Authors (including presenting author) :
Yuen KL, Ching WK
Affiliation :
Occupational Therapy Department, North District Hospital
Introduction :
Cognitive Stimulation Therapy (CST) is an effective non-pharmacological intervention for enhancing cognition and quality of life (QoL) for people with mild to moderate dementia. Regarding high occupational therapy referral volume for dementia management, feasibility of using evidence-based CST in occupational therapy department is important
Objectives :
To investigate the feasibility of implementing CST delivered by occupational therapists in an ambulatory care setting targeting people with mild to moderate dementia.
Methodology :
14-session CST group programs led by certified CST occupational therapist were studied. Two major clinical outcomes of CST including cognition and QoL were evaluated by HK-MoCA and Quality of Life in Alzheimer’s Disease (QoL-AD) respectively. Moreover, condition of staff readiness, intervention delivery, patient recruitment, acceptability and attrition were also studied.
Result & Outcome :
60 patients, age 60 to 94, who attended 6 CST groups during October 2018 to September 2019 were included. The results of paired samples t-test showed that patients had significant improvement in communication at completion (p < .0001) and three months after completion (p =.016) of the program. Cognition and QoL of 60.3% patients remained stable.
Staff trainings, program development and promotion were arranged in order to facilitate the rediness of CST service. For the staff trainings, more than 10 occupational therapists had attained the Certified CST-Hong Kong Practitioner qualification. In terms of program development, run-down, materials, equipment and environment were prepared with reference to the official CST manual and inspiration of CST-HK trainer hub. Program promotion was delivered to the potential referring doctors. Regarding acceptability, positive feedbacks and requests were constantly received from elders and their care-givers for the wish of extending the program. For the attrition, only 4 participants were quitted because of medical and escorting issues.
In conclusion, the implementation of CST in ambulatory setting is feasible in respect of the positive studied outcomes and program readiness. With regard to the study implication, larger scale of CST implementation is recommended in order to achieve the full benefit of CST, including recruitment of the targeted elders at an earlier stage of their illness and continuation of the CST beyond the initial program while the elders are still willing and able to participate.
