Brief Report: Parent Perspectives on Sensory-Based Interventions for Children with Autism Spectrum Disorder.

Sensory-Based Interventions (SBIs) are often recommended to enable function/participation in children with ASD. Still, there are limited studies to evaluate their effectiveness. Acceptability studies are an important step towards establishing effective interventions. We examined parents' perceptions of the uptake and acceptability of such interventions. An online survey was sent to 399 families; response rate was 39%. The most frequently therapist-recommended interventions were trampoline (54.6%), massage (47.8%), and oral-motor tools (43.8%). Highest use was reported for massage (96.3%), trampoline (89.2%) and joint compressions and brushing (89.2%). The majority of parents viewed these interventions to be very important /important, (74.8%) but barriers to their use were identified. High acceptability of SBIs was reported by parents of children with ASD.

A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status. METHODS: Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists. RESULTS: Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains. CONCLUSIONS: This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.

Effects of audio and visual distraction on patients' vital signs and tolerance during esophagogastroduodenoscopy: a randomized controlled trial.

BACKGROUND: Esophagogastroduodenoscopy (EGD) provides an indispensable and unambiguous inspection allowing the discovery upper gastrointestinal lesions. However, many patients are anxious about undergoing EGD. Few studies have investigated the influence on patients' vital signs and tolerance during EGD using subjective and objective assessments. This study was a prospective randomized controlled study that investigated the influence of audio and visual distraction on EGD. METHODS: We randomly divided 289 subjects who underwent EGD into 4 groups (control group, audio group, visual group, combination group) and examined their vital signs, heart rate variability (HRV), psychological items, and acceptance of distraction. RESULTS: Pulse rate (PR) at post-distraction and post-EGD in the 3 distraction groups were significantly lower than those of control group (p <  0.001 and p <  0.01, respectively). Blood pressure (BP) during and post-EGD was significantly higher than that at pre-EGD in control group (p <  0.05), but no significant elevation of BP was observed during the latter half of EGD and post-EGD in the 3 distraction groups. BP at post-distraction improved significantly compared to pre-distraction in the 3 distraction groups (p <  0.05). There was a significant difference in the low-frequency (LF) power/ high-frequency (HF) power at post-distraction and post-EGD among the 4 groups (p <  0.001 and p <  0.001, respectively). The LF power/HF power at post-distraction and post-EGD in the 3 distraction groups was significantly lower than that in control group (p <  0.05). Several items of profile of mood states (POMS) and the impression of EGD at post-distraction improved significantly compared to those at pre-distraction among the 3 distraction groups (p <  0.05). Visual analog scale (VAS) of willingness for the next use of distraction in the 3 distraction groups was excellent because VAS was more than 70. CONCLUSIONS: Distractions effectively improved psychological factors, vital signs and some of HRV at pre and post-EGD. Distractions may suppress BP elevation during the latter half of EGD and lead to stability of HRV on EGD. TRIAL REGISTRATION: This prospective trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000029637. Registered on 20 October 2017.

"Now I Write Songs": Growth and Reciprocity After Long-Term Nursing Home Placement.

BACKGROUND AND OBJECTIVES: Nursing home residents have a need for activities that are meaningful, yet mandated scheduled activities remain poorly characterized. In order to understand how scheduled activities provide meaning for nursing home residents, we conducted a study of daily life in a nursing home with a robust activities program. RESEARCH DESIGN AND METHODS: This 2-year, longitudinal ethnographic study embedded an ethnographer into the activities department of a 430-bed, not-for-profit, faith-based nursing home. Forty-three interviews and more than 250 hr of participant-observation were conducted, with a focus on creative arts and religious activities. Thirty-two residents and 15 activities staff were followed more than 12-23 months. Data were coded concurrently, and emerging themes challenged through purposive recruitment until thematic saturation was reached. RESULTS: Scheduled activities in the nursing home offered opportunities for learning and personal growth regardless of functional or cognitive disability. Three major themes emerged. Artistic development included new self-identification as a musician, painter, or sculptor through arts programming. Intellectual and spiritual growth involved the use of activities to support ongoing practice and study. Reciprocity occurred as residents used the arts to remain contributing members of their institutional society, reciprocating with the institution that housed them. DISCUSSION AND IMPLICATIONS: Nursing home scheduled activities can facilitate the transformation of identity from resident or patient to the normalized social roles of artist, Torah scholar, and productive member of society.

