Technology-based non-pharmacological interventions for stress and distress in dementia care: a systematic review; and, A mixed-method multiple-baseline single-case study exploring the impact of the Tovertafel (Magic Table) on factors impacting staff burnout in an acute dementia care hospital ward

Abstract

Technology-based non-pharmacological interventions are a fast-growing area of dementia care and are being applied in a variety of care settings. Due to the readily available nature of many technology-based interventions which often have high face validity and are perceived to have very minimal side effects, research can lag behind clinical applications. Current research suggests that these interventions may be beneficial people to with dementia, but the extent of their effectiveness in specific aspects of dementia care and the impact on the wider care system is still being determined.

A systematic review of the literature was conducted to review the effectiveness of technology based non-pharmacological interventions on stress and distress in dementia care settings. The term ‘stress and distress’ encompasses behaviour, affect, perception or thought disturbance symptoms in dementia, such as depression, anxiety, agitation, poor sleep and high levels of distress. While there is evidence that technology-based non-pharmacological interventions can be effective in reducing for stress and distress for people with dementia, the findings of the studies included in the review are mixed, meaning that there is not yet a clear indication of which, if any interventions are most effective. These results are discussed in relation to findings from other studies, with recommendations for future research and clinical applications.

Current research on technology-based non-pharmacological interventions in dementia care often fails to consider staff as a significant factor in the application of interventions. A mixed method multiple-baseline single-case study methodology was used to assess the impact of the Tovertafel, a technology-based non-pharmacological intervention, on factors related to staff burnout in an acute dementia care ward. The Tovertafel (meaning Magic Table in Dutch) is a digital projection device which provides an interactive and playful recreation activity for people with dementia. The results suggested that the majority of participants demonstrated improvement in factors related to burnout, and a meta-analysis suggested small to medium effect sizes across participants. The thematic analysis of a qualitative staff experience questionnaire established three themes: patient’s positive engagement and response to the Tovertafel; benefits to staff from using the Tovertafel; and opportunities to enhance care with no changes to the normal workload. These results suggest that the Tovertafel may have the potential to improve staff outcomes in relation to burnout factors.

Potential directions for future research are discussed.