The Action Research Of Recreational Therapy In Elderly With Dementia

Objective: In order to promote the elderly in the nursing home to participate in recreational activities,to get the fun of life,and to improve behavioral and psychological symptoms of dementia,we designed recreation therapy program for the elderly with dementia,and explored the role of recreation therapy in the elderly and the experience of the carers in the course of the recreation therapy.Methods:1 According to Lewin’s plan,action,observation,reflection and re-planning action research framework,a three-round recreational therapy programs for 37 elderly people with dementia were conducted in a nursing home in Shijiazhuang.The recreational therapy program included six different types of activities: coloring activities,paper activities,music care,puzzles,gardening,and finger exercises.2 Before the implementation of the program,the researchers trained the carers.The contents of the training included the characteristics of the elderly with dementia,the skills of the implementation of the specific activities,the promotion techniques of the activities and the methods of communication with the elderly with dementia.3 The team of action research consisted of seven researchers,eleven practitioners(one researcher and ten carers).Researchers were responsible for reviewing the relevant literature and developing an initial program for recreational therapy.Practitioners were responsible for implementing activities,finding problems,and setting up adjustment programs with researchers.At the time of the event,two carers were enrolled,one was the main implementor and the other was responsible for assisting,one researcher was responsible for setting up video,recording and observation.4 The affect and behavioral observation scale was used to measure the affect and behaviors of the elderly with dementia in the course of activities.The degree of engagement assignment rule was used to measure the degree of engagement of the elderly with dementia.The depression and apathy symptoms of the elderly with dementia were measured before and after the end of each round using the Geriatric Depression Scale and the Apathy Scale.Each round of affect and behavior,degree of engagement,depression and apathy symptoms were compared.5 After the end of the study,a qualitative interview was conducted to understand the experience of the carers in the course of the action research.Based on the phenomenological research method,the ten nursing staff of the nursing home were enrolled as the interview object,and the data were collected by semi-structured interview.Colaizzi Analysis method was used for data analysis.Colaizzi analysis method was used for data analysis.Results:1 Through the three rounds of circulation,constantly revised and improved,and ultimately formed a sustainable recreation therapy program in nursing homes.2 Depression of the elderly with dementia: Compared with pre-intervention,at the end of the first round,the second round,the third round,the majority of elderly with dementia’s depression score at normal levels,did not show depressive symptoms,and the depression score of the elderly in the dementia experienced a significant decline at the end of the first round of intervention,P<0.05,and the intervention effect continued at the end of the second and third rounds of intervention.3 Apathy of the elderly with dementia: Compared with pre-intervention,the apathy score of the elderly with dementia had a significant decline at the end of the second round of intervention,P<0.05.At the end of the third round,the effect of the intervention was still maintained,the apathy score gradually decreased,the apathy symptoms gradually improved.4 Activity engagement of elderly with dementia: The researchersdesigned a total of 18 activities for the elderly with dementia,the number of participants in the elderly with dementia was 13.59±3.80 times,the number of participants in 33 patients was 9 or more.The average score of degree of engagement in the three rounds of participation was 2.43,2.42 and 2.52 points,and the average score of degree of engagement was kept at a high level.5 Affect and behavior of the elderly with dementia: In addition to a few people had sad,angry negative affect,most of the elderly could remain alertness and show pleasure in the course of activities.Most of the elderly could respond to the words of the carers and the elderly,show positive verbal behavior,and a few elderly people praised other old people or joked.In the nonverbal behavior part,only a few elderly people had eyes closed,uncooperative and restless behavior,most of the elderly could participate in activities,and show psychosocial tasks,some older people would be in positive touch with other elderly and carers.No older people had aggression.Compared with the first round of intervention,positive touch increased significantly during the second round of interventions;pleasure,positive verbal behavior,positive touch significantly increased,null behavior,eyes closed and uncooperative significantly reduced during the third round of intervention.Compared with the second round of intervention,pleasure,positive verbal behavior,psychosocial task increased significantly,null behavior and uncooperative were significantly reduced in the third round of intervention.6 Interview Results: With the principle of data saturation,the sample size in qualitative research was eight.Four main themes were classified through analysis: affirmation of activity,improve the relationship,factors of engagement in activities,personal growth.Conclusions: The recreational therapy program developed by this study,modified and improved by action research,could improve behavioral and psychological symptoms of dementia,promote engagement,improve positive affect and behavior,and reduce negative affect and behavior,and thecarers could experience the fun of the recreation therapy and gain personal growth.