Serviço social e arte educação: cuidado na prevenção da asma / Social work and art education: attention on prevention of asthma / Trabajo social y arte educación: atención a la prevención del asma

Objetivo: Descrever sobre a experiência em arte educação do Serviço Social em equipe multiprofissional, no cuidado preventivo à asma, e as mudanças sentidas pelos participantes do "Coral Voices em Superação", mediante as (inter)experiências e vivências de cantar e conviver com a asma. Método: Pesquisa qualitativa, empírica, bibliográfica e fenomenológica. Com uso de diário de campo, entrevista semiestruturada e análise de conteúdo. Participaram 14 mulheres e um homem entre 23 e 75 anos, acompanhados no Centro de Referência em Asma. Resultado: Arte educação, por meio da música, é um recurso para o assistente social potencializar a autoestima de pessoas em tratamento de asma. Conclusão: O convívio de pessoas com asma, em uma atividade de arte educação, influencia na sua qualidade de vida

Objective: The purpose of this article is to describe the experience in art education of Social Work in a multiprofessional team, in the preventive care for asthma, and the changes felt by the participants of the "Choir Voices in Overcoming", through the (inter) experiences and experiences of singing and living with to asthma. Methods: Qualitative, empirical, bibliographical and phenomenological research. Using field diary, semi-structured interview and content analysis. A total of 14 women and a man between the ages of 23 and 75 participated in the Asthma Reference Center. Results: Art education, through music, is a resource for the social worker to enhance the self-esteem of people in asthma treatment. Conclusion: The conviviality of people with asthma, in an activity of art education, influences their quality of life

Objetivo: Describir sobre la experiencia en arte educación del Trabajo Social en equipo multiprofesional, en el cuidado preventivo del asma, y los cambios sentidos por los participantes del "Coral Voices en Superación", mediante las (inter) experiencias y vivencias de cantar y convivir con el asma. Métodos: Investigación cualitativa, empírica, bibliográfica y fenomenológica. Con uso de diario de campo, entrevista semiestructurada y análisis de contenido. Participaron 14 mujeres y un hombre entre 23 y 75 años, acompañados en el Centro de Referencia en Asma. Resultado: El arte de la educación, a través de la música, es un recurso para que el asistente social potencializar la autoestima de las personas en el tratamiento del asma. Conclusión: La convivencia de personas con asma, en una actividad de arte educación, influye en su calidad de vida

Estudio de una nueva técnica psicoterapéutica grupal en esquizofrenia basada en el cine de ficción: efectos sobre síntomas positivos y negativos / Study of a new group psychotherapy technique in schizophrenia based on fictional cinema: effects on positive and negative symptoms

