Adopting a Diary to Support an Ecological Assessment of Neuropsychiatric Symptoms of Dementia

A systematic review of the application of a diary for people with dementia: how to maximise the effect of diary use?

Diaries have been widely used among people with dementia as a data collection tool and memory aid. An understanding of their usage is conducive to the subsequent development of intervention measures, but comprehensive evidence is still lacking. This review synthesises the existing literature to obtain an in-depth understanding of the positive and negative effects of diary usage among people with dementia and the influencing factors. The data were collected from eight databases from the inception of each database to November 2020. A thematic synthesis method was used to sort and summarise the included studies. Ten studies were chosen for the review. The following three analytical themes were identified: (i) positive changes; (ii) factors affecting the record; and (iii) negative feelings. Diaries can cause positive changes in people with dementia, but the specific patterns of stimulation and changes over time remain to be explored. Furthermore, researchers should encourage patients and their families to have a correct understanding of the diary, improve their motivation and social support, fully use the positive effects of the diary, and reduce the occurrence of negative effects. Medical staff should help caregivers improve their awareness of the usefulness and ease of the diary and encourage them to provide support and companionship to people with dementia while exhibiting a positive attitude.

Testing of Journal Writing for Symptom Concordance in Adults with Multiple Sclerosis

Background

Adults with multiple sclerosis (MS) experience many complex symptoms. However, research is lacking on the best method to record their symptom experience. The primary goal of this study was to test the feasibility of journal writing to capture the description of core symptoms experienced by adults with MS. A secondary goal was to collect self-report symptom data to assess concordance between the journal entries and MS-Related Symptom Checklist (MS-RS) scores.

Methods

A preselected group of participants (n = 5) from the total sample of 16 participants with MS were asked to complete the revised MS-RS and Web-based journal writing for 20 minutes per day for 4 consecutive days over a 4-week period. Feasibility was evaluated by journal completion rates.

Results

Most participants found journal writing acceptable as a method for writing about symptoms. Participants were able to write about symptoms that formed clusters: unpredictable physical alterations and unpredictable sensory and emotional changes. Likewise, participants reported frequent fatigue, difficulty sleeping, heat intolerance, and difficulty concentrating/cognitive problems from the revised MS-RS. Disconcordance between revised MS-RS data and journal entries included lack of disclosure of difficulty sleeping and "pins and needles" in the journals.

Conclusions

Preliminary findings from this study provide the personal perspectives of core symptoms experienced by adults with MS. These results provide preliminary evidence of the feasibility of journal writing, along with self-report survey, to describe symptoms in adults with MS.