Effects of Drama Therapy on Depressive Symptoms, Attention, and Quality of Life in Patients With Dementia

10.1097/jnr.0000000000000468

Li-Wei LIN；Yi-Hsin LU；Tasi-Hsiu CHANG；Shu-Hui YEH

dementia ； drama therapy ； depressive symptoms ； attention ； quality of life

The Journal of Nursing Research

30卷1期（2022 / 02 / 01）

1 - 9

英文

Background: The prevalence of dementia in Taiwan continues to rise, and related patient care is becoming challenging for family members and caregivers. Nondrug treatments are often used as a care strategy to alleviate the behaviors associated with worsening dementia. Many international researchers have examined the effectiveness of drama therapy on dementia care. However, there is a lack of related studies in Taiwan. Purpose: The aim of this study was to examine the effects of drama therapy in terms of improving depressive symptoms, attention, and quality of life in patients with senile dementia. Methods: A two-group pretest-and-posttest design was employed in this randomized controlled trial. Cluster sampling was employed at four dementia daycare centers in central Taiwan. Two centers were randomly assigned to the experimental group, and the other two centers were assigned to the control group. Results: Forty-two patients with dementia (23 in the experimental group and 19 in the control group) participated in this study. The study results showed that, after 8 weeks of drama therapy, the experimental group showed a significant improvement in depressive symptoms (β= -5.07, p ＜ .001), attention (β=5.86, p ＜ .001), and quality of life (β= -6.08, p ＜ .001). Furthermore, after 12weeks of drama therapy, the experimental group continued to show a significant improvement in depressive symptoms (β= -4.65, p ＜ .01), attention (β= 6.76, p ＜ .001), and quality of life (β= -4.94, p ＜ .01). Conclusions: On the basis of the results of this study, patients with senile dementia who participate in 8- and 12-week drama therapy programs significantly improved in terms of depressive symptoms, attention, and quality of life. The authors hope that the findings of this study provide a reference for the intervention method, content, frequency, and timing of drama therapy in patients with dementia.

