Cognitive stimulation therapy for brazilian people with dementia: examination of implementation’ issues and cultural adaptation

Abstract

Objectives: The prevalence of dementia has been increasing particularly in developing countries. However, people with dementia (PwD) in Brazil are currently offered no psychosocial treatment upon diagnosis. Cognitive Stimulation Therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in PwD. We investigate the possible issues for the implementation of CST for the Brazilian population and its cultural appropriateness.Method: Individual interviews and focus groups were conducted with PwD, their caregivers and health professionals (n=37). Data were recorded and transcribed, before being analyzed using Framework Analysis.Results: Regarding the issues for implementation of CST in the Brazilian population, two main themes emerged, "Barriers" and "Facilitators", along with nine subthemes. Overall, the activities and materials were seen as being appropriate for use with the Brazilian population, some minor changes were suggested. Conclusions:The results indicate that CST is appropriate for use in the Brazilian population, only some cultural adaptations are necessary. In the stakeholders' opinions, CTS intervention is needed in Brazil, due to the lack of treatment options for PwD in developing countries.

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

“…A shortage of qualified professionals was identified here as a barrier to delivering CST and this shortage across services has also been suggested as negatively impacting on how a service user evaluates the quality of a healthcare service (28). In Brazil, it has been suggested that CST could be viewed as additional work for both caregivers and healthcare professionals (24). This is consistent with the barrier of healthcare professionals having competing demands on their time documented here.…”

“…Dispensaries serve local communities, followed by health centers, hospitals and larger referral hospitals (20). The three countries chosen for this work were part of the CST-International research programme (21) and teams in each country had previously completed the formal adaptation of CST (22)(23)(24) using the established methodology (25). As this was a stakeholder project and not a formal research study, no identifying information was collected from stakeholders beyond their job title and no formal analysis was conducted.…”

Cognitive stimulation therapy for people with dementia in Brazil (CST‐Brasil): Results from a single blind randomized controlled trial

“…To facilitate CST implementation in other cultures, adaptation guidelines have been developed 17 with an approach involving stakeholders in the cultural adaptation process. A previous report by our group has described steps used for translating CST materials, also examining implementation issues and cultural adaptation 18 . The results indicate that CST is appropriate for the Brazilian population, with some minor amendment needed to address cultural issues (e.g., faces of famous Brazilian people or typical Brazilian foods).…”

“…The CST program has been described elsewhere, 12 with the intervention in the current study being implemented according to the translated and adapted procedures described by Bertrand and colleagues 18 . For the treatment group, the program was conducted by three researchers (Valeska Marinho, Iris Bomilcar and Renata Naylor), in groups with between five and eight participants.…”

The Petrified Self 10 Years After: Current Evidence for Mnemonic anosognosia

“…There is, in fact, important evidence that contradicts these notions. For example, all rehabilitation and cognitive stimulation efforts (e.g., Bertrand E. et al, 2019) attest to the potential of improvement of people with dementia and other patients with amnesia (Wilson, 2009). Specifically related to awareness of difficulties, the notion of implicit awareness (Morris and Mograbi, 2013) suggests that behavioral and affective change may happen without explicit knowledge by patients.…”