Critical Evaluation Assignment Help

Introduction

The aim of this report is to critically evaluate the journal article that deals with whether lifelike baby dolls can reduce symptoms of stress, anxiety, agitation or aggression for people suffering from dementia in long term care and understand the perceptions of care staff on the idea of doll therapy. Methods used in this research include pilot, parallel, mixed-method, randomised controlled trial with semi-structured interviews that will be used to conduct follow-ups. People living with dementia often face complex health and social crises and are in continuous need for support. The journal article considers the outcomes of using doll therapy on this population. This method has become increasingly popular as several benefits have been noted in small scale qualitative studies that have been conducted. The journal has been published by Australian authors in the English language and does not present any translation barriers. The qualifications of the author are highly relevant to the field of research that is being conducted and they are easily identified. The journal provides valuable insight into the field of psychotherapy and offers various outlines on handling long term care for patients suffering from dementia. The following critical evaluation will highlight the various areas that have been brought into focus by this article.

Title and Abstract

The title of any research paper makes a great deal of contribution to how it will be used for citations. A good title needs to be precise, clear, informative and descriptive and includes keywords that are likely to be used when searching for relevant information.b in this case, e ai of the study is to validate the effects and advantages of doll therapy on dementia patients as compared to usual facility care (Ng, et al. 2017). The aim is justifiably reflected in the title of the article.

The abstract needs to contain a concisely accurate summary of the paper and help the reader decide whether the paper contains information that will be relevant to their needs. In this case, the abstract accurately summarises the entirety of the paper and provides a clear outline of what can be expected of the research. The outcomes and failure rate how they can affect the future research that will be done in this field.

The literature cited in this review is comprehensive, up to date and relevant to the field of research. Research in the article is supported by seminal studies and provides highly influential insights that will provide the basis for further research in the future.

Research Design

The research design implemented in this study is a mixed-method pilot study that employed a two-group parallel, randomized controlled (RCT) trial, with followed descriptive semi-structured interviews using open-ended questions. RCTs are considered the gold standard in clinical research when it comes to evaluating the relationship between intervention and the desired outcome. This method is considered as the core of evidence-based practices and their results often guide clinical practice.

The research question in this particular study is conspicuous and relevant to the use of doll therapy and its effectiveness in treating dementia patients as compared to regular standard therapeutic care. Doll Therapy involves interactions between a person with dementia and anthropomorphic doll. Research elaborates the various ethical concerns that have been raised about using this method (Vaccaro, et al. 2020)). They include potential infantilization, a lack of dignity, encouragement and false beliefs. But several potential benefits have been presented by small scale qualitative studies. These benefits include improved communication, well being, social connections, socially appropriate behaviours and decrease in agitation. These benefits seem to arise from the development therapeutic bond that seemingly influences prosocial behaviours.

The tile used a total of 35 patients who were recruited from five LTC facilities located within a 10-mile radius of the Brisbane Central Business district. An independent randomisation service was used to randomly allocate either lifelike dolls or usual care to the designated group. In order to fulfil the qualitative components, five care staff from the three facilities were interviewed in a semi-structured manner with the use of open-ended questions. The interviews were digitally recorded with consent and professional transcribed verbatim and used for considerations in the later stage.

 

The Sample

The eligibility of the study included a dementia diagnosis. The inclusion criteria included. Individuals aged 65 and above who were diagnosed with dementia and had a documented history of anxiety, agitation and aggression within the last four weeks from when the study was conducted 65 such residents were recruited within the 60km radius of the Brisbane Central Business District and were contacted by LTC facility managers. redes were excluded if they had undergone doll therapy of any kind in their previous treatment sessions. An independent service was recruited to randomise the allocation of either lifelike dolls or usual care. Since a non-cluster group was used, residents from the same facility could be either group. Allocations of these groups were concealed from the staff of the face. The study was approved by the Griffith University Ethics Committee. Written informed consent was obtained from all the articles and verbal assent was sought from each resident at the start of the therapy. Registration of the trial was done with the Australian and New Zealand Trials Register in order to protect the rights and privacy of the trial.

Data Collection

The outcomes that were of relevance to the study were changes in the resident's behavioral pattern in which indicators included anxiety, agitation and aggression from the baseline to week 3. The outcomes were measured by coded video observation. The recordings were made once per week at the baseline and covered a total number of 40 minutes each time. Various demographic information was collected by RAs and included a face to face assessment of cognitive impairment as a proxy assessment of the indicting criterias. The project managers conducted the semi-structured interviews and were guided by nine basic questions that exposed the effectiveness of doll therapy.

All the interviews were done over the telephone and recorded digitally. This RCT mentioned no bias. Trials can often be vulnerable to biases pertaining to performance and reporting. These can indeterminate validity of the research (Fry, et al. 2017). Bias can occur if undivided trials are organized where recruiters selectively enroll participants that are relevant to the trials.  In this random stain eliminate the chance of any such bias.

 

Data Analysis

For the RCT the baseline statistics were computed in comparison to the data collected after the trial was completed the comparison of the intervention were examined to spot significant differences. Twenty percent of all data were checked with raw data files and paperwork. The interview transcripts were reviewed and analysed with thematic analysis being the identifying key (Mitchell, 2016). Two of team members were responsible for analysing and reaching consensus for each of the themes that was produced. Phrases were grouped into three themes the analyses table was constructed based on these quotations.