Introducción: La esquizofrenia es uno de los trastornos mentales que mayor discapacidad humana genera en todo el mundo. Hasta el momento, el tratamiento de síntomas negativos en esquizofrenia dista de estar resuelto de un modo satisfactorio. La singular capacidad del cine para activar la atención, la imaginación y la memoria, así como de activar procesos mentales complejos en los espectadores, permite pensar que puede ser una herramienta terapéutica eficaz para el tratamiento de determinados trastornos mentales. Objetivos: Evaluar el eficacia de una nueva técnica psicoterapéutica (diseñada ad hoc) basada en el análisis fílmico por secuencias y el doble visionado utilizando cine de ficción en pacientes con diagnóstico de trastornos del espectro de la esquizofrenia y otros trastornos psicóticos. Metodología: Se realizó un ensayo clínico multicéntrico, aleatorizado y en grupos paralelos en el que participaron 48 pacientes con diagnóstico de trastornos psicóticos del espectro de la esquizofrenia. Se compararon los efectos de la aplicación de una técnica psicoterapéutica grupal, basada en el uso de cine de ficción como soporte y cuya técnica estaba inspirada en el análisis fílmico, frente a un grupo control que también trabajaba con una técnica más inespecífica sobre el mismo soporte. Para el desarrollo de la nueva técnica psicoterapéutica grupal -objeto de este estudio- se seleccionaron 3 técnicas del análisis fílmico en las que los investigadores en su práctica clínica observaron un potencial terapéutico: 1) la segmentación del material fílmico en secuencias; 2) el análisis por secuencias de los contenidos de la película, y 3) el doble visionado del material cinematográfico. La intervención constaba de 26 sesiones, que implicaban la doble visión de los 13 episodios de la primera temporada de la serie de televisión Los Soprano. Las medidas primarias de resultado fueron los cambios obtenidos en las subescalas de la Escala de Síndromes Positivo y Negativo de la Esquizofrenia, según el modelo pentafactorial de Wallwork, entre la situación basal y final tras el tratamiento. Como medidas de resultado cognitivas se utilizaron los cambios en las escalas de cognición incluidas en la MATRICS Consensus Cognitive Battery y en escalas de cognición social (MSCEIT, FEIT, FBS) antes y después del tratamiento. Resultados: Los resultados mostraron una mejoría estadísticamente significativa en el grupo experimental frente al grupo control en los síntomas, positivos (p=0,01; d=0,82 [IC del 95%, 0,2-1,43]), negativos (p=0,005; d=0,89 [IC del 95%, 0,26-1,51]) y desorganizados (p=0,013; d=0,49 [IC del 95%, 0,11-1,09]). En el análisis post-hoc del factor negativo se encontró mejorías estadísticamente significativas en las variables: embotamiento afectivo (p=0,041; d=0,64 [IC del 95%, 0,03-1,24]), retraimiento emocional (p=0,012; d=0,80 [IC del 95%, 0,18-1,41]), contacto pobre (p=0,000; d=1,18 [IC del 95%, 0,52-1,82]) y enlentecimiento motor (p=0,003; d=0,96 [IC del 95%, 0,33-1,58]). En el análisis post-hoc del factor positivo se encontró mejoría significativa en el subdominio delirios (p=0,01; d=0,82 [IC del 95%, 0,2-1,4]). No se encontraron diferencias significativas entre ambos grupos en síntomas afectivos ni en ninguno de los dominios cognitivos estudiados. Conclusiones: La nueva técnica psicoterapéutica propuesta es aplicable y bien aceptada por los pacientes con esquizofrenia y otros trastornos psicóticos. El uso de esta nueva técnica psicoterapéutica inspirada en el uso del análisis fílmico puede servir para mejorar los síntomas positivos, negativos y desorganizados en pacientes con esquizofrenia

Introduction: Schizophrenia is one of the mental disorders that generate the greatest human disability in the world. The treatment of negative symptoms in schizophrenia is still far from being resolved satisfactorily. The unique ability of cinema to activate attention, imagination and memory, as well as to activate complex mental processes in viewers leads one to think that it can be an effective therapeutic tool for the treatment of certain mental disorders. Objective: To evaluate the efficacy of a new psychotherapeutic technique (designed ad hoc) based on the analysis of film sequences and double viewed using fiction films in patients diagnosed with spectrum disorders of schizophrenia and other psychotic disorders. Methods: A multicentre, randomised and parallel group clinical trial was conducted on 48 patients with a diagnosis of psychotic disorders of the schizophrenia spectrum. The effects of the application of a psychotherapeutic group therapy technique, based on the use of fiction films, were compared to a control group that also worked with fiction films, but using a non-specific technique. Three film analysis techniques with potential therapeutic properties were selected for the development of the new group psychotherapy technique: 1) the segmentation of the cinematic material into sequences, 2) the analysis by sequences of the contents of the film, 3) the double viewing of the cinematographic material. The intervention consisted of 26 sessions, which involved the double viewing of the 13 episodes of the first season of the television series Los Soprano. The primary outcome measures were the changes obtained in the Positive and Negative Syndrome Scale (PANSS) subscales, according to Wallwork's five-factor model, between the baseline and final situation after treatment. Cognitive outcome measurements included changes in the cognition scales included in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) and in social cognition scales, like MSCEIT, FEIT, and FBS (Mayer-Salovey-Caruso Emotional Intelligence Test, Facial Emotion Identification Test, and Frankfurt self-assessment scale for persons with schizophrenia, respectively), before and after treatment. Results: The results showed a statistically significant improvement in the experimental group versus the control group in the positive [P=.01; d=0.82 (95% CI; 0.2-1.43)], negative [P=.005; d=0.89 (95% CI; 0.26-1.51)] and disorganised symptoms [P=.013; d=0.49 (95% CI; 0.11-1.09)]. In the "post-hoc" analysis of the negative factor, statistically significant improvements were found in the following variables: blunted effect (P=.041, d=0.64 (95% CI; 0.03-1.24)], emotional withdrawal (P=.012, d=0.80 (95% CI; 0.18-1.41)], poor contact (P=.000, d=1.18 (95% CI; 0.52-1.82)], and motor retardation (P=.003, d=0.96 (95% CI; 0.33-1.58).] In the "post-hoc" analysis of the positive factor there was a significant improvement in the delusions subdomain [P=.01; d=0.82 (95% CI; 0.2-1.4).] No significant differences were found between groups in affective symptoms or in any of the cognitive domains. Conclusions: The proposed new psychotherapy technique is applicable and well accepted by patients with schizophrenia and other psychotic disorders. The use of this new psychotherapy technique inspired in film analysis is effective in leading to improvements in the positive, negative, and disorganised symptoms in patients with schizophrenia

