Free Nursing Dissertations - Both Studies From The Systematic Review By Bates Et Al (2004) Included The
Both studies from the systematic review by Bates et al (2004) included the MMSE and Geriatric Depression Scale (GDS) as outcome measures, but there were differences in the time frame, rate of attrition, how reality orientation therapy was delivered and sample size between studies. Baseline MMSE scores for the dementia patients were similar, suggesting that there were clinically approximate populations in terms of cognitive functioning. In the study by Zanetti and colleagues, a statistically significant difference in cognitive ability, as measured by the MMSE scores, between the treatment group and control group was observed. However, no statistically significant differences were recorded in communication, cognitive ability measured through a memory task, functional performance and well-being of the patients. In a second study by Baldelli and colleagues, a significant improvement was found in the treatment group in terms of cognitive ability and functional performance but there was no statistically significant differences in both groups. In this study, follow up data were obtained from patients three months after the intervention stopped and it showed that treatment effects were enduring. As Bates et al (2004) suggest, there is evidence that reality orientation is an effective intervention in improving cognitive ability, as measured using the MMSENeither study demonstrated that reality orientation is effective in improving well-being, as measured by the GDS. Finally, no evidence as found that reality orientation is effective in improving communication, functional performance and cognitive ability measured in terms of memory recall (p 651). One study by Zanetti and colleagues (1997) was reviewed that evaluated the procedural memory stimulation method. This compared 10 dementia patients, to 10 adult controls. Cognitive ability and functional performance was recorded before and after the intervention for each participant, but no statistically significant improvement was found after treatment. The researchers had concluded that the treatment had not been beneficial on the patients, but they failed to consider that their low sample size may have affected their ability to achieve a statistically significant result. A further study by LaBarge and colleagues was included in the systematic review that was a standard counselling intervention on dementia patients. There were 19 research participants and 8 of these had diagnosed mild dementia. The intervention comprised of two 50 minute counselling sessions, but the first session was used for assessment and test taking activities. The second session provided an opportunity for patients to ‘ventilate’ their concerns about their illness and receive information from professionals.
