Effectiveness of Story-Centred Care Intervention Program in older persons living in long-term care facilities: A randomized, longitudinal study

Just 1-min exposure to a pure tone at 100 Hz with daily exposable sound pressure levels may improve motion sickness

BACKGROUND

Motion sickness is a common transportation issue worldwide. Vestibular dysfunction has been reported to be a key etiology of motion sickness. However, there are limited technologies for alleviating motion sickness.

METHODS

The most appropriate frequency (Hz) and level (dBZ) of pure tone for modulation of vestibular function were determined by an ex vivo study using murine utricle explants. The preventive effects of the selected pure tone on motion sickness were then confirmed by using a beam balance test in mice. The alleviating effects of pure tone on motion sickness induced by a swing, driving simulator or real car were objectively assessed by using posturography and electrocardiography (ECG) and were subjectively assessed by using the Motion Sickness Assessment Questionnaire (MSAQ) in humans.

RESULTS

The effect of short-term (≤5 min) exposure to a pure tone of 80-85 dBZ (= 60.9-65.9 dBA) at 100 Hz on motion sickness was investigated in mice and humans. A mouse study showed a long-lasting (≥120 min) alleviative effect on shaking-mediated exacerbated beam test scores by 5-min exposure to a pure tone of 85 dBZ at 100 Hz, which was ex vivo determined as a sound activating vestibular function, before shaking. Human studies further showed that 1-min exposure to a pure tone of 80-85 dBZ (= 60.9-65.9 dBA) at 100 Hz before shaking improved the increased envelope areas in posturography caused by the shakings of a swing, a driving simulator and a vehicle. Driving simulator-mediated activation of sympathetic nerves assessed by the heart rate variable (HRV) and vehicle-mediated increased scores of the MSAQ were improved by pure tone exposure before the shaking.

CONCLUSION

Since the exacerbated results of posturography and HRV reflect shaking-mediated imbalance and autonomic dysfunction, respectively, the results suggest that the imbalance and autonomic dysregulation in motion sickness could be improved by just 1-min exposure to a pure tone with daily exposable sound pressure levels.

TRIAL REGISTRATION

Registration number: UMIN000022413 (2016/05/23-2023/04/19) and UMIN000053735 (2024/02/29-present).

My Dog, My Hero: Assessing the Feasibility of a Cross-Generational Digital Storytelling Intervention for Veterans

During the COVID-19 pandemic, social isolation had a devastating effect on well-being. Veterans were among the most vulnerable given their high rates of military trauma-related conditions. Research supports that dogs can provide veterans with a sense of purpose, social support, and stress management. Digital storytelling provided a unique perspective with focus on a recognized hero, the veteran's dog, and an opportunity for engagement with other veterans during COVID-19. The purpose of the study was to assess the feasibility of this digital storytelling intervention based on Story Theory framework and tailored to encompass components of cross-generational collaboration in combination with individual and group virtual sessions as a mechanism to promote social engagement. The research was conducted using a descriptive exploratory design. Veterans (N = 8) were paired with a trained student and grouped in sets of four. There were eight guided 1-hour weekly virtual sessions to create their digital story. Demographic and pre-post intervention survey data were also collected. Based on eight established criteria, this article systematically evaluates the feasibility of the digital storytelling intervention for veterans. The findings suggest practical considerations to ensure viability of digital storytelling as a therapeutic intervention for veterans and other populations at-risk for suboptimal well-being.

Evaluating an intergenerational art and storytelling program with older adults and medical students

Older adults in residential communities face loneliness and isolation, challenges exacerbated by COVID-19, leading to adverse physical and mental health outcomes. Intergenerational arts and humanities programs have been successful in addressing these challenges while also enabling medical learners to better understand aging populations. Draw YOUR Story, a program at a Houston residential senior living community, connects premedical and medical student volunteers with older adults through an art and storytelling activity. To evaluate the program, we conducted a focus group with older adults and pre and post-volunteering student surveys with questions about attitudes towards older adults and an Interpersonal Reactivity Index. Student surveys (n = 18) showed increased comfort working with older adults after volunteering (p = 0.02). Students who spent less time volunteering reported a decline in their perceptions of older adult quality of life, when compared to more frequent volunteers (p = 0.02). Older adults shared that the program encouraged learning new skills, offered time for reflection, connected them to medicine, and furthered desire for community. Draw YOUR Story benefitted students and older adults, increasing student comfort with older adults, providing aging adults opportunities to learn new skills and reflect, and building intergenerational connections.

Patient co-design of digital health storytelling tools for multimorbidity: A phenomenological study

BACKGROUND

Interest in both narrative medicine and electronic health records has increased over the past 30 years. However, electronic health records are mainly written by and for clinicians, and the patient narrative and voice are not incorporated. Recent studies within the United Kingdom have indicated that there is a need to incorporate patient stories into health records, to improve quality and continuity of care. This is particularly important when treating people with multiple long-term health conditions (multimorbidity), whose health stories can be particularly complex.

OBJECTIVE

To understand the goals and requirements of people with multimorbidity for digital health storytelling tools.

METHODS

The methodology uses narrative within a phenomenological approach to inform a process of co-design.

RESULTS

The findings indicate that people living with multimorbidity would use health storytelling tools to understand and reflect on their journeys, convey their experiences to others and advocate for themselves against scepticism.

CONCLUSION

Outputs from the project give insight into the lived experience of multimorbidity, as well as understanding the goals of people living with multimorbidity for using health storytelling tools as part of treatment and self-management. Future research could explore other areas such as collaborative health storytelling or the technical implementation of tools.

