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Table 3 Results for effectiveness of activity-based interventions to improve experience of care outcomes for Plwd in hospital

From: Activity interventions to improve the experience of care in hospital for people living with dementia: a systematic review

Study

Outcome (tool)

Comparison group

(or pre-intervention)

Intervention group

(or post-intervention)

Effect size

d (95% CI)

Mean difference

(95% CI)

p

Significant change

N

Mean

SD

N

Mean

SD

DiNapoli et al. [36] (2016)

Quality of life (DQoL)

13

3.27

0.72

21

3.64

0.66

0.53 (− 0.17 to 1.23)

0.37 (− 0.12 to 0.86)

0.13

↔

BPSD (NRS-R)

26

10.04

6.97

26

7.19

5.58

−0.45 (− 0.99 to 0.11)

−2.85 (−6.37 to 0.67)

0.11

↔

Gitlin et al. [37] (2016)

Emotional state (pleasure-AARS)

10

9.9

range 2–20

15

13.76

range 0–57

NA

(increase)

NA

NA

Mood (general alertness-AARS)

10

88.7

range 45–139

15

75.68

range 17–174

NA

(decrease)

NA

NA

Mood (anxiety and anger-AARS)

10

22.6

range 0–34

15

5.3

range 0–29

NA

(decrease)

NA

NA

Patient engagement (positive verbalisations)

10

56.2

range 15–126

15

40.67

range 0–116

NA

(decrease)

NA

NA

Patient engagement (negative verbalisations)

10

17.5

range 0–84

15

5.58

range 0–32

NA

(decrease)

NA

NA

Patient engagement (positive nonverbal)

10

38.6

range 9–65

15

41.87

range 1–152

NA

(increase)

NA

NA

Patient engagement (negative nonverbal)

10

11.6

range 0–21

15

5.72

range 0–36

NA

(decrease)

NA

NA

Weber et al. [38] (2009)

Patient engagement (therapeutic progress-GES)

76

NA

NA

76

NA

NA

NA

(increase, β = 2.01)

0.04

↑

Behaviour-Neuropsychiatric symptoms (NPI)

76

NA

NA

76

NA

NA

NA

(decrease, β = −4.21)

< 0.001

↑

Cheong et al. [39] (2016)

Mood (pleasure and general alertness-OERS)

25

0.68

NA

25

3.12

NA

NA

(increase)

0.01

↑

Mood (anger, anxiety and sadness-OERS)

25

0.48

NA

25

0.32

NA

NA

(decrease)

0.05

↑

Patient engagement (Constructive & passive-MPES)

25

6.26

NA

25

8.0

NA

NA

(increase)

0.01

↑

Patient engagement (self- and non-engagement-MPES)

25

1.04

NA

25

0.72

NA

NA

(decrease)

0.01

↑

Daykin et al. [40] (2017)

Mood (happiness-ArtsObs)

20

NA

NA

20

NA

NA

NA

(increase)

NA

NA

Patient engagement (relaxation, distraction, engagement-ArtsObs)

20

NA

NA

20

NA

NA

NA

(positive impact)

NA

NA

Behaviour (agitation-ArtsObs)

20

NA

NA

20

NA

NA

NA

(decrease)

NA

NA

Windle et al. [41] (2018)

Quality of life (DEMQOL self-report, 3 months)

15

91.5

14

13

92.5

10.7

0.08 (−0.67 to 0.82)

1.0 (−8.80 to 10.80)

0.84

↔

Quality of life (DEMQOL self-report, 6 months)

15

91.5

14

12

90.3

14.6

− 0.08 (− 0.84 to 0.68)

−1.20 (− 12.58 to 10.18)

0.83

↔

Quality of life (DEMQOL proxy, 3 months)

19

86.7

12.6

9

96.3

10.2

0.78 (− 0.04 to 1.60)

9.60 (− 0.31 to 19.51)

0.06

↔

Quality of life (DEMQOL proxy, 6 months)

19

86.7

12.6

4

85.5

15.6

−0.09 (−1.17 to 0.99)

− 1.20 (− 16.15 to 13.75)

0.87

↔

Patient engagement (communication*, 3 months)

