Experiences and Management of Distress and the Use of Music, Including Music Therapy, on NHS Inpatient Mental Health Dementia Wards: A Qualitative Study

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2025-05-02 DOI:10.1002/gps.70091

Naomi Thompson, Rachel Hunt, Helen Odell-Miller, Abdulwarrith Olawale, Lucy Pickering, Chris Pointon, Benjamin R. Underwood, Alison Wilkinson, Christine Wise, Emma Wolverson, Ming-Hung Hsu

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引用次数: 0

Abstract

Background

Inpatient mental health dementia wards in the National Health Service (NHS) provide specialist care for people with dementia experiencing acute levels of distress. There is little research exploring how best to manage and prevent distress. Music therapy may be feasible to deliver and reduce the prevalence of distress behaviours.

Aims

To further understanding of experiences of distress in inpatient mental health dementia NHS wards, how distress is managed and ways music and music therapy is used.

Methods

Semi-structured focus groups and interviews were co-designed and conducted with people with dementia, families, staff, music therapists and managers with experience of this setting. Data were transcribed and analysed using reflexive thematic analysis, with findings corroborated with participants, a co-design group and experts-by-experience.

Results

49 people took part from 17 wards. Three overarching themes were identified, with 10 subthemes. The first theme highlighted the complex physical and mental health care needs of people on these wards, including high levels of distress. Secondly, staff and families aimed to personalise care to manage and prevent distress. Thirdly, music, including music therapy, could support the delivery of personalised care and help prevent and deescalate distress behaviours, potentially reducing the need for restrictive interventions. However, managers, staff, families and patients reported that care provision did not always meet patient need and resource limitations often prevented delivery of personalised care.

Conclusions

NHS mental health dementia wards provide specialist care for people with dementia experiencing high levels of distress. Personalised care, including the use of music, was essential for preventing and managing distress, and could be enhanced through specialist support from a music therapist. Findings should inform best practice guidelines for NHS inpatient mental health dementia wards, including the use of music and music therapy, to support the prevention and management of distress for this client group.

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经历和管理的痛苦和使用音乐，包括音乐治疗，在NHS住院精神健康痴呆病房：一项定性研究

背景：国民健康服务（NHS）的住院精神健康痴呆症病房为患有急性痛苦的痴呆症患者提供专业护理。很少有研究探索如何最好地管理和预防痛苦。音乐疗法可能是可行的，可以传递和减少痛苦行为的流行。目的进一步了解住院精神健康痴呆症NHS病房的痛苦经历，如何管理痛苦以及音乐和音乐治疗的方法。方法与痴呆患者、家属、工作人员、音乐治疗师和管理人员共同设计半结构化焦点小组和访谈。使用反身性专题分析对数据进行转录和分析，并与参与者、共同设计小组和经验专家一起证实了调查结果。结果来自17个病区的49人参加了调查。确定了三个总体主题和10个次级主题。第一个主题强调了这些病房患者复杂的身心保健需求，包括高度痛苦。其次，工作人员和家属的目标是个性化护理，以管理和预防痛苦。第三，音乐，包括音乐治疗，可以支持个性化护理的提供，帮助预防和减轻痛苦行为，潜在地减少对限制性干预的需求。然而，管理人员、工作人员、家属和患者报告说，提供的护理并不总是满足患者的需要，资源限制往往阻碍了个性化护理的提供。结论：NHS精神健康痴呆症病房为经历高度痛苦的痴呆症患者提供专业护理。个性化护理，包括使用音乐，对于预防和管理痛苦是必不可少的，可以通过音乐治疗师的专业支持来加强。研究结果应告知NHS住院精神健康痴呆病房的最佳实践指南，包括使用音乐和音乐治疗，以支持该客户群体的痛苦预防和管理。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.