Feasibility of Three Novel Forms of Passive Exercise in a Multisensory Environment in Vulnerable Institutionalized Older Adults with Dementia.

BACKGROUND: Increasing physical activity levels in patients with dementia can reduce pathology severity and progression of the disease. However, physical activity programs can be challenging to adhere to for this vulnerable population. Three novel forms of passive exercise in a multisensory environment may be feasible alternatives for patients who can no longer be involved in physical activity. OBJECTIVE: To determine the feasibility of three different forms of passive exercise in a multisensory environment in inactive institutionalized older adults with dementia. METHODS: 120 patients with dementia participated in this single blind randomized controlled trial (64.5% female, age 85.3±6.8 years Mini-Mental State Examination range 0-29). Ninety participants were randomly assigned to one of the three intervention groups: Therapeutic Motion Simulation (TMSim), Whole Body Vibration (WBV), and TMSim + WBV. Participants received 6 weeks of passive exercise, 4 sessions a week, 4 (WBV) to 12 (TMSim and TMSim + WBV) minutes per session. Feasibility of the novel forms of passive exercise was evaluated based on attendance, compliance, (proxy) experience scores, adverse events and drop-out rates. RESULTS: On average 87.9% of the offered intervention sessions were attended. All three forms of passive exercise were well appreciated by the participants (7.3 on a scale from 0 to 10). Intervention related drop-out rates were reasonable (12.2%) and no serious adverse events occurred. CONCLUSION: The novel passive exercise interventions TMSim, WBV, and TMSim + WBV are feasible to apply in patients at all stages of dementia. More research is needed to establish effectiveness of passive exercise to limit adverse effects of dementia.

It's like another world: the perceived beneficial effects of an artistically designed multisensory environment.

Self-management strategies have been identified as having a key role in supporting mental health and preventing mental illness. Evidence suggests that spending time in nature, experiencing or viewing artwork and accessing sensory rooms all support self-management and positive mental health among varied clinical populations. This evidence informed the design of the sensory-art space (SAS), an artistically designed multisensory environment, which drew on themes and images of nature.The aim of this study was to explore the experiences and perceived benefits of the SAS among members of a university community.A maximum variation approach to sampling was used, and 18 participants were included in this qualitative study. Data were gathered via semi-structured interviews, which were audio-recorded and transcribed verbatim for thematic analysis.The findings presented six themes. The two core themes were: it's like another world, and easy to focus and describe how the SAS produced the beneficial effects described in the four remaining themes of: emotionally nutritious, meditative effects, relaxation and therapeuticParticipants identified beneficial effects of the SAS that were consistent with the evidence for other self-management strategies. The identified benefits also aligned with existing theories suggesting that the SAS functioned as a restorative environment. This study is the first to explore the experience of art in a multisensory and multidimensional capacity, which further contributes to the growing field of receptive engagement with the arts for health outcomes.