Results

Enrolled into the RCT were a total number of 35 residents who were from the LTC facilities. !8 of them were randomly given lifelike dolls and 17 were randomly subjected to usual care. Two of them dropped at the beginning of the trial. All the participants were female and there were similarities between the residents in the two groups at the baseline. No specific group time effects were found in all the outcomes of interest. A single group by time interest was found in the outcome of pleasure (Balzotti, et al. 2019). As the primary objective of the study no evidence was found that intervention with lifelike dolls reduced anxiety, aggression and agitation in the residents' behaviour. But uni-variate tests showed that the lifelike doll group showed a significant increase in leisure. The moderate to large effect size helps conclude that this is a significant finding and holds pertinent clinical meaning (Julian & Duran, 2020). There were no significant short term effects that can be mentioned. The study conducted with thoroughness essentially concluded that the use of lifelike doll intervention in cemetai patients did not have any significant change in the desired criteria (Vaccaro, et al. 2019). There was no improvement in the behaviour of the patient's anxiety, agitation and aggression.

Conclusion

Lifelike baby dolls are increasingly gaining prominence in the treatment of dementia as several small scales qualitative studies have shown that they have a number of potential benefits including improved communication, social connectedness and appropriate social behaviour. The study uses a randomised controlled trial to analyse patient behavior and check the facts of this to come to the conclusion of whether or not doll therapy yields better results in terms of cases related to dementia patients in comparison to regular care. The results show that there are no significant improvements in the indicators through interviews with caregivers show that there are some non facilitated psychoactive benefits to this therapy.

Relevance to Clinical Nursing Practice

The findings of this research support the fact that there is a need for more research in this particular field. The designs of these trials may need to be more innovative with larger sample size. The requirements would need to be stringent towards treatment fidelity and should focus on a standardised dose. Future studies should also consider a varied amount of time that should be based on their needs. The findings from this RCT can be used to recommend doll therapy therapy in clinical practice (Williams, 2017). But the subjects need to be monitored closely and it should be ensured that the staff monitors the level of interactions that the patient has with the doll. Residents should not be overburdened with the task of taking care of the doll.

Various other ethical concerns need to be kept in mind while recommending doll therapy. Staff should be mindful that doll therapy may not be suitable for all LTC residents with dementia. Even if a patient is responsive to the therapy in the first week they may not be receptive in the subsequent days. The study aims at finding the suitability for Doll therapy in dementia patients. For future clinical implications the study has established the doll therapy does not provide any improvement in the majority of areas that were taken as indicators. They might provide some residents with the feelings of enjoyment and purposeful enjoyment did not significantly reduce stress, anxiety, agitation or aggression (JJ, 2020). Limitations of this therapy include being not suitable for all patients of dementia. The interview with the staff yielded results as the staff perceived benefits that included a calming effect, emotional comfort and providing a purposeful activity.

The study found that doll therapy may be effective to a small portion of dementia residents. The therapy should be targeted. The different needs of the patient needs to be monitored and based on those needs the time of engagement should be recommended in order to achieve effective results. The doll therapy may only work in certain cases. In certain cases residents may show some improvement in the first week and then they may become unresponsive thus, eliminating any positive outcomes from the therapy. In conclusion it can be said that doll therapy may be effective in some cases on residents with dementia but the outcomes are limited and may only be effective for a limited period of time (Moyle, et al. 2019). In relevance to clinical practice staff should be focused on the needs of particular residents when it comes recommending doll therapy and the relevance of the therapy needs to be ensured in a fixed timeline in order to understand the implications and conclude whether it is effective or not.

 

 

References

Balzotti, A., Filograsso, M., Altamura, C., Fairfield, B., Bellomo, A., Daddato, F., ... & Altamura, M. (2019). Comparison of the efficacy of gesture?verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia. International journal of geriatric psychiatry, 34(9), 1308-1315.

Fry, L., Hamilton, S., Kobiessi, L., Ornelas, L., Sondgeroth, J., & Ziedonis, J. (2017). Innovative Use of Interactive Doll Therapy in Addressing Management of Dementia with Behaviors and Reducing Antipsychotic Usage. Journal of the American Medical Directors Association, 18(3), B16.

JJ, G. M. (2020). Design and validation of two scales about attitudes and knowledge regarding doll therapy in dementia. Revista Espanola de Geriatria y Gerontologia.

Julian, M. K., & Duran, J. (2020). Managing challenging behaviors in patients with dementia: The use of therapy dolls. Nursing made Incredibly Easy, 18(2), 38-45.

Mitchell, G. (2016). Doll Therapy in Dementia Care: Evidence and Practice. Jessica Kingsley Publishers.

Moyle, W., Murfield, J., Jones, C., Beattie, E., Draper, B., & Ownsworth, T. (2019). Can lifelike baby dolls reduce symptoms of anxiety, agitation, or aggression for people with dementia in long-term care? Findings from a pilot randomised controlled trial. Aging & mental health, 23(10), 1442-1450.

Ng, Q. X., Ho, C. Y. X., Koh, S. S. H., Tan, W. C., & Chan, H. W. (2017). Doll therapy for dementia sufferers: A systematic review. Complementary therapies in clinical practice, 26, 42-46.

Vaccaro, R., Ballabio, R., Molteni, V., Ceppi, L., Ferrari, B., Cantù, M., ... & Poletti, B. (2020). Doll therapy intervention for women with dementia living in nursing homes: a randomized single-blind controlled trial protocol. Trials, 21(1), 1-12.

Vaccaro, R., Molteni, V., Ballabio, R., Ceppi, L., Tropea, E., Cantù, M., ... & Pezzati, R. (2019). THE DOLL THERAPY STUDY ON EFFICACY FOR PEOPLE WITH DEMENTIA LIVING IN NURSING HOMES: PRELIMINARY RESULTS FROM A RANDOMIZED SINGLE-BLIND CONTROLLED TRIAL. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 15(7), P1169.

Williams, N. N. (2017). Effects of Doll Therapy on Dementia Resident's Negative Behaviors (Doctoral dissertation, Brandman University).

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