19

12.9

9.5

15

19.3

10

0.64 (−0.05 to 1.34)

6.40 (−0.44 to 13.24)

0.07

↔

Patient engagement (communication*, 6 months)

19

12.9

9.5

9

20.7

10.9

0.76 (−0.06 to 1.58)

7.80 (−0.48 to 16.08)

0.06

↔

Wellbeing domains (GCCWBOT, 2 weeks)

          

Interest

18

52.5

28.9

20

50.5

18.8

−0.08 (−0.72 to 0.56)

−2.0 (−17.88 to 13.88)

0.80

↔

Attention

18

67.5

21

20

71.9

16.5

0.23 (−0.41 to 0.87)

4.4 (−7.96 to 16.76)

0.48

↔

Pleasure

18

26

22.2

20

25.9

14.0

−0.01 (−0.64 to 0.63)

−0.10 (−12.18 to 11.98)

0.99

↔

Normalcy

18

46.1

20.2

20

41.5

15.3

−0.25 (−0.89 to 0.39)

−4.60 (−16.32 to 7.12)

0.43

↔

Self-esteem

18

29.2

5.5

20

27.9

6.4

−0.21 (−0.85 to 0.43)

−1.30 (−5.25 to 2.65)

0.51

↔

Disengagement

18

19.8

25.0

20

19.0

24.0

−0.03 (−0.67 to 0.60)

−0.80 (−16.93 to 15.33)

0.92

↔

Sadness

18

2.1

6.4

20

2.1

7.0

0.0 (−0.64 to 0.64)

0.0 (−4.43 to 4.43)

1.00

↔

Negative affect

18

2.8

5.0

20

1.3

2.9

−0.36 (−1.01 to 0.28)

−1.50 (−4.16 to 1.16)

0.26

↔

Wellbeing domains (GCCWBOT, 3 months)

          

Interest

18

52.5

28.9

12

47.9

18.3

−0.18 (−0.91 to 0.55)

−4.6 (−23.89 to 14.69)

0.63

↔

Attention

18

67.5

21

12

69.5

20.4

0.09 (−0.64 to 0.82)

2.00 (−13.85 to 17.85)

0.80

↔

Pleasure

18

26

22.2

12

25.5

18.9

−0.02 (−0.75 to 0.71)

−0.50 (−16.51 to 15.51)

0.95

↔

Normalcy

18

46.1

20.2

12

44.3

13.8

−0.10 (−0.83 to 0.63)

−1.80 (−15.51 to 11.91)

0.79

↔

Self-esteem

18

29.2

5.5

12

30

5.3

0.14 (−0.59 to 0.87)

0.80 (−3.34 to 4.94)

0.70

↔

Disengagement

18

19.8

25.0

12

15.9

16

−0.17 (−0.90 to 0.56)

−3.90 (−20.63 to 12.83)

0.64

↔

Sadness

18

2.1

6.4

12

0.4

1.3

−0.33 (−1.06 to 0.41)

−1.70 (−5.56 to 2.16)

0.37

↔

Negative affect

18

2.8

5.0

12

1.7

2.6

−0.25 (−0.99 to 0.48)

−1.10 (−4.32 to 2.12)

0.49

↔

  1. AARS Apparent Affect Rating Scale, BPSD Behavioural and psychological symptoms of dementia, CI Confidence interval, d: Cohen’s d, DEMQOL Dementia Quality of Life, DQoL Dementia Quality of Life instrument, GCCWBOT Greater Cincinnati Chapter Well-Being Observation Tool, GES Group Evaluation Scale, MPES Menorah Park Engagement Scale, NRS-R Neurobehavioral Rating Scale-Revised, NA Indicates relevant data was not reported or calculable, OERS The Lawton Observed Emotion Rating Scale, SD Standard deviation, p-value: for the mean difference between groups/pre-post
  2. *: higher scores indicating more communication difficulties, ↑: statistically significant difference for outcome in this comparison and direction of effect beneficial for intervention group or post-test, ↓: statistically significant difference for outcome in this comparison and direction of effect not beneficial for intervention group or post-test, ↔: no statistically significant difference for outcome in this comparison