Effect of singing interventions on symptoms of postnatal depression: three-arm randomised controlled trial.

This study assessed whether a novel psychosocial intervention could reduce symptoms of postnatal depression (PND) in the first 40 weeks post-birth. Analyses were carried out of 134 mothers with symptoms of PND randomised into 10 weeks of group singing workshops or group play workshops for them and their babies, or usual care (trial registration: NCT02526407). Overall, among all mothers with symptoms of PND, there was a non-significant faster improvement in symptoms in the singing group (F 4,262 = 1.66, P = 0.16, η 2 = 0.012). When isolating mothers with moderate-severe symptoms of PND, this result became significant, with a faster improvement in symptoms in the singing group (F 3.9,139.8 = 2.74, P = 0.033, η 2 = 0.028). Declaration of interest None.

Creating an inclusive leisure space: strategies used to engage children with and without disabilities in the arts-mediated program Spiral Garden.

PURPOSE: This article describes how service providers use a set of practical strategies to create an inclusive leisure space in Spiral Garden, an arts-mediated outdoor summer day program for children with and without disabilities. METHODS: This study was guided by an interpretive qualitative approach. Fourteen Spiral Garden service providers participated in semi-structured interviews. Nine had extensive experience with the program and had been present during key phases of program development spanning over a 26-year period and five were service providers during the summer of 2013. Transcript data were analyzed using inductive thematic analysis. RESULTS: The analysis produced eight strategies organized under three larger categories that service providers perceived to be essential in creating an inclusive leisure space: (1) engaging children in collective experiences; (2) encouraging peer interactions and friendships; and (3) facilitating collaborative child-directed experiences. CONCLUSIONS: Service providers working across different inclusive settings can use findings from this study to contribute to program design and implementation. Presented strategies enable children to experience opportunities for spontaneous free play, individualized structured support, and meaningful social participation. Overall, service providers are encouraged to enhance supportive child and service provider relationships and reciprocal child and environment relationships in group-based programs. Implications for Rehabilitation Exploring and facilitating reciprocal relationships between children and their environment is essential to creating inclusive leisure spaces. Transforming program intentions of meaningful social participation into practice requires learning about and affecting change in children's individual social contexts. Service providers can engage themselves as full participants in inclusive leisure spaces through playful negotiations, internal reflections, and artistic expressions.

Effects of multisensory and motor stimulation on the behavior of people with dementia.

A quasi-experimental study using a pre-posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) program, implemented by direct care workers, on the behaviors of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviors were analyzed. The frequency of engagement in task decreased significantly ( p = .002) however, its duration increased ( p = .039). The duration of gaze directed at direct care workers improved significantly ( p = .014) and the frequency of closed eyes decreased ( p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC-MSS and MS programs as they may stimulate residents' behaviors.

The Multisensory Environment (MSE) in Dementia Care: Examining Its Role and Quality From a User Perspective.

BACKGROUND: Multisensory environments (MSEs) for people with dementia have been available over 20 years but are used in an ad hoc manner using an eclectic range of equipment. Care homes have endeavored to utilize this approach but have struggled to find a design and approach that works for this setting. AIMS: Study aims were to appraise the evolving concept of MSEs from a user perspective, to study the aesthetic and functional qualities, to identify barriers to staff engagement with a sensory environment approach, and to identify design criteria to improve the potential of MSE for people with dementia. METHODS: Data were collected from 16 care homes with experience of MSE using ethnographic methods, incorporating semi-structured interviews, and observations of MSE design. Analysis was undertaken using descriptive statistics and thematic analysis. RESULTS: Observations revealed equipment that predominantly stimulated vision and touch. Thematic analysis of the semi-structured interviews revealed six themes: not knowing what to do in the room, good for people in the later stages of the disease, reduces anxiety, it's a good activity, design and setting up of the space, and including relatives and care staff. CONCLUSION: Few MSEs in care homes are designed to meet needs of people with dementia, and staff receive little training in how to facilitate sessions. As such, MSEs are often underused despite perceived benefits. Results of this study have been used to identify the design principles that have been reviewed by relevant stakeholders.

