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Review Articles
Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis
Eun Young Kim, Sung-Dong Hwang, Eun Joo Kim
J Korean Acad Nurs 2016;46(4):475-489.   Published online August 15, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.4.475
AbstractAbstract PDF
Abstract Purpose

This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia.

Methods

Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the ‘meta’ package and the Comprehensive Meta-Analysis (CMA 2.0) program.

Results

Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as ‘++’ for eight studies and ‘+’ for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges’ g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity (I2=62.8%), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected.

Conclusion

Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia patients.

Citations

Citations to this article as recorded by  
  • Effects of Horticultural Therapy on Korean Elderly with Dementia: A Meta-analysis
    Kyung Ja Kang, Mi-Jung Kang
    Journal of Korean Academy of psychiatric and Mental Health Nursing.2021; 30(4): 352.     CrossRef
  • Effect of aquatic exercise on gait in persons with chronic stroke: a meta-analysis study in Korea
    Dong-Jin Lee, Sung-Hyoun Cho
    Physical Therapy Rehabilitation Science.2019; 8(2): 112.     CrossRef
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Effects of Cognitive Behavioral Therapy on Attention Deficit Hyperactivity Disorder among School-aged Children in Korea: A Meta-Analysis
Wan-Ju Park, Shin-Jeong Park, Sung-Dong Hwang
J Korean Acad Nurs 2015;45(2):169-182.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.169
AbstractAbstract PDF
Purpose

This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea.

Methods

Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis.

Results

Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected.

Conclusion

Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.

Citations

Citations to this article as recorded by  
  • Effectiveness of sensory integration therapy in children, focusing on Korean children: A systematic review and meta-analysis
    Seri Oh, Jong-Sik Jang, A-Ra Jeon, Geonwoo Kim, Mihwa Kwon, Bahoe Cho, Narae Lee
    World Journal of Clinical Cases.2024; 12(7): 1260.     CrossRef
  • Trends in South Korean Medical Device Development for Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: Narrative Review
    Yunah Cho, Sharon L Talboys
    JMIR Biomedical Engineering.2024; 9: e60399.     CrossRef
  • Self-management training vs. neurofeedback interventions for attention deficit hyperactivity disorder: Results of a randomized controlled treatment study
    Ann-Kathrin Korfmacher, Oliver Hirsch, Mira-Lynn Chavanon, Björn Albrecht, Hanna Christiansen
    Frontiers in Psychiatry.2022;[Epub]     CrossRef
  • Effects of hippotherapy on children with cerebral palsy: systematic review and meta-analysis
    Kwon-Hoi Kim, Suk-Min Lee
    Physical Therapy Rehabilitation Science.2020; 9(1): 55.     CrossRef
  • Effect of aquatic exercise on gait in persons with chronic stroke: a meta-analysis study in Korea
    Dong-Jin Lee, Sung-Hyoun Cho
    Physical Therapy Rehabilitation Science.2019; 8(2): 112.     CrossRef
  • Risk and protective factors for the development of ADHD symptoms in children and adolescents: Results of the longitudinal BELLA study
    Anne Wüstner, Christiane Otto, Robert Schlack, Heike Hölling, Fionna Klasen, Ulrike Ravens-Sieberer, Kenji Hashimoto
    PLOS ONE.2019; 14(3): e0214412.     CrossRef
  • A Meta Analysis on Variables related to Death Anxiety of Elderly in Korea
    Sinhyang Kim, Kyung Sook Park
    Korean Journal of Adult Nursing.2016; 28(2): 156.     CrossRef
  • A Meta-analysis of Intervention Studies on the Effects of Self Management and Education in Adult Asthmatic Patients
    Chae-Bong Kim, Min-Kyung Han, Mi-Seon Jeong, Bo-Young Choi, Kil-Yong Choi, Moo-Young Kim
    The Korean Journal of Health Service Management.2015; 9(3): 175.     CrossRef
  • Effects of a Social Skills Training Program on Problem Behaviors, Social Skill, and Peer Relationship in Children using a Community Child Center at Vulnerable Area
    Myeong-Hui Choe, Yong-Mi Lee
    Journal of Korean Academy of Psychiatric and Mental Health Nursing.2015; 24(3): 156.     CrossRef
  • Clinical Application of the Korean Personality Rating Scale for Children in Attention-Deficit Hyperactivity Disorder
    Woon Yoon, Kee-Jeong Park, Kukju Kweon, Hyo-Won Kim
    Journal of the Korean Academy of Child and Adolescent Psychiatry.2015; 26(3): 217.     CrossRef
  • 304 View
  • 9 Download
  • 10 Crossref
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