A Most Significant Change evaluation of a new co-designed tool to measure holistic well-being in consumers of community aged care services.

OBJECTIVES: To evaluate a Wellbeing Check-in tool and process for use with BlueCare's home care package (HCP) clients by care and well-being practitioners. The tool had been co-designed with HCP clients and trialled with 15 clients. METHODS: The Most Significant Change (MSC) methodology was used to gather stories from five practitioners, five HCP staff and seven clients. A workshop with senior staff was held to determine themes and whether the tool met its aims. RESULTS: Out of 22 MSC stories, 18 were judged in scope by workshop participants. Eight themes were then identified. Four themes reflected the content of the narratives (i.e. what was discussed): Isolation and connection; Grief; Faith/explicit spirituality; and Client preference. The other four themes reflected the process (i.e. what the discussions meant to participants): Being there/Meaningful conversations; Impact on significant others; New insight; and Purpose of the check-in. These eight themes largely reflected the aims of the Wellbeing Check-in tool in terms of providing a means to optimise connectedness, well-being and spiritual care in accordance with the client's needs, goals and preferences. Unanticipated findings included its benefits for family members and uncertainty about the aim or value of the tool, which highlighted the need for BlueCare to be clear about the purpose of the tool in promoting it to clients and their informal carers. CONCLUSIONS: The Wellbeing Check-in tool was found to be fit for purpose. A tool used flexibly to prompt discussion about well-being can be helpful to clients and pastoral care staff.

ParkinSong Online: Feasibility of Telehealth Delivery and Remote Data Collection for a Therapeutic Group Singing Study in Parkinson's.

BACKGROUND: Parkinson's disease can negatively affect vocal functioning and social wellbeing, particularly in the latter stages of disease progression. Face-to-face group singing interventions can improve communication and wellbeing outcomes, yet not all people can access in-person sessions. To help overcome barriers to participation, exploration of the feasibility and utility of online therapeutic singing programs is needed. OBJECTIVES: To evaluate the feasibility, acceptability, and preliminary efficacy of a 12-week ParkinSong Online intervention on speech and wellbeing for people with Parkinson's disease. METHODS: A total of 28 participants with idiopathic Parkinson's disease were recruited to a single-arm feasibility study. Weekly 90-minute online sessions were co-facilitated by a music therapist and speech pathologist. Speech and wellbeing assessments were conducted pre and post intervention. Participant and facilitator surveys were administered after each session, with focus group interviews at the end of the program. RESULTS: The recruitment rate was high (90%) with no attrition, adverse events, or safety issues. There was good intervention fidelity, attendance (average 89%), and positive participant experience. Feasibility was good, with technology reported as the main challenge (connecting and navigating Zoom). No improvements were seen in voice measures or wellbeing outcomes in this small trial. The online format used in this study did not provide the same benefits as in-person ParkinSong sessions. CONCLUSIONS: ParkinSong Online is feasible for recreational purposes and social engagement provided that people have adequate technological knowledge or support. The optimal online delivery format to achieve communication improvements in Parkinson's awaits confirmation.

Dancing for Parkinson's Disease Online: Clinical Trial Process Evaluation.

Background: Dancing is an engaging physical activity for people living with Parkinson's disease (PD). We conducted a process evaluation for a PD trial on online dancing. Methods: "ParkinDANCE Online" was co-produced by people with PD, healthcare professionals, dance instructors, and a PD organisation. The evaluation mapped the following inputs: (i) stakeholder steering group to oversee program design, processes, and outcomes; (ii) co-design of online classes, based on a research evidence synthesis, expert advice, and stakeholder recommendations; (iii) trial fidelity. The key activities were (i) the co-design of classes and instruction manuals, (ii) the education of dance teachers, (iii) fidelity checking, (iv) online surveys, (v) and post-trial focus groups and interviews with participants. The outputs pertained to: (i) recruitment, (ii) retention, (iii) adverse events, (iv) fidelity, (v) protocol variations, and (vi) participant feedback. Results: Twelve people with PD, four dance instructors and two physiotherapists, participated in a 6-week online dance program. There was no attrition, nor were there any adverse events. Program fidelity was strong with few protocol variations. Classes were delivered as planned, with 100% attendance. Dancers valued skills mastery. Dance teachers found digital delivery to be engaging and practical. The safety of online testing was facilitated by careful screening and a home safety checklist. Conclusions: It is feasible to deliver online dancing to people with early PD.