Arteterapia e depressão: efeitos da arteterapia como terapia complementar no tratamento da depressão em idosos / Art therapy and depression: effects of art therapy as a complementary therapy in the treatment of depression in the elderly

O Transtorno Depressivo Maior (TDM) está entre as síndromes psiquiátricas que mais atingem a população em geral. A prevalência da depressão durante a vida é de 7 a 12% para homens e 20 a 25% para mulheres, independente de raça, educação, estado civil ou renda. Entre os idosos a prevalência é de aproximadamente 5%. Além do tratamento medicamentoso, as psicoterapias têm um papel importante durante a fase aguda e na fase de remissão. A Arteterapia é uma abordagem terapêutica primordialmente não verbal, e tem sido utilizada em diversos contextos, mas há carência de estudos quantitativos que comprovem sua eficácia. O objetivo deste trabalho foi avaliar a eficácia da Arteterapia para uma população de mulheres idosas com diagnóstico de TDM, segundo o DSM - 5 = Manual de Diagnóstico e Estatística dos Transtornos Mentais - 5º versão, medicadas. Participaram do estudo 66 idosas com diagnóstico de TDM em tratamento medicamentoso, sem mudança medicamentosa durante o estudo e intactas no ponto de vista da cognição. Essas idosas foram alocadas aleatoriamente em dois grupos: 33 constituíram o Grupo Experimental (GE), que constou de 20 oficinas de Arteterapia com duração de noventa minutos, semanalmente, e 33 participaram do Grupo Controle (GC) o qual não recebeu nenhuma intervenção. Ambos os grupos foram avaliados com as mesmas escalas no início e após 20 semanas. Foram utilizadas as seguintes escalas para avaliar aspectos cognitivos - Mini exame do Estado Mental (MEEM), o Teste do Desenho do Relógio (TDR), o teste de Fluência Verbal - categoria animal (FV), e o teste Trilhas A. Para a avaliação Visuoconstrutiva foi utilizada a Figura complexa de Rey - cópia e evocação. Para avaliar aspectos psiquiátricos foram utilizadas a Geriatric Depression Scale (GDS), a Escala de Beck para Depressão (BDI) e a Escala de Beck para Ansiedade (BAI). Para avaliar qualidade de vida - Functional Assessment Staging Test (FAST). No final do estudo 31 idosas completaram todas as oficinas do GE e 25 idosas do GC retornaram para as avaliações finais, apesar de todas terem sido contatadas. O GC diminuiu na GDS 0,6 ± 2,3 pontos, enquanto o GE diminuiu 3,2 ± 3,4 pontos, e esta diferença entre os grupos foi significante (p = 0,007). Na escala BDI, o GC diminuiu 1,6 ± 4,9 pontos e o GE diminuiu 8,6 ± 12,8 pontos (p = 0,025). Na escala BAI, o GC diminuiu 2,9 ± 1,4 pontos e o GE diminuiu 8,9 ± 14,5 pontos (p = 0,032). Não foram encontradas diferenças nas demais escalas. Assim, houve diferença entre os grupos Controle e Experimental após as 20 semanas nos aspectos psiquiátricos de depressão e ansiedade. Não foram observadas mudanças na cognição. Desta forma, intervenções como a deste estudo parecem auxiliar no tratamento de sintomas depressivos e ansiosos de idosas com TDM.(AU)

