Source Evaluation Essay 

Pezzati R., et al. (2014). Is Doll therapy able to preserve or promote attachment in people with Cognitive, emotional and behavioral issues?

The authors are the physician and nutritional biochemists. Their diverse backgrounds in the medical field has given them immense knowledge and experience to become experts in the field of Dementia. The design that has been applied in this source is experimental. The authors have tried to describe how non-pharmacological intervention such as doll therapy affects patients with dementia by managing behavioral problems: agitation, aggressiveness and wandering the sample was some patients selected from a small population of dementia patients. Ten patients were selected for this study where 9 of them were females and 1 male, their age range was between 72 and 94. The participants were diagnosed between the year 2005 and the year 2010 and had resided in the distinctive care unit for a period of at least three years. Five of the participants had previously been treated using the Doll therapy for a period of two years and this was selected as the experimental group while the other five were the control group. The selection of the patients was in harmony with the opinion of the referring physician and also in accord with the experimental state. The addition conditions included at people who are 70 years and above, a diagnosis of Alzheimer’s or vascular dementia with severe perceptive damage, existence of behavioral syndromes and a minimum capability to appreciate simple language and produce statements.  The elimination principles included an MMSE score that is above 15, a diagnosis of non-vascular dementia or Alzheimer.

Data for the study was collected by means of observation. 10 experimental sessions were prepared for the participants and they were conducted over 30 days, two of the participants did not however complete the sessions where one was transferred to another nursing home and the other one died. The experiment sessions were held in the residential complex room with a chair and a bed all which was familiar to the patients. 5 of the sessions included the presentation of a doll while the other 5 sessions involved the presentation of a soft colored velvety foam rubber cube.

 Being a quantitative research, data collected was analyzed by means of critical analysis and interpretation of figures and numbers. This was in an attempt to find the justification behind the occurrence of key discoveries. The results did not show any significant differences between the experiment and control group in regards to age, education, institutionalization time or even the number of family visits. Both groups showed a high fall risks, a severe privation of independence in their daily lives events and a great level of interactive difficulties. The experimental participants showed more interest in the doll since they had been treated with Doll therapy before and they exhibited exploratory behaviors with the cube as an instrumental object without any relational value.

Their study was valid since it was found to be closely related to Bowlby’s theory of attachment (Pezzati R., et al. 2014). According to Bowlby, 1979, 1988; Van Assche et al., 2013, “affection demonstrations have an effect from the cradle to the grave” when vulnerable dementia population exposed to loss and separation develop an attachment with a person. One limitation of this study is the fact that the study group was limited and so not much data could be collected. The other limitation is the fact that there were no standardized tools and so only observational indices were used. 

 I find the findings of this study quite reliable and helpful in my study.

Mitchell G. & O’Donnell H. (2013). Therapeutic use of doll therapy in dementia.  “British Journal of Nursing”. 22(6)

My next source to evaluate is a paper by Mitchell G. & O’Donnell H published in the year 2013. Mitchell and Donnell are both experts of the field of dementia. Their study is a descriptive one. The sample for this study was a group of individuals suffering from dementia. Data for the study was collected through the use of questionnaires that contained both closed and open-ended questions. The study basically reviews findings from other past literature on use of Doll therapy for dementia. A selection of  several studies including ((Ellingford et al., (2007), James et al., (2006a) and Mackenzie et al., (2006)) who seek to define the effectiveness of the beneficial use of Doll therapy.

All the studies used mixed method strategy to aid in observational statistics collection from the staff supportive for people suffering from dementia. In the study by James et al., (2006), there was the use of Likert scale which was used to help in measuring the stages of activity, nervousness and cheerfulness in the selected residents. There was also the use of open ended queries that were used to help provide a qualitative element from the study. The study used 15 dolls and 15 teddy bears and it was observed that the participants preferred the dolls to bears. Majority of the participants appeared to be less anxious and more active. The same findings were observed by the study by Ellingford at al., (200) who used a comparable technique of data collection in four dementia care homes. In this study, 66 participants were selected where 34 of them used dolls and the other 32 did not over a period of 6 months after the Doll therapy had been applied. It was observed that ensuing the introduction of Doll therapy, there was a great improvement in positive behaviours. The study by Mackenzie et al., (2006), where questionnaires were directed to the 46 care staff after a 3 week test; providing 14 dolls to 37 people in 2 dementia care homes. 32 of the care givers testified that the life of the inhabitants that involved in the Doll therapy showed much more improvement while the rest of the 14 carers basically indicated that the life of the residents was a little better.

The results from all this studies indicated an acknowledgement that Doll therapy showed a positive change in the residents in regard to improved behaviour and that it is a good implementation for dementia patients.

The limitation to both these studies is the fact that they were both conducted in the same environmental areas which basically raises generalizability concerns. The results would have been more accurate and dependable if they provided additional information in regard to the growth and analysis of the methods that were used for gathering of data.

I found the study valid and reliable, especially for my study. It is reliable since it represents about 60-90% of the items under study.

Turner F. & Shepherd M. (2014). Doll Therapy in dementia care: A review of current literature. Communicare1(1).

This study uses an explanatory approach. The author tries to explain how doll therapy affects persons with dementia.  The study uses data collected from other past studies for instance; Gibson, (2005), Alander et al., (2013), Tamura et al., (2001), James, et al., (2005) among many others. The study samples in this studies included both dementia patients and their caregivers. Most of the participants for the studies were aged people who are 70 years and above and are residents in dementia care homes. Data in the studies was collected using both observation and interviews. The data collected were analyzed through a critical interpretation of figures to define a pattern.

