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Biomedical subjects

R T Woods

Publications and source records attributed to R T Woods.

At least 19 recordsLinked to original sources
PubMed2003

Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia.

BACKGROUND: Memory problems are a defining feature of the early stages of Alzheimer's disease (AD) and vascular dementia. Cognitive training and cognitive rehabilitation are specific approaches designed to address everyday memory difficulties. OBJECTIVES: The main aim was to evaluate the effectiveness and impact of cognitive training and cognitive rehabilitation interventions aimed at improving memory functioning for people in the early stages of Alzheimer's disease or vascular dementia. The two types of intervention were considered separately. SEARCH STRATEGY: The CDCIG Specialized Register, which contains records from MEDLINE, EMBASE, CINAHL, PsycINFO and many other databases, was searched on 9 April 2003. SELECTION CRITERIA: RCTs comparing cognitive rehabilitation or cognitive training interventions with comparison conditions, and reporting outcomes for the person with dementia and/or the family caregiver, were considered for inclusion. DATA COLLECTION AND ANALYSIS: Six studies reporting cognitive training interventions were included. Statistical analyses were conducted to provide an indication of intervention effect sizes. Data from ordinal scales was treated as continuous, and a fixed effects model was applied in calculating weighted mean differences and 95% confidence intervals. No studies were found that reported a fully individualised cognitive rehabilitation approach. MAIN RESULTS: None of the six studies reporting cognitive training interventions demonstrated any statistically significant effects in any domain, although there were indications of some modest, non-significant effects in various domains of cognitive functioning. REVIEWER'S CONCLUSIONS: The present findings do not provide strong support for the use of cognitive training interventions for people with early-stage AD or vascular dementia, although these findings must be viewed with caution due to the limited number of RCTs available and to the methodological limitations identified, and further well-designed trials would help to provide more definitive evidence. Due to a complete absence of RCTs evaluating an individualised cognitive rehabilitation approach, It is not possible at present to draw conclusions about the efficacy of individualised cognitive rehabilitation interventions for people with early-stage dementia, and further research is required in this area.

Alzheimer Disease↗
PubMed2001

Functional analysis of challenging behaviour in dementia: the role of superstition.

BACKGROUND: Intervention for challenging behaviour of residents living in care homes is a neglected area of research. Pharmacological methods of management are widespread, although support for their efficacy is, on the whole, poor. AIMS: There is little research on non-pharmacological methods of management and the present study aimed to add to the small literature in this area, by examining the meaning of behaviour for a given resident, within a functional analytic experimental framework. METHODS: The study involved a systematic manipulation of specific trigger situations to evaluate their influence on challenging behaviour, using a single case experimental design. RESULTS: Five residents with agitated and aggressive behaviour were successfully managed. The difficulties in engaging staff in the use of non-pharmacological, rather than pharmacological, methods and the scope for future randomised trials using psychological and environmental interventions to manage challenging behaviour, are discussed.

Aged↗
PubMed2001

Discovering the person with Alzheimer's disease: cognitive, emotional and behavioural aspects.

The person-centred approach to dementia care emerges from a new emphasis on the experience of the person with dementia. The person is seen as attempting to manage and cope with their difficulties, through a variety of coping mechanisms. Some are able to seek to maximize their cognitive capacities, and there are a number of strategies now available to assist in this process. However, the emotional aspects merit increased attention, with more awareness needed of the range of powerful emotions that may be present, and of the possibility of therapeutic interventions to alleviate symptoms of anxiety and depression. Many of the difficult behaviours seen in dementia may be understood more fully with an appreciation of their emotional underpinning, in feelings of anger, fear, insecurity and hopelessness. The interaction between caregiver strain and challenging behaviour also merits further exploration. The person-centred approach has many implications for practice, as well as for research. The perspective of the person with dementia, and outcomes reflecting that perspective, must be represented in research studies in dementia care. Caregivers, whether family members or paid workers, require additional support in order to recognize the person's needs and to meet them in ways which enable the person's identity and full human value to be upheld.

Affective Symptoms↗
PubMed2000

Reminiscence therapy for dementia.