Major Depressive Disorder (MDD) is, among the psychiatric syndromes, that most affect the general population. The prevalence of depression during life is 7 to 12% for men and 20 to 25% for women, regardless of race, education, marital status or income. Among the elderly, the prevalence is approximately 5%. In addition to drug treatment, psychotherapies have an important role during the acute phase and in the remission phase. Art Therapy is a therapeutic approach primarily nonverbal, and has been used in several contexts, but there is a lack of quantitative studies that prove its efficacy. The objective of this study was to evaluate the efficacy of Art therapy for a population of elderly women diagnosed with MDD, according to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM - 5). A total of 66 elderly women with a diagnosis of MDD were enrolled in the drug treatment, without drug change during the study and intact from the point of view of cognition. These elderly women were randomly allocated into two groups: 33 were the Experimental Group (EG), which consisted of 20 Art therapy workshops lasting 90 minutes, weekly, and 33 participated in the Control Group (CG), which received no intervention. Both groups were evaluated with the same scales at baseline and after 20 weeks. The following scales were used to evaluate cognitive aspects - Mini Mental State Examination (MMSE), Clock Drawing Test, Verbal Fluency Test - Animal Category (VF), and Trail A. To evaluate psychiatric aspects, the Geriatric Depression Scale (GDS), the Beck Depression Scale (BDI) and the Beck Anxiety Scale (BAI) were used. For the Visuoconstructive evaluation, Rey's Complex Figure and Delayed Recall was used. And to evaluate quality of life - Functional Assessment Staging Test (FAST). At the end of the study, 31 elderly women completed all EG workshops and 25 elderly women of CG returned to the final evaluations, although all were contacted. The CG decreased in the GDS 0.6 ± 2.3 points, while the EG decreased by 3.2 ± 3.4 points, and this difference between the groups was significant (p = 0.007). On the BDI scale, the CG decreased by 1.6 ± 4.9 points and the EG decreased by 8.6 ± 12.8 points (p = 0.025). On the BAI scale, the CG decreased by 2.9 ± 1.4 points and the EG decreased by 8.9 ± 14.5 points (p = 0.032). No differences were found in the other scales. Thus, there was difference between the Control and Experimental groups after the 20 weeks in the psychiatric depression and anxiety aspects. No changes in cognition were observed. Thus, interventions such as this study seem to aid in the treatment of depressive and anxious symptoms of elderly patients with TDM.(AU)

Comparing the Effects of Multisensory Stimulation and Individualized Music Sessions on Elderly People with Severe Dementia: A Randomized Controlled Trial.

The objective of this study was to compare the effects of a multisensory stimulation environment (MSSE) and individualized music sessions on agitation, emotional and cognitive status, and dementia severity in a sample of institutionalized patients with severe dementia. Twenty-two participants with a diagnosis of severe or very severe dementia were randomly assigned to two groups: MSSE and individualized music sessions. Both groups participated in two 30-min weekly sessions over 16 weeks. Outcomes were agitation (Cohen-Mansfield Agitation Inventory, CMAI), mood (Cornell Scale for Depression in Dementia, CSDD), anxiety (Rating Anxiety in Dementia, RAID), cognitive function (Severe Mini-Mental State Examination, SMMSE), and the overall severity of dementia (Bedford Alzheimer Nursing Severity Scale, BANS-S). They were assessed at baseline (pre-trial), in the middle (mid-trial), at the end of the intervention (post-trial), and 8 weeks after the intervention (follow-up). Patients in the MSSE group showed significant improvement in their RAID and BANS-S scores compared with the individualized music group post- versus pre-trial. With regard to agitation, there was improvement during the intervention in both the MSSE and individualized music groups in the CMAI total score after 16 weeks of intervention, with no significant differences between the groups. The results suggest that MSSE could have better effects on anxiety symptoms and dementia severity in comparison with individualized music sessions in elderly patients with severe dementia.

Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia: A Pilot Randomized Controlled Trial.

The objective of this study was to compare the effect of multisensory stimulation environment (MSSE) and one-to-one activity sessions in the symptomatology of elderly individuals with severe dementia. Thirty-two participants were randomly assigned to the following 3 groups: MSSE, activity, and control group. The MSSE and activity groups participated in two 30-minute weekly sessions over 16 weeks. Pre-, mid-, and posttrial; 8-week follow-up behavior; mood; cognitive status; and dementia severity were registered. Patients in the MSSE group demonstrated a significant improvement in the Neuropsychiatric Inventory and Bedford Alzheimer Nursing Severity Scale scores compared with the activity group. Both MSSE and activity groups showed an improvement during the intervention in the Cohen-Mansfield Agitation Inventory aggressive behavior factor and total score, with no significant differences between groups. The MSSE may have better effects on neuropsychiatric symptoms and dementia severity in comparison with one-to-one activity sessions in patients with severe dementia.

COMMUNI-CARE: Assessment tool for reactions and behaviours of patients with dementia in a multisensory stimulation environment.