Evaluation of the impact of The Little Things training on personal care assistants' confidence to communicate with residents in aged care.

OBJECTIVES: To evaluate The Little Things training program, designed to assist personal care assistants (PCAs) from culturally and linguistically diverse (CALD) backgrounds to communicate more effectively with aged care residents. METHODS: This project included PCAs from residential aged care facilities (RACFs) and Certificate III students from registered training organisations (RTOs) in Melbourne, Australia. A control group (n = 18) was also included. Measures included the following: pre- and posttraining confidence to communicate and rankings of task importance; posttraining perceived change in confidence; and posttraining impacts on practice. RESULTS: Altogether, 75 PCAs and 30 RTO students participated in Intake I of the training and 31 PCAs and 34 RTO students in Intake 2. Confidence increased in The Little Things participants relative to those in the control group (ß = 0.11, T = 1.99, p = 0.05). Change did not vary by Intake or whether someone was in the RACF or RTO group, F (2, 147) = 0.58, p = 0.5; nor by sociodemographic characteristics. Most training participants (84%) thought their ability to communicate with older people would 'improve a lot' as a result of the training. Training participants also ranked the importance of duties such as 'Speaking in a friendly and informal way to older people' more highly after than before the training (p = 0.01), while little change was observed in the control group. CONCLUSIONS: The Little Things program increased training participants' confidence to communicate and shifted perceived priorities towards interacting with residents in a way that enhanced resident well-being.

Sources of Resilience in Frontline Health Professionals during COVID-19.

BACKGROUND: While the challenges for psychological well-being for Australian healthcare workers have been documented, there has been a dearth of qualitative research on the sources of resilience that sustained workers during the COVID-19 pandemic. This study identified sources of resilience that clinicians used to cope with frontline challenges during the COVID-19 pandemic. METHODS: Semi-structured interviews were conducted with 20 frontline health professionals, across five Australian hospitals, between October 2020 and April 2021. The interviews were recorded and transcribed, and the results were analysed using thematic analysis based on a phenomenological approach. RESULTS: Three sources of resilience were identified by respondents: personal, relational, and organisational. A positive mindset, sense of purpose, and self-care behaviours emerged as key sources of personal resilience. Teamwork, altruism, and social support from family and friends contributed to relational resilience. Leadership, effective communication, and effective implementation of COVID-19 policies were associated with resilience at the organisational level. Frontline healthcare workers also voiced the need for the implementation of further strategies to support personal resilience whilst nurturing resilience within clinical teams and across entire healthcare organisations. CONCLUSIONS: Trust in healthcare systems, organisation leaders, colleagues, and personal support teams was an overarching theme supporting resilience.

ParkinSong Online: protocol for a telehealth feasibility study of therapeutic group singing for people with Parkinson's disease.

INTRODUCTION: Parkinson's disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline; however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and acceptability of an online mode of delivery for a Parkinson's singing intervention (ParkinSong) as well as remote data collection procedures. METHODS AND ANALYSIS: This ParkinSong Online feasibility trial is a single-arm, pre-post study of online singing delivery and remote data collection for 30 people living with Parkinson's. The primary outcome measure is feasibility: recruitment, retention, attendance, safety, intervention fidelity, acceptability and associated costs. Secondary outcomes are speech (loudness, intelligibility, quality, communication-related quality of life) and wellbeing (apathy, depression, anxiety, stress, health-related quality of life). This mode of delivery aims to increase the accessibility of singing interventions. ETHICS AND DISSEMINATION: Ethics approval was obtained from The University of Melbourne Human Research Ethics Committee (2021-14465-16053-3) and the trial has been prospectively registered. Results will be presented at national and international conferences, published in a peer-reviewed journal, and disseminated to the Parkinson's community, researchers and policymakers. TRIAL REGISTRATION NUMBER: ACTRN12621000940875.

Online Dance Therapy for People With Parkinson's Disease: Feasibility and Impact on Consumer Engagement.