The result from the literature indicate that there are benefits to using Doll therapy for dementia patients and that this can be practiced by a variety of specialists within a domiciliary nursing home, in clinical settings and also for people without dementia. Prevalent outcomes from the studies indicate that Doll therapy increases wellbeing and hence reduce challenging behaviors. The study connected the findings with theories such as Maslow’s hierarchy of needs and Erikson’s life stage approach to illustrate their importance of interaction as a need. The study has also provided some recommendations for the doll therapy to effective, dolls should be: soft bodies, eyes that open and close to avoid thought about doll being sleep or dead, clothing and skin color should reflect on gender/ethnicity. The limitation with these studies is the fact that the participants are all from the same geographical area which limits transferability of the results. Family and staff members should be encouraged and trained in doll therapy. I found the information much valid with the fact that most of the studies established the effectiveness of Doll therapy and its potential benefits for dementia patients thus the study but is very useful for my study.

Fernandez R, et al. (2014). Consequence of doll therapy in handling perplexing behaviors in persons with dementia: a systematic review. JBI Database of Systematic Reviews and Implementation Reports, 12(8), 330-363.

This study is descriptive, trying to describe how therapy affects disturbing behaviors in patients living with dementia doll. The authors sampled a number of the patients and observed them for a period of time. The study sampled six studies from various data bases with participants who are above the age of 18 and have been diagnosed with dementia. The participants had to be living in an unrestricted setting or a domiciliary accommodation. The interest in this study was to basically compare Doll therapy with pharmacology or other non-pharmacological interventions.

The studies were selected if they were randomized controlled trials, case control, cohort or descriptive in nature. The data was analyzed using meta-analysis statistical tools. Five of the studies indicated a major improvement in agitation and aggressive behaviors for patients after the Doll therapy and one illustrated a minor change. The findings of the study will really aid my study. Giving a dementia patient a doll to take care of it plays a significant role in enhancing a sense of belonging and responsibility. I found the study valid because the statement was backed up by evidence and hence very reliable in my study.

Edvardsson D et al. (2014). Routine actions for individuals with dementia in inhabited aged care: associations with person‐centredness and value of life. International Journal of Older People Nursing, 9(4), 269-276.

The purpose of this study was to attempt to understand the normal activities for aged folks with dementia in Sweden. The study sought to understand if the participation of residents in daily activities had an advanced superiority of life as equated to the residents that did not partake in daily activities. The authors had an aim to evaluate the method in which dementia residents involved themselves in daily activities such as preparing lunch, making phone calls, visiting friends, attending social gatherings among other events. The study used a sample of 1266 dwellers all from 156 domiciliary aged care nursing homes. This study used a cross sectional design to help gather valid and dependable facts on activity participation with the use of questionnaires. It was also explorative in trying to find out the difference between those who involved themselves with chores and those who did not. The main tool of data collecting here was the use of observation of the sample by the researcher over a period of time. The collected data was analyzed via SPSS, a statistical tool.

The results showed that only 18% of the residents partook in everyday activities for instance making coffee and cleaning or watering plants. 62% of them preferred to make out-of-doors walks, 27% participated in business establishment games while 13% of the rest participated in tours and church visits. This study illustrate that the residents who partook in daily activities subsisted in more person focused units and they had considerably advanced life importance as well as mental scores as equated to those that did not participate in daily activities. The limitation of this study is the fact that it used the cross sectional design which only consents the recognition of variances rather than the contributory directions.  I found this source valid and but not really very reliable to use for my study because it does not touch on Doll therapy.

Stephens A et al. (2013). An exploration into the relationships people with dementia has with physical objects: An ethnographic study. Dementia, 12(6), 697-712.

This study was conducted to try and understand the way that persons with dementia use the items that are around them and to understand whether they are able to apply the objects transitionally. The authors of this study applied the descriptive design through the use of the ethnography method to conduct the study and applied Winnicott’s theory to elaborate the results. This method employed the use of observation and interviews to acquire data; it involved the collection of data from the sample of people existing with dementia and their caregivers through interviews and observation. The participants of the study were 21 residents and 27 staff members of Woodleigh care for people with dementia. 30 hours of surveillance were accomplished over a two years period where data included behavior observation of both the staff and the residents. Data collected was analyzed using statistical tools and presented on graphs. The results confirmed that people with dementia perceived transitional and precursor objects such as dolls with some sense of ownership and they were negatively affected when they were taken away from them. The findings of the study are reliable and valid since it was backed up by data and the theory. I found this paper quite important and it will be very useful in my study.

 

 

 

References

  Edvardsson D et al. (2014). Everyday activities for people with dementia in residential aged care: associations with person‐centredness and quality of life. International Journal of Older People Nursing, 9(4), 269-276.

Fernandez R, et al. (2014). Effect of doll therapy in managing challenging behaviors in people with dementia: a systematic review. JBI Database of Systematic Reviews and Implementation Reports, 12(8), 330-363.

Mitchell G. & O’Donnell H. (2013). Therapeutic use of doll therapy in dementia.  “British Journal of Nursing”. 22(6)

Pezzati R., et al. (2014). Can Doll therapy preserve or promote attachment in people with cognitive, behavioral, and emotional problems?

Stephens A et al. (2013). An exploration into the relationships people with dementia has with physical objects: An ethnographic study. Dementia, 12(6), 697-712.

Turner F. & Shepherd M. (2014). Doll Therapy in dementia care: A review of current literature. Communicare1(1).