6-12-2010 Presentatietitel: aanpassen via

Beeld, Koptekst en voettekst

1

‘The Chitchatters’: a leisure activity for people with

dementia to stimulate social interaction.

N. Nijhof Msc., dr. J.E.W.C.van Gemert-Pijnen, H. van Rijn Msc., dr. J. van Hoof, prof. dr. E.R.Seydel

30 november 2010

6-12-2010Research results ‘the Chitchatters’ 2

Introduce…

PhD student University of Twente

www.eHealthresearchcentre.com

Projectmanager Focus Cura

www.focuscura.nl

Dementia worldwide

If dementia care were a country, it would be the world’s 18th largest

economy, ranking between Turkey and Indonesia.

If it were a company, it would be the world’s largest by annual

revenue exceeding Wal-Mart (US$414billion) and Exxon Mobil

(US$311 billion).1

1. Alzheimer’s Disease International. World Alzheimer Report, The Global impact of dementia, 2010

6-12-2010Research results ‘the Chitchatters’ 4

Dementia

Use of leisure activities for people with dementia

Use of technology innovative in leisure activities

Use of technology focus on safety and monitoring for people with

dementia

Scientific research shows us that leisure activities can support:

- make someone feel comfortable

- create social contact

- prevent boredom

- prevent isolation

- prevent agitation 1

1. Sterns HL, Camp CJ. Applied gerontechnology. Applied Psychology. 1998;47:175-198.

6-12-2010Research results ‘the Chitchatters’ 6

The Chitchatters (www.deklessebessers.nl)

Movie

http://www.klessebessers.nl/

?page_id=6

6-12-2010Research results ‘the Chitchatters’ 7

Research question

How does the Chitchatters game

differentiate in terms of social interaction

compared to the Questiongame and are

their differences in behavior in relation to

the MMSE score?

Research

Morning: Chitchatters (45 min) Afternoon: Questiongame (45 min)

(with technology) (without technology)

Social interaction

(Oshkosh Behavior Coding Scale)1

1. McFadden SH, Lunsman M, Andel R. Comparative analysis and interrater reliability of the Oshkosh

Social Behaviors Checklist (OSBC) for persons with dementia. Poster session presented at: the meeting

of the Gerontological Society of America; 2007 November; San Francisco, CA.

6-12-2010Research results ‘the Chitchatters’ 9

Study and Research design

Study design

4 different groups from 3 to 8 persons assisted by 1 or 2 activity therapists

Games were played twice in period October and November 2009

Research design

Two researchers observed

Video taped all the sessions

Oshkosh: verbal/nonverbal/activism (category) and person-/other-initiated

(21 behavioral codes)

Analyzed by SPSS 16.0; paired sample t-test (quantitative)

Semi structured interviews 6 therapists (qualitative)

Participants: N=21, 9 males, 12 females, Mean MMSE= 17, Range MMSE

3-28

6-12-2010Research results ‘the Chitchatters’ 10

Method: Oshkosh (behavior scale)

Verbal, non-verbal and activism

Behavior; person initiated, therapist initiated and activity initiated

21 codes:

- comments

- questions

- smiling

- touching

- sleeping

- wandering

- etc. -> cross the codes

6-12-2010Research results ‘the Chitchatters’ 11

Method: Oshkosh

6-12-2010Research results ‘the Chitchatters’ 12

Method: Oshkosh

6-12-2010Research results ‘the Chitchatters’ 13

Results data analysis

Person level:

Significant differences for 3 persons between games:

• Less handling objects for KB (p=0,049, MMSE=14; p=0,042,

MMSE=28)

• Less talking to self for KB (p=0,042, MMSE=14)

• Less sentences responses for KB (p=0,049, MMSE=3)

6-12-2010Research results ‘the Chitchatters’ 14

Results data analysis

Behavioral code differences between games:

• Less comments for KB (p=0,005)

• Less sentences responses for KB (p=0,000)

• More story responses for KB (p=0,011)

• Less questions for KB (p=0,028)

• Less sing/hum/whistle for KB (p=0,002)

• Less talking to self for KB (p=0,035)

• More observing/listening for KB (p=0,007)

• More wandering for KB (p=0,020)

• Less handling objects for KB (p=0,000)

6-12-2010Research results ‘the Chitchatters’ 15

Results data analysis

Behavioral category differences between games:

• Less verbalism for KB (p=0,000)

• Less activism for KB (p=0,000)

Behavior initiated differences between games:

• Less person initiated for KB (p=0,043)

• Less activity therapist initiated for KB (p=0,005)

6-12-2010Research results ‘the Chitchatters’ 16

Results data analysis

MMSE differences for the Chitchatters:

MMSE <10 = low

• Less comments for low MMSE (p=0,028)

• Less story responses for low MMSE (p=0,0045)

• More fidgeting/rocking for low MMSE (p= 0,0045)

• More non verbal behavior for low MMSE (p=0,016)

6-12-2010Research results ‘the Chitchatters’ 17

Results coding interviews

Easy to use, sometimes checking ‘how it works’

Supportive in work

Supports interaction

Lights aren’t noticed by the patients

Choosing fragments is desirable

Explanation fragments is desirable

Hasn’t been used that much

Teaching patient is necessary

Unnatural not pointing out to object

6-12-2010Research results ‘the Chitchatters’ 18

Conclusions

The Chitchatters:

• stimulate more and more advanced conversations without distraction

• makes people more wandering during the game

• prompts communication

• supports activity therapists in their work

• stimulate especially for persons with high MMSE (>10)

• is easy to use and easy to understand

The Chitchatters is a suitable leisure activity to stimulate social

interaction, it supports activity therapist in their work, but the

content of the Chitchatters should be focused more on younger

people with dementia as well.

6-12-2010Research results ‘the Chitchatters’

’

19

Contact and questions?

Nienke Nijhof

n.nijhof@utwente.nl

6-12-2010Research results ‘the Chitchatters’

’

20

Discussion

Technology shouldn’t be used in leisure

activities for people with dementia, it

causes stress and agitation, cause

they’re not used to it.