Cultural Adaptation of Cognitive Stimulation Therapy for Māori with Dementia (CST-Māori).

Abstract

Māori are the indigenous people of Aotearoa New Zealand. Cognitive Stimulation Therapy (CST) was initially developed in the UK, lacking in Māori cultural content and values. Cultural adaptation is needed to ensure Māori with dementia can benefit from this evidence-based treatment. This paper reports the outcome of a project aimed to adapt CST for Māori. We followed the five phases of international guidelines using the formative method for adapting CST to other cultures, including a critical cultural examination of the 18 CST principles. We piloted two CST-Māori programmes and collected pre- and post-outcome measures using the RUDAS and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Written qualitative feedback was sought from participants and their family at the end of the CST-Māori programme. A total of 15 Māori (female: 53.3%) participated in the two programmes. Their mean age was 75.9 years (SD = 6.6) and mean baseline RUDAS scores was 17.7 (SD = 2.3). There was a statistically significant improvement in cognition (RUDAS: pre = 17.7, post = 19.4, p = 0.003) and in the WHOQOL subscales of physical (pre = 75.9, post = 88.5, p = 0.003), psychological (pre = 72.7, post = 81.3, p = 0.024) and environment (pre-80.6, post = 88.0, p = 0.006). Written feedback confirmed the acceptability of this culturally adapted programme by Māori living with dementia and their whanau (families). CST was successfully adapted for Māori with dementia. It is a culturally acceptable cognitive intervention and preliminary data confirmed the effectiveness of CST-Māori in improving cognition and quality of life.