Cognitive stimulation therapy (CST) for dementia: a systematic review of qualitative research

Abstract

Introduction: Cognitive Stimulation Therapy (CST) is a well-established intervention for people with dementia shown to improve cognition and quality of life. Past research includes development of a longer term 'maintenance CST' and an individual CST programme. Previous reviews of CST have focused on quantitative outcomes or excluded certain formats of CST. This review aimed to fill this gap by evaluating how the voices of facilitators, carers and people with dementia in qualitative studies of CST can contribute to our understanding of its implementation and how it is experienced. Methods. The current systematic review explored the experience and perspectives of people with dementia, facilitators and carers. Thematic Analysis (Braun and Clarke, 2012) was used to analyse this data, alongside Thomas and Harden's (2008) guidance on synthesising qualitative findings. Results.A systematic literature search retrieved 10 relevant studies using qualitative methodology. Eighteen themes were generated, which were grouped into three categories: 'Acceptability and feasibility', 'Features of CST' and 'Key outcomes'. Conclusions.To our knowledge, this is the only review to explore solely qualitative studies of CST. Findings provided insight into the shared features, outcomes and factors affecting implementation, and suggested theories for discrepancies between quantitative and qualitative findings in the literature. Some of the common themes were also in keeping with past reviews.

A New Approach for Developing “Implementation Plans” for Cognitive Stimulation Therapy (CST) in Low and Middle-Income Countries: Results From the CST-International Study

“…The most common individual rating for activities was 6 (Desirable and Intermediate), however, there was a large amount of variance in responses. For example, the activity “psychoeducation should include information on the underlying pathology of neurodegenerative diseases” was rated as advisory and difficult ( 1 ) by two responders and essential and easy ( 11 ) by two responders. All activities were discussed at a local team meeting, with reference to how many could be implemented and the prioritization of those activities that were rated as both essential for implementation and easy to use.…”

“…CST has also been widely implemented in UK National Health Service (NHS) Memory Clinics (7) and is consistently recommended for people with dementia in the UK (8,9). Whilst many programmes similar to CST have since been developed, the original UK version remains the most consistently evidenced (10)(11)(12).…”

Analysis of the effect of cognitive stimulation program in older adults with normal cognition: randomized clinical trial

“…Los elementos ocupacionales (profesión, intereses y roles) permitieron a los participantes expresar diferentes niveles de complejidad y aumentar su satisfacción personal. La intervención se administró de modo grupal 14 , en 10 sesiones prácticas de 45 minutos, de un día a la semana. Se realizaron cuatro subgrupos (dos MEC alto y dos MEC bajo) de 25-26 personas en función de su nivel cognitivo inicial.…”

“…Los elementos ocupacionales 18 contemplados en este programa, permiten experimentar satisfacción personal en la realización de los ejercicios. A pesar de existir evidencia científica de estas técnicas 14 , en España los terapeutas ocupacionales no forman parte de los servicios de Atención Primaria en la mayoría de las comunidades autónomas.…”

“…Las intervenciones en este campo, dentro de las cuales se encuentra la estimulación cognitiva, producen beneficios cognitivos y psicológicos que ayudan a reducir la ansiedad y depresión en los adultos mayores y a retrasar el deterioro 13,14 . Los programas de terapia ocupacional combinan estas intervenciones con actividades de ejercicio físico y de ocio 15 .…”