Dangling conversations: reflections on the process of creating digital stories during a workshop with people with early-stage dementia

Reminiscence and Digital Storytelling to Improve the Social and Emotional Well-Being of Older Adults With Alzheimer's Disease and Related Dementias: Protocol for a Mixed Methods Study Design and a Randomized Controlled Trial

BACKGROUND

Increasing attention is being given to the growing concerns about social isolation, loneliness, and compromised emotional well-being experienced by young adults and older individuals affected by Alzheimer disease and related dementias (ADRD). Studies suggest that reminiscence strategies combined with an intergenerational approach may yield significant social and mental health benefits for participants. Experts also recommended the production of a digital life story book as part of reminiscence. Reminiscence is typically implemented by trained professionals (eg, social workers and nurses); however, there has been growing interest in using trained volunteers owing to staffing shortages and the costs associated with reminiscence programs.

OBJECTIVE

The proposed study will develop and test how reminiscence offered by trained young adult volunteers using a digital storytelling platform may help older adults with ADRD to improve their social and emotional well-being.

METHODS

The proposed project will conduct a randomized controlled trial to assess the effects of the intervention. The older and young adult participants will be randomly assigned to the intervention (reminiscence based) or control groups and then be randomly matched within each group. Data will be collected at baseline before the intervention, in the middle of the intervention, at end of the intervention, and at 3 months after the intervention. An explanatory sequential mixed methods design will be used to take advantage of the strengths of both quantitative and qualitative methods. The quantitative data from surveys will be entered into SPSS and analyzed using covariate-adjusted linear mixed models for repeated measures to compare the intervention and control groups over time on the major outcomes of participants. Conventional content analysis of qualitative interviews will be conducted using data analysis software.

RESULTS

The project was modified to a telephone-based intervention owing to the COVID-19 pandemic. Data collection started in 2020 and ended in 2022. In total, 103 dyads were matched at the beginning of the intervention. Of the 103 dyads, 90 (87.4%) dyads completed the midtest survey and 64 (62.1%) dyads completed the whole intervention and the posttest survey. Although we are still cleaning and finalizing data analyses, the preliminary results from both quantitative and qualitative data showed promising results of this intergenerational reminiscence approach that benefits both the older adults who have cognitive impairments and the young adult participants.

CONCLUSIONS

Intergenerational reminiscence provided by young adult college student offers promising benefits for both the younger and older generations. Future studies may consider scaling up this pilot into a trackable, replicable model that includes more participants with diverse background (eg, public vs private college students and older adults from other agencies) to test the effectiveness of this intervention for older adults with ADRD.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05984732; https://classic.clinicaltrials.gov/ct2/show/NCT05984732.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49752.

Digital Storytelling as an Intervention for Older Adults: A Scoping Review

The population of older adults is rapidly increasing worldwide. Owing to fewer interactions between generations, older adults experience ageism and various psychological issues, such as depression and loneliness. Digital storytelling (DST) has the potential to share vivid lived experiences, support the forming of social relationships, and lead to improved well-being. This scoping review examines the potential psychosocial benefits of individual DST interventions for older adults and people with dementia. We adopted the methodological framework for scoping reviews outlined in the Joanna Briggs Institute's (JBI) manual. A scoping review was performed using the following bibliographic databases: Web of Science, PubMed, Cochrane Library, CINAHL, Research Information Sharing Service, and National Assembly Library. There were 395 references retrieved, of which 19 articles were selected after applying inclusion and exclusion criteria. Our findings revealed that the most common effects of DST on older adults included the promotion of mental health, an increased amount of meaningful community connections, greater digital literacy, the mitigation of negative ageism, and enhanced intellectual ability. We suggest randomized controlled trials are conducted to confirm the efficacy of intergenerational DST intervention and the effects of DST interventions at multilevel outcomes, including the community level.

The use of technology for arts-based activities in older adults living with mild cognitive impairment or dementia: A scoping review

For older adults living with mild cognitive impairment or dementia, creative arts-based activities can offer many benefits from enjoyment as leisure/recreation to an avenue to maintain cognitive, social and emotional wellbeing. With growing interest and recognition that technology could have potential to assist in delivering these activities in more accessible and personalised ways, a scoping review was undertaken to systematically examine the scientific literature for technology-assisted creative arts activities for older adults living with dementia. We searched PubMed, PsychINFO, Web of Science, Scopus and ACM Digital Library databases using keywords centering on population with dementia, an intervention using technology, and a context of creative arts, with no restrictions on the type of outcome measured. We retrieved 3739 records, with an additional 22 from hand-searching. 51 full-text articles met the inclusion and exclusion criteria. Findings of the review indicate technologies principally being designed for music activities (listening, and music-making), as well as storytelling and visual arts. The majority of devices were custom-made, with studies mainly reporting on validating the success of the device/intervention. This suggests most work in the field is currently at prototyping stage, although a few devices are now commercially available. Recommendations for future research includes involvement of participants reporting on their previous experiences in the arts and how this influences co-design choices, and inclusion of different severities of dementia in the participant/co-design group. Furthering device development past prototyping stage as well as collaboration between teams would enable comparisons to be made across different types of devices used for the same activity, and comparisons across arts-based activities that could lead to cross-disciplinary outcomes for the design of creative arts-based assistive technologies.