PATIENT OR PUBLIC CONTRIBUTION

Five adults with multiple long-term conditions participated in the project, and research was carried out in three stages. First, semistructured interviews were used to understand each participant's health story. Second, each participant worked with the researcher to co-design a visual representation of their story. Finally, digital prototypes based on their health story were reviewed with each of the participants.

What long-term care interventions have been published between 2010 and 2020? Results of a WHO scoping review identifying long-term care interventions for older people around the world

OBJECTIVE

The global population is rapidly ageing. To tackle the increasing prevalence of older adults' chronic conditions, loss of intrinsic capacity and functional ability, long-term care interventions are required. The study aim was to identify long-term care interventions reported in scientific literature from 2010 to 2020 and categorise them in relation to WHO's public health framework of healthy ageing.

DESIGN

Scoping review conducted on PubMed, CINHAL, Cochrane and Google Advanced targeting studies reporting on long-term care interventions for older and frail adults. An internal validated Excel matrix was used for charting.Setting nursing homes, assisted care homes, long-term care facilities, home, residential houses for the elderly and at the community.

INCLUSION CRITERIA

Studies published in peer-reviewed journals between 1 January 2010 to 1 February 2020 on implemented interventions with outcome measures provided in the settings mentioned above for subjects older than 60 years old in English, Spanish, German, Portuguese or French.

RESULTS

305 studies were included. Fifty clustered interventions were identified and organised into four WHO Healthy Ageing domains and 20 subdomains. All interventions delved from high-income settings; no interventions from low-resource settings were identified. The most frequently reported interventions were multimodal exercise (n=68 reports, person-centred assessment and care plan development (n=22), case management for continuum care (n=16), multicomponent interventions (n=15), psychoeducational interventions for caregivers (n=13) and interventions mitigating cognitive decline (n=13).

CONCLUSION

The identified interventions are diverse overarching multiple settings and areas seeking to prevent, treat and improve loss of functional ability and intrinsic capacity. Interventions from low-resource settings were not identified.

Non-pharmacological Approaches to Depressed Elderly With No or Mild Cognitive Impairment in Long-Term Care Facilities. A Systematic Review of the Literature

Introduction: Compared to old people who live at home, depressive symptoms are more prevalent in those who live in long-term care facilities (LTCFs). Different kinds of non-pharmacological treatment approaches in LTCFs have been studied, including behavioral and cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy and life review/reminiscence. The aim of the current review was to systematically review non-pharmacological treatments used to treat depressed older adults with no or mild cognitive impairment (as described by a Mini Mental State Examination score > 20) living in LTCFs. Methods: A research was performed on PubMed and Scopus databases. Following the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) flowchart, studies selection was made. The quality of each Randomized Controlled Trial was scored using the Jadad scale, Quasi-Experimental Design studies and Non-Experimental studies were scored based on the Newcastle-Ottawa Scale (NOS) Results: The review included 56 full text articles; according to the type of intervention, studies were grouped in the following areas: horticulture/gardening (n = 3), pet therapy (n = 4), physical exercise (n = 9), psychoeducation/rehabilitation (n = 15), psychotherapy (n = 3), reminiscence and story sharing (n = 14), miscellaneous (n = 8). Discussion and Conclusion: Despite mixed or negative findings in some cases, most studies included in this systematic review reported that the non-pharmacological interventions assessed were effective in the management of depressed elderly in the LTCFs context. Regrettably, the limitations and heterogeneity of the studies described above hinder the possibility to generalize and replicate results.

Frailty and Comprehensive Geriatric Assessment

Frailty is defined as a reduced physiologic reserve vulnerable to external stressors. For older individuals, frailty plays a decisive role in increasing adverse health outcomes in most clinical situations. Many tools or criteria have been introduced to define frailty in recent years, and the definition of frailty has gradually converged into several consensuses. Frail older adults often have multi-domain risk factors in terms of physical, psychological, and social health. Comprehensive geriatric assessment (CGA) is the process of identifying and quantifying frailty by examining various risky domains and body functions, which is the basis for geriatric medicine and research. CGA provides physicians with information on the reversible area of frailty and the leading cause of deterioration in frail older adults. Therefore frailty assessment based on understanding CGA and its relationship with frailty, can help establish treatment strategies and intervention in frail older adults. This review article summarizes the recent consensus and evidence of frailty and CGA.

Story-Sharing Intervention to Improve Depression and Well-Being in Older Adults Transitioning to Long-Term Care

Older adults frequently experience depression and reduced well-being when transitioning to long-term care (LTC) that can lead to increased risk for mortality. In the current randomized controlled trial, older adults (N = 93) who were transitioning to LTC facilities in Southeast Florida were enlisted. It was hypothesized that when transitioning to LTC (a) story sharing (i.e., sharing stories in groups) could lead to reduced depression and improved well-being, and (b) baseline sociodemographic characteristics could predict depression and well-being. Baseline results revealed that participants were not depressed and had moderate well-being, and postintervention results indicated that there were no significant improvements in depression (p = 0.35) and well-being (p = 0.41). Some baseline sociodemographic characteristics predicted depression (p = 0.04) and well-being (p = 0.03). Future research should incorporate moderate depression as an inclusion criterion and more weeks of story-sharing sessions. Targets: Adults age 65 and older transitioning to LTC. Intervention Description: Two to three participants met as a group to share five stories over 3 weeks. Mechanisms of Action: Story sharing will improve well-being. Outcomes: Participant level of well-being will improve, and sociodemographic characteristics and factors related to the move will predict risk for depression and reduced well-being. [Res Gerontol Nurs. 2019; 12(2):81-90.].