BACKGROUND: The 'Snoezelen' is an approach based on stimulation and sensory stimulation proposals, giving priority to the notion of caretaking. The aim of this paper is to present the creation and validation of the COMMUNI-CARE scale. This is a new tool that allows for an evaluation of the psycho-emotional well-being that the patient with dementia shows in a 'Snoezelen' multisensory stimulation environment. METHODS: In total 429 evaluations in 143 multisensory stimulation interventions were made using the COMMUNI-CARE scale, in 16 patients between 53 and 85 years of age, diagnosed with moderate to severe dementia. The goal was to evaluate the psycho-emotional well-being the patients present. RESULTS: The tool's internal consistency showed a Crombach alpha of 0.90. The concurrent validity between the COMMUNI-CARE scale and the Clinical Global Impression (CGI) was of r = -0.961. The Kappa index used to determine the reliability between evaluators was of K = 0.87. CONCLUSIONS: The COMMUNI-CARE scale fulfills the basic principles of classic psychometrics of construct, and criterion validity and reliability. It does so while showing a clear idea, through its five subscales (anxiety, communication, pleasure, adaptation to the surroundings and affection), of the degree of well-being that the patient with dementia shows during such interventions. This scale embodies, through psychometrics, a very subjective human experience with a tool unavailable to date.

Técnica da silhueta e escuta corporal como instrumento de ampliação da percepção corporal e contato com a visão simbólica / Body silhouette and listening as a tool for expansion of body perception and a simbolic view

Em busca do cuidado integral do interagente, o naturólogo tem como recurso o uso da prática de arteterapia silhueta corporal associada à escuta corporal. Este estudo tem por objetivo aprofundar o conhecimento sobre como essas técnicas influenciam na percepção corporal, bem como compreender as associações simbólicas surgidas em sua aplicação. Material e método: Foram utilizados papel pardo, tinta guache, pincéis, giz de cera, recortes de revistas variadas, tesoura, cola e papel sulfite. Esta pesquisa caracteriza-se como uma pesquisa exploratória de natureza qualitativa. As unidades observacionais foram as escutas corporais e as silhuetas corporais, bem como o fenômeno em si, a realização da prática da silhueta e o depoimento das 6 participantes sobre estas. Os dados obtidos foram analisados e categorizados de acordo com os conteúdos surgidos. Resultados e discussão: a prática possibilitou que as participantes entrassem em contato e expressassem o modo como elas percebem e lidam com cada parte de seu corpo, assim, 5 dentre as 6 participantes relataram que a prática ampliou a percepção corporal. Um dos aspectos mais marcantes foram a ampliação da percepção sobre a autoestima e o autocuidado. Os resultados mostraram maior familiaridade com a cabeça, que está ligado ao excesso de pensamentos/racionalização e corrobora para a negação do lado sentimental.(AU)

In search of the holistic care of the interactor, the naturologist use the practice of art therapy body silhouette associated with body listening. This article aims tto deepen understanding of how theese techniques affect the body awareness and understanding the symbolic associations arising from its application. Methods: brown paper, ink, brushes, crayons, cutouts of various magazines, scissors, glue and paper. This researcch is characterized as an exploratory qualitative. The observational units were composed by listens and body silhouettes as well the phenomenon itself, the realization of practical silhouette the testimony of the participants about their experience. The results were analyzed and categorized according to the emerged content. Results And Discussion: The practice enabled the participants to get in touch and to express how they perspective and deal with every aprt of their body, five among six participants reported that the practice has expanded their body perception. One the most striking aspects was the perception of self-esteem and self-care. The results showed bigger familiarity with the head, which is linked to the excess of thoughts / rationalization and confirms the denial of the sentimental side.(AU)

[Healing with art?]. / Beter met kunst?

Music and other forms of art are increasingly being integrated into hospitals. As well as the aesthetic value of art, more and more attention is being paid to its contribution to the healing of the patient. Scientific research indicates the possible benefits of specific art in healthcare facilities. Using this knowledge of the role and employability of surroundings and art in the healing of patients may be complementary to the high quality of care in the Netherlands. By means of proper, methodologically correct research, it is possible to investigate the use of different aspects of the patient's environment as simple, safe and low-cost measures in improving health and well-being of patients.