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

The use of digital storytelling of patients' stories as an approach to translating knowledge: a scoping review

BACKGROUND

A growing interest has centered on digital storytelling in health research, described as a multi-media presentation of a story using technology. The use of digital storytelling in knowledge translation (KT) is emerging as technology advances in healthcare to address the challenging tasks of disseminating and transferring knowledge to key stakeholders. We conducted a scoping review of the literature available on the use of patient digital storytelling as a tool in KT interventions.

METHODS

We followed by Arksey and O'Malley (Int J Soc Res Methodol 8(1):19-32, 2005), and Levac et al. (Implement Sci 5(1):69, 2010) recommended steps for scoping reviews. Search strategies were conducted for electronic databases (Medline, CINAHL, Web of Science, ProQuest dissertations and theses global, Clinicaltrials.gov and Psychinfo). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) was used to report the review process.

RESULTS

Of 4656 citations retrieved, 114 full texts were reviewed, and twenty-one articles included in the review. Included studies were from nine countries and focused on an array of physical and mental health conditions. A broad range of interpretations of digital storytelling and a variety of KT interventions were identified. Digital storytelling was predominately defined as a story in multi-media form, presented as a video, for selective or public viewing and used as educational material for healthcare professionals, patients and families.

CONCLUSION

Using digital storytelling as a tool in KT interventions can contribute to shared decision-making in healthcare and increase awareness in patients' health related experiences. Concerns centered on the accuracy and reliability of some of the information available online and the impact of digital storytelling on knowledge action and implementation.

Digital Storytelling in Older Adults With Typical Aging, and With Mild Cognitive Impairment or Dementia: A Systematic Literature Review

The rates of dementia are on the rise as populations age. Storytelling is commonly used in therapies for persons living with dementia and can be in the form of life review, and reminiscence therapy. A systematic literature review was conducted to examine the range and extent of the use of digital technologies for facilitating storytelling in older adults and their care partners, and to identify the processes and methods, the technologies used and their readiness levels, the evidence, and the associated outcomes. Eight electronic databases were searched: Medline, EMBASE, PsycINFO, CINAHL, Abstracts in Social Gerontology, ERIC, Web of Science, and Scopus. We included 34 studies. Mild cognitive impairment or dementia represented over half of medical conditions reported in the studies. Overall, our findings indicate that the most common use of digital storytelling was to support older adults’ memory, reminiscence, identity, and self-confidence; however, the level of evidence of its effectiveness was low.

Evaluating a digital life story app in a nursing home context - A qualitative study

AIMS AND OBJECTIVES

To evaluate how digital life stories can be used to support person-centred care focusing on benefits and challenges experienced by the staff and the management team in a nursing home context.

BACKGROUND

Life story work can be used to support person-centred care and help people with dementia maintain their identity. The use of digital life stories provides opportunities to easily share the content between staff and relatives and combine different types of multimedia, for example pictures, videos, text and sound.

DESIGN

Six healthcare professionals and two members of the management team at a nursing home were recruited. Participant observations with informal interviews of the formal health career were conducted in two day shifts and two night shifts. Field notes were taken during the observations. Also, individual semi-structured interviews were held with four of the recruited participants. This article adheres to the Standards for Reporting Qualitative Research (SRQR).

RESULTS

Themes revealed were (1) person-centred care and life story work as interrelated approaches; (2) Pros and cons related to the My Life Story app; and how (3) Time and information and communication technology (ICT) can restrict life story work.

CONCLUSION

Digital life stories can be used to support a person-centred care approach. However, a number of challenges exist related to digital life story work. When using digital life stories, it is important to ensure the staff time and competences needed to work with, for example an app and that visible support and encouragement are provided by the management team.

RELEVANCE TO CLINICAL PRACTICE

Challenges are revealed when life story work is embedded in the culture and everyday work of a nursing home. It is of great importance to clinical practice to be aware of and address these challenges in order to succeed with digital life story work.

