overview of the customization of CBT to the needs of older adults with anxiety and cognitive impairment. Adaptations for assessment, case conceptualization, socialization, therapeutic alliance, and treatment strategies are discussed. A case study to illustrate implementation of these adaptations is presented. Limitations to the current state of the literature on the efficacy and feasibility of CBT for anxiety in older adults with cognitive impairment are identified, and future directions for treatment research are proposed.