Evidence map›Paper›PMID 26889843›Full record

ArticleJournal of the American Geriatrics Society2016

Elder-Clowning in Long-Term Dementia Care: Results of a Pilot Study.

Pia Kontos, Karen-Lee Miller, Romeo Colobong, Luis I Palma Lazgare, Malcolm Binns, Lee-Fay Low, Claire Surr, Gary Naglie

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Humour interventions for patients in palliative care-a randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
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  9. "I made you a small room in my heart": how therapeutic clowns meet the needs of older adults in nursing homes.International journal of qualitative studies on health and well-being · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Pia KontosToronto Rehabilitation Institute-University Health Network, Toronto, Ontario.
Karen-Lee MillerToronto Rehabilitation Institute-University Health Network, Toronto, Ontario.
Romeo ColobongToronto Rehabilitation Institute-University Health Network, Toronto, Ontario.
Luis I Palma LazgareDalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
Malcolm BinnsDalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
Lee-Fay LowFaculty of Health Sciences, University of Sydney, Sydney, Australia.
Claire SurrInstitute for Health and Wellbeing, Leeds Beckett University, Leeds, UK.
Gary NaglieToronto Rehabilitation Institute-University Health Network, Toronto, Ontario.

Funding

CIHR 114953-1CIHR MOP-114953
6 · The paper itself

Abstract

objectivesTo assess the effects of elder-clowning on moderate to severe behavioral and psychological symptoms of dementia (BPSD) in nursing home residents with dementia, primarily of the Alzheimer's type.

designBefore-and-after study.

settingNursing home.

participantsNursing home residents with moderate to severe BPSD, as defined according to a Neuropsychiatric Inventory-Nursing Home version (NPI-NH) score of 10 or greater (N = 23), and their care aides.

interventionA pair of elder-clowns visited all residents twice weekly (~10 minutes per visit) for 12 weeks. They used improvisation, humor, empathy, and expressive modalities such as song, musical instruments, and dance to individualize resident engagement. MEASUREMENTS: Primary outcomes were BPSD measured using the the NPI-NH, quality of life measured using Dementia Care Mapping (DCM), and nursing burden of care measured using the Modified Nursing Care Assessment Scale (M-NCAS). Secondary outcomes were occupational disruptiveness measured using the NPI-NH, agitation measured using the Cohen Mansfield Agitation Inventory (CMAI), and psychiatric medication use.

resultsOver 12 weeks, NPI-NH scores declined significantly (t22 = -2.68, P = .01), and DCM quality-of-life scores improved significantly (F1,50 = 23.09, P < .001). CMAI agitation scores decreased nominally, but the difference was not statistically significant (t22 = -1.86, P = .07). Occupational disruptiveness score significantly improved (t22 = -2.58, P = .02), but there was no appreciable change in M-NCAS scores of staff burden of care.

conclusionResults suggest that elder-clowning reduced moderate to severe BPSD of nursing home residents with dementia, primarily of the Alzheimer's type. Elder-clowning is a promising intervention that may improve Alzheimer's disease care for nursing home residents.

Indexed as

Quality of LifeAged, 80 and overBehavioral SymptomsCanadaDementiaFemaleHumansLaughter TherapyLong-Term CareMaleNursing HomesTreatment Outcomearts-based interventionbehavioral and psychological symptoms of dementialoss of selfperson-centered care

Identifiers

PMID26889843
PMCPMC4846348

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.