BACKGROUND: Reminiscence Therapy (RT) has been defined as vocal or silent recall of events in a person's life, either alone, or with another person or group of people. It typically involves group meetings, at least once a week. in which participants are encouraged to talk about past events, often assisted by aids such as photos, music, objects and videos of the past. There is, often, little consistent application of psychological therapies in dementia services. A number of these 'therapies' were greeted with enthusiasm by health care practitioners in understimulating care environments. They were expected to work miracles and their 'failure' to do this has led to their widespread disuse. A systematic review of the available evidence is important in order to identify the effectiveness of the different therapies. Subsequently, guidelines for their use can be made on a sound evidence base. OBJECTIVES: RT involves groups of elderly people talking of past events, assisted by aids such as videos, pictures and archives, as a means of communicating and reflecting upon their life experiences. The objective of the review is to assess the effects of RT for dementia. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register, MEDLINE, PSYCHLIT, EMBASE, OMNI, BIDS, Dissertation Abstracts International, SIGLE and reference lists of relevant articles up to 1998, and we contacted specialists in the field. We also searched relevant internet sites and we handsearched Aging and Mental Health, the Gerontologist, Journal of Gerontology, Current Opinion in Psychiatry, Current Research in Britain: Social Sciences, British Psychological Society conference proceedings and Reminiscence database. SELECTION CRITERIA: Randomised controlled trials and quasi-randomised trials of RT for dementia in elderly people. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. MAIN RESULTS: Two trials are included in the review, but only one trial with 15 participants had extractable data. The results were statistically non-significant for both cognition and behaviour. REVIEWER'S CONCLUSIONS: No firm conclusions could be reached regarding the effectiveness of RT for dementia. The review highlighted the urgent need for more systematic research in the area.

Dementia↗
PubMed1991

Gender differences in carers of dementia sufferers.

Recent research shows that the demands of the caregiving role are experienced differently by men and women. Both the subjective and the objective strain and burden appear to be greater in female carers of dementia sufferers, and factors that influence this include differences in role expectations and coping strategies. These findings have implications for the provision of services for dementia sufferers and their carers.

Adaptation, Psychological↗
PubMed1990

Daughters of people with dementia. Expressed emotion, strain and coping.

Twenty-five women who were the primary carers for a parent with dementia rated for expressed emotion (EE) and then divided into two groups: 11 with low-EE ratings and 14 with high-EE ratings. Although there were no differences between these groups in the levels of their parents' cognitive impairment, when such impairment was taken into account, high-EE subjects were found to report higher levels of strain and distress. More efficient coping strategies were reported by subjects who made fewer critical comments and more positive remarks. High-EE subjects more frequently had no living siblings, and were more likely to have had a respite break from caring. EE status was not associated with continuing care in the community at a nine-month follow-up.

Adaptation, Psychological↗
PubMed1986

Automated cognitive assessment of elderly patients: a comparison of two types of response device.

Groups of 14 cognitively impaired elderly people were tested on two automated cognitive tests on several occasions. Patients registered their responses using either a touch-sensitive screen or a board with illuminated response buttons. The results indicate that the touch-sensitive screen is probably a more suitable response device than the button-board. Suggestions that it would prove disadvantageous to elderly patients were not supported, and its continued use is recommended.

Aged↗
PubMed1984

Effect of family relationships on psychogeriatric patients.

Severe strain has been repeatedly reported in the families of psychogeriatric patients. Nevertheless, many families continue to provide a great deal of support, despite the undoubted burden involved. A retrospective study of short-term outcome in 60 psychogeriatric referrals demonstrated the importance of some aspects of the relationship between the patient and their key supporting relative. In the sample as a whole, and in functional patients, the extent to which a positive communication system existed was significant. In patients with dementia, poor outcome was related to the patient being less dependent and more dominant in their interaction with the relative. The implications of this study for intervention and future research are discussed.

Aged↗
PubMed1983

Why do we assess the aged?

The relevance of assessment to the psychological management of elderly patients is outlined. Issues raised by Kendrick (1982) and Rabbitt (1982) are discussed in this context.

Aged↗
PubMed1979

Reality orientation and staff attention: a controlled study.

A trial was carried out of Reality Orientation (R.O.) in a residential home for the elderly mentally infirm with a 'social therapy' control group, receiving the same amount of staff attention as the R.O. group, in addition to an untreated control group. R.O. residents improved more on tests of information and orientation and various aspects of memory than controls. These results support the hypothesis that the nature of staff attention is crucial and that it should encourage and reward appropriate behaviour. No differential effects of treatment were found on rating scale assessments of the resident's functioning in the home.

Aged↗
PubMed1977

Psychological approaches to the treatment of the elderly.

Various psychological approaches to the treatment of elderly patients (including activity and stimulation programmes, reality orientation, environmental approaches and behabiour modification) are discussed with regard to their efficacy and those features that approaches claiming success have in common. The importance of the attitudes of the care staff is discussed, especially in relation to the consistency and intensity of application of treatment programmes. It is argued that the behavioural model is a useful starting point for future progress, and that much of the present literature is comprehensible in this framework.

Aged↗