Reducing Digital Storytelling Implementation Barriers in Nursing Education Workshops

Digital stories have the potential to transform health care systems by cultivating understanding and compassion; however, limited research explores the use of this innovative strategy in continuing education. This article describes how a collaborative partnership of an Academic Team and Translational Partners (n = 15) implemented a four-phase study that included a continuing education workshop with digital stories as the central strategy. The study's guiding questions focused on adapting approaches to creating digital stories to reduce logistic concerns and overcome implementation challenges yet empower nurses in their practice with families. Numerical and narrative responses from workshop participant evaluations (n = 160) affirmed storytelling as the most valuable component, and reflection increased understandings to influence their thinking and actions. This study affirms using digital stories as an implementation strategy in health care systems has the potential to transform nursing education, supports the transfer of family nursing practice knowledge, encourages reflection, and develops empathy for families and nurse peers. [J Contin Educ Nurs. 2019;50(9):411-416.].

People with dementia and caregiver preferences for digital life story work service interventions. A discrete choice experiment and digital survey

Objectives: Little is understood about the optimal way to implement digital life story work (LSW). The aim of this research was to explore the preferences of people with dementia and caregivers in relation to digital LSW in an effort to improve future engagement.Methods: 67 caregivers responded to an online discrete choice experiment (DCE) survey containing 16 pairwise choices. The DCE was analysed using a random effects logit model. Willingness to pay and odds ratios were also calculated. 17 participants with dementia completed an online survey in which they made choices about different aspects of digital LSW services.Results: Caregivers valued four out of five attributes [setting (p = 0.000), price (p = 0.000), elementary usability and accessibility (p = 0.001), and follow-up assistance (p = 0.034)]. In data from participants with dementia, the most preferred setting was individual one-to-one (70.6%), and the most preferred use of digital life storybooks was to share memories with others (64.7%). Marginally more participants with dementia said they would pay for the service (53%) rather than only use it free of charge (47%). Those with advanced ICT skills preferred to learn how to use the digital life storybook (64.7%), while those with elementary/intermediate skills, preferred to have it created for them (35.3%).Conclusions: This exploratory study provides an insight into preferences of people with dementia and caregivers, of how digital LSW is implemented. Results can contribute to future planning and tailoring of these services.

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.

Digital Story Retelling - Evaluation of a Story-reading Workshop Promoting Open-mindedness in the Community

PURPOSE

Digital storytelling (DST), broadly speaking, is a storytelling method that is interwoven with digital media. It is commonly used in educational settings or human services to support various sorts of social advocacy. While many of these DST practices have devised methods to engage marginalized groups to express their voices, they lack parallel initiatives to enable audiences to understand those voices. This study examined a story-retelling workshop model called StoryAd, which utilizes productions from DST activities to facilitate face-to-face contact. The workshop itself is also a lite version of DST activity.

METHOD

A pilot study was conducted in Hong Kong in 2019. Participants enrolled online, met offline, and their advertisement ideas might go online and contribute back to the stories. The workshop model was evaluated using a one-group pretest-posttest design. The participants were 45 Hong Kong Chinese, aged 18-60.

RESULTS

Participants' critical thinking disposition, self-esteem, perspective-taking, and curiosity toward new information increased, while their need for cognitive-closure decreased.

DISCUSSION AND CONCLUSION

This study has proved the feasibility and acceptability of the workshop model. It also opens the discussion about extending DST pedagogy to engage and influence story-readers.

Digital storytelling in health professions education: a systematic review

BACKGROUND

Digital stories are short videos that combine stand-alone and first-person narratives with multimedia. This systematic review examined the contexts and purposes for using digital storytelling in health professions education (HPE) as well as its impact on health professionals' learning and behaviours.

METHODS

We focused on the results of HPE studies gleaned from a larger systematic review that explored digital storytelling in healthcare and HPE. In December 2016, we searched MEDLINE, EMBASE, PsycINFO, CINAHL, and ERIC. We included all English-language studies on digital storytelling that reported at least one outcome from Levels 2 (learning) or 3 (behaviour) of The New World Kirkpatrick Model. Two reviewers independently screened articles for inclusion and extracted data.

RESULTS

The comprehensive search (i.e., digital storytelling in healthcare and HPE) resulted in 1486 unique titles/abstracts. Of these, 153 were eligible for full review and 42 pertained to HPE. Sixteen HPE articles were suitable for data extraction; 14 focused on health professionals' learning and two investigated health professionals' learning as well as their behaviour changes. Half represented the undergraduate nursing context. The purposes for using digital storytelling were eclectic. The co-creation of patients' digital stories with health professionals as well as the creation and use of health professionals' own digital stories enhanced learning. Patients' digital stories alone had minimal impact on health professionals' learning.

CONCLUSIONS

This review highlights the need for high-quality research on the impact of digital storytelling in HPE, especially on health professionals' behaviours.

PROSPERO REGISTRATION NUMBER

CRD42016050271 .