1. Hsiao, C.-Y.,Chen, S.-L.,Hsiao, Y.-S.,Huang, H.-Y.,Yeh, S.-H.(2020).Effects of art and reminiscence therapy on agitated behaviors among older adults with dementia.The Journal of Nursing Research,28(4),Article e100.
   連結：
2. Lin, J.-N.,Wang, J.-J.(2008).Psychometric evaluation of the Chinese version of the Cornell Scale for Depression in Dementia.The Journal of Nursing Research,16(3),202-210.
   連結：
3. Wang, Y.-N.,Hsu, W.-C.,Shyu, Y.-I. L.(2020).Job demands and the effects on quality of life of employed family caregivers of older adults with dementia: A cross-sectional study.The Journal of Nursing Research,28(4),Article e99.
   連結：
4. Wu, M.-C.,Tsai, S.-Y.,Sung, H.-C.(2016)。Development of guideline for screening and detecting depression in older adults。Journal of Tzu Chi University of Science and Technology，3，1-28。
   連結：
5. Albert, S. M.,Del Castillo-Castaneda, C.,Sano, M.,Jacobs, D. M.,Marder, K.,Bell, K.,Bylsma, F.,Lafleche, G.,Brandt, J.,Albert, M.,Sterm, Y.(1996).Quality of life in patients with Alzheimer's disease as reported by patient proxies.Journal of the American Geriatrics Society,44(11),1342-1347.
6. Alexopoulos, G. S.,Abrams, R. C.,Young, R.-C.,Shamoian, C. A.(1988).Cornell scale for depression in dementia.Biological Psychiatry,23(3),271-284.
7. American Psychiatric Association(2014).Desk reference to the diagnostic criteria from DSM-5 (Taiwanese Society of Psychiatry).Ho-Chi.
8. Barca, M. L.,Engedal, K.,Selbaek, G.,Knapskog, A.-B.,Laks, J.,Coutinho, E.,Benth, J. Š.(2015).Confirmatory factor analysis of the Cornell scale for depression in dementia among patient with dementia of various degrees.Journal of Affective Disorders,188,173-178.
9. Boersma, P.,Van Weert, J. C. M.,van Meijel, B.,van de Ven, P. M.,Dröes, R.-M.(2018).Study protocol implementation of the Veder contact method (VCM) in daily nursing home care for people with dementia: An evaluation based on the RE-AIM framework.Aging & Mental Health,21(7),730-741.
10. Davidson, J. W.,Fedele, J.(2011).Investigating group singing activity with people with dementia and their caregivers: Problems and positive prospects.Musicae Scientiae,15(3),402-422.
11. De Vreese, L. P.,Uberti, M.,Mantesso, U.,De Bastiani, E.,Weger, E.,Marangoni, A. C.,Weiner, M. F.,Gomiero, T.(2012).Measuring quality of life in intellectually disabled persons with dementia with the Italian version of the Quality of Life in Late-Stage Dementia (QUALID) scale.Journal of Alzheimer's Disease & Parkinsonism,2(1),Article 104e.
12. Emunah, R.(2015).Self-revelatory performance: A form of drama therapy and theatre.Drama Therapy Review,1(1),171-85.
13. Holm, A. K.,Lepp, M.,Ringsberg, K. C.(2005).Dementia: Involving patients in storytelling-A caring intervention. A pilot study.Journal of Clinical Nursing,14(2),256-263.
14. Jaaniste, J.,Linnell, S.,Ollerton, R. L.,Slewa-Younan, S.(2015).Drama therapy with older people with dementia-Does it improve quality of life?.The Arts in Psychotherapy,43,40-48.
15. Jones, P.(1996).Drama as therapy: Theatre as living.Psychology Press.
16. Kim, S.,Park, M. H.,Han, S.-H.,Na, H. R.,Cho, S.,Choi, M. S.,Lee, J. H.,Na, D. L.,Kimi, J. E.,Park, K. W.(2011).Validation analysis of the attention questionnaire scale.Journal of Alzheimer's Disease,24(2),393-402.
17. Logsdon, R. G.,Gibbons, L. E.,McCurry, S. M.,Teri, L.(2002).Assessing quality of life in older adults with cognitive impairment.Psychosomatic Medicine,64(3),510-519.
18. Lu, Y.-H.,Kuo, W.-L.,Chao, S.-C.,Lin, L.-W.(2020)。Application of drama therapy in dementia care。Cheng Ching Medical Journal，16(4)，73-78。
19. Mechaeil, R.,Graybow, A.,Cobham, P.(2010).Towards a purposeful ending: A study exploring the impact of dramatherapy on the quality of life of people suffering from dementia.Dramatherapy,31(2),27-34.
20. Ministry of Health and Welfare. (2021). Dementia prevention and care policy and action plan 2.0 (2018–2025). Retrieved July 12, 2021, from https://1966.gov.tw/LTC/cp-4020-42469-201.html (Original work published in Chinese)
21. Mjørud, M.,Kirkevold, M.,Røsvik, J.,Engedal, K.(2014).Principal component analysis of the Norwegian version of the Quality of Life in Late-Stage Dementia scale.Dementia and Geriatric Cognitive Disorders,37,265-275.
22. Sherratt, K.,Thornton, A.,Hatton, C.(2004).Emotional and behavioural responses to music in people with dementia: An observational study.Aging & Mental Health,8(3),233-241.
23. Smith, S. C.,Lamping, D. L.,Banerjee, S.,Harwood, R. H.,Foley, B.,Smith, P.,Cook, J. C.,Murray, J.,Prince, M.,Levin, E.,Mann, A.(2007).Development of a new measure of healthrelated quality of life for people with dementia: DEMQOL.Psychological Medicine,37(5),737-746.
24. Taiwan Alzheimer Disease Association. (2021). Estimated population of dementia in Taiwan. Retrieved April, 2021, from http://www.tada2002.org.tw/About/IsntDementia (Original work published in Chinese)
25. van Dijk, A. M.,van Weert, J. C. M.,Dröes, R.-M.(2012).Does theatre improve the quality of life of people with dementia?.International Psychogeriatrics,24(3),367-381.
26. Wilkinson, M.,Srikumar, S.,Shaw, K.,Owwell, M.(1998).Drama and movement therapy in dementia: A pilot study.The Arts in Psychotherapy,25(3),195-201.
27. World Health Organization. (2020). Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia
28. Zeisel, J.,Skrajner, M. J.,Zeisel, E. B.,Wilson, M. N.,Gage, C.(2018).Scripted-IMPROV: Interactive improvisational drama with persons with dementia-Effects on engagement, affect, depression, and quality of life.American Journal of Alzheimer's Disease & Other Dementias,33(4),232-241.