Digitising the wisdom of our elders: connectedness through digital storytelling

Digital storytelling provides older adults with an opportunity to become digital producers, connect with others through story and explore their life history. The authors report on the results of a digital storytelling project for older adults. The study investigated the experiences and perceived benefits of older adults who created digital stories during a ten-week course and explored the reactions of story viewers to the digital stories they viewed during a special sharing event. Eighty-eight older adult participants in Metro Vancouver who attended one of 13 courses offered were included in the study. Most of the participants were female and over half were immigrants. Results from the focus group interviews demonstrated a rich array of reported social and emotional benefits experienced through the process of creating a digital story within the course. Three main themes emerged: social connectedness through shared experience and story, reminiscence and reflecting on life, and creating a legacy. Viewers who attended a ‘Sharing Our Stories’ event reported that the stories were meaningful, well constructed and invoked a range of emotions. The researchers conclude that digital storytelling may help digital storytellers increase connectedness to others and to self. Additionally, this connectedness may extend over time through the process of examining the past to create a digital story that can serve as a legacy to connect to future generations.

Digital storytelling as a method in health research: a systematic review protocol

BACKGROUND

Digital storytelling is an arts-based research method with potential to elucidate complex narratives in a compelling manner, increase participant engagement, and enhance the meaning of research findings. This method involves the creation of a 3- to 5-min video that integrates multimedia materials including photos, participant voices, drawings, and music. Given the significant potential of digital storytelling to meaningfully capture and share participants' lived experiences, a systematic review of its use in healthcare research is crucial to develop an in-depth understanding of how researchers have used this method, with an aim to refine and further inform future iterations of its use.

METHODS

We aim to identify and synthesize evidence on the use, impact, and ethical considerations of using digital storytelling in health research. The review questions are as follows: (1) What is known about the purpose, definition, use (processes), and contexts of digital storytelling as part of the research process in health research? (2) What impact does digital storytelling have upon the research process, knowledge development, and healthcare practice? (3) What are the key ethical considerations when using digital storytelling within qualitative, quantitative, and mixed method research studies? Key databases and the grey literature will be searched from 1990 to the present for qualitative, quantitative, and mixed methods studies that utilized digital storytelling as part of the research process. Two independent reviewers will screen and critically appraise relevant articles with established quality appraisal tools. We will extract narrative data from all studies with a standardized data extraction form and conduct a thematic analysis of the data. To facilitate innovative dissemination through social media, we will develop a visual infographic and three digital stories to illustrate the review findings, as well as methodological and ethical implications.

DISCUSSION

In collaboration with national and international experts in digital storytelling, we will synthesize key evidence about digital storytelling that is critical to the development of methodological and ethical expertise about arts-based research methods. We will also develop recommendations for incorporating digital storytelling in a meaningful and ethical manner into the research process.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registry number CRD42017068002 .

Digital Storytelling: Families' Search for Meaning after Child Death

Bereaved families that collectively make meaning of their grief experiences often function better than those that do not, yet most social work bereavement interventions target individuals rather than family units. In this article, authors describe an innovative social work intervention that employs digital storytelling. This is a narrative technique that combines photography, music, and spoken word to help families bereaved by child death make meaning of their loss and envision a future without their deceased child.

How digital storytelling is used in mental health: A scoping review

The creative arts can be used to support stakeholders of mental health services to communicate and share their lived experience. Digital storytelling is one method that has been used to capture people's lived experience. In this scoping review, we were interested in mapping how digital storytelling has been used in mental health, and to identify gaps in the literature. Nine databases were searched to identify peer reviewed literature published between January 2000 and August 2015; 15 articles were included in the review. The articles were categorized across four broad areas: educational interventions, learning skills, learning about other people's lived experience, and learning about personal lived experience. We identify that while digital storytelling has potential as a participatory process to promote mutual understanding of and empathy towards lived experiences in mental health, there is a dearth of research in this area. More research is needed on the use of digital storytelling in mental health to determine its effectiveness in progressing a recovery orientation in service provision that is built on solidarity and a social justice agenda.

Supporting conversations between individuals with dementia and their family members

Remembrance of recent events is a major problem for individuals with dementia. Consequently, this article explores the process of acceptance and integration of a digital photograph diary (DPD) as a tool for remembrance of and conversations about daily life events. A design for multiple case studies was used. Seven couples, in which one individual in the couple had Alzheimer's disease, tested the DPD for 6 months. Data were collected in three sequences with interviews, observations, and screening instruments. In the analysis, all data were integrated to find common patterns of content. Some couples became regular users, while others used the DPD more sporadically. Factors contributing to regular use were how the DPD matched expectations, actual use, support, experienced usefulness, and reactions from family and friends. For those couples who became regular users, the DPD facilitated their conversation about recent daily activities.

A situated practice of ethics for participatory visual and digital methods in public health research and practice: a focus on digital storytelling

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.