BACKGROUND: Therapeutic dancing can be beneficial for people living with Parkinson's disease (PD), yet community-based classes can be difficult to access. OBJECTIVE: To evaluate the feasibility and impact of online therapeutic dancing classes for people in the early to mid-stages of PD. METHODS: Co-produced with people living with PD, physiotherapists, dance teachers and the local PD association, the 'ParkinDANCE' program was adapted to enable online delivery during the COVID-19 pandemic. Participants completed 8 one-hour sessions of online therapeutic dancing. Each person was assigned their own dance teacher and together they selected music for the classes. A mixed-methods design enabled analysis of feasibility and impact. Feasibility was quantified by attendance and adverse events. Impact was determined from individual narratives pertaining to consumer experiences and engagement, analysed with qualitative methods through a phenomenological lens. RESULTS: Attendance was high, with people attending 100% sessions. There were no adverse events. Impact was illustrated by the key themes from the in-depth interviews: (i) a sense of achievement, enjoyment and mastery occurred with online dance; (ii) project co-design facilitated participant engagement; (iii) dance instructor capabilities, knowledge and skills facilitated positive outcomes; (iv) music choices were key; and (v) participants were able to quickly adapt to online delivery with support and resources. CONCLUSIONS: Online dance therapy was safe, feasible and perceived to be of benefit in this sample of early adopters. During the pandemic, it was a viable form of structured physical activity. For the future, online dance may afford benefits to health, well-being and social engagement.

Acting with the future in mind: Testing competing prospective memory interventions.

Prospective memory (PM) is a critical determinant of whether a person is able to lead an independent life. Because PM declines in late adulthood, an important question is therefore whether, and if so, which types, of PM interventions might lead to meaningful benefits. In the present study, we randomly assigned older adults to one of four conditions, in three of which participants received a structured PM intervention (Restorative, Compensatory, and Combined Restorative and Compensatory); the fourth was an Active Control condition. The results showed that there were significant gains on the PM training task used for both the Restorative and Combined conditions. We then analyzed change in PM tasks that were independent of the PM training task (Near Transfer). Only the Combined condition led to post-training improvement. Finally, we analyzed performance on measures of untrained cognitive abilities and everyday functioning: Far transfer effects were not evident for any intervention. These data align with prior literature in showing that interventions that target a single cognitive ability do not reliably generate far transfer effects, and additionally extend our understanding of these effects in two important ways. Firstly, they indicate that, even when the memory challenges that older adults are most concerned about are the direct target of restorative training, transfer effects to untrained cognitive domains may be difficult to achieve. Secondly, they indicate that for older adults whose primary goal is to enhance PM function, combining Restorative and Compensatory approaches is an effective approach. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Event-Based but Not Time-Based Prospective Memory Is Related to Oral Health in Late Adulthood.

BACKGROUND: Most evidence now indicates that cognitive function is related to poorer oral health in late adulthood, but that this relationship is not invariant across specific cognitive domains. Prospective memory (PM) is a core memory skill that refers to memory for future intentions and is known to be related to the formation of habits such as tooth flossing. However, the relationship between PM and oral health has been subject to only limited empirical study. OBJECTIVE: The two studies reported in this paper were designed to test whether PM is related to oral health in older adults of varying vulnerability status. METHODS: Study 1 sampled community-dwelling older adults (N = 172) living independently in the community; Study 2 sampled older adults living in a retirement village (N = 32). Participants in both studies were asked to complete a behavioural measure of PM, with their oral health indexed via self-report (Study 1) or an objective oral health exam (Study 2). RESULTS: In both studies, relationships emerged between event-based PM and oral health, with Study 2 showing that these relationships were specific to oral health measures of plaque and calculus. CONCLUSIONS: Older adults are particularly vulnerable to dental pathology, with important implications for their broader health and well-being. By showing that there is a relationship between oral health and a particular type of PM, this work will have potential implications for the development of more effective interventions focused on enhancing oral health outcomes in this group, such as those focused on strengthening habit formation.

Differences in time-based task characteristics help to explain the age-prospective memory paradox.

Prior prospective memory (PM) research shows paradoxical findings-young adults outperform older adults in laboratory settings, but the reverse is found in naturalistic settings. Moreover, young-old outperform old-old adults in laboratory settings, but show no age differences in naturalistic settings. Here we highlight how time-based task characteristics have differed systematically between studies conducted in laboratory (time-interval cues) and naturalistic settings (time-of-day cues) and argue that this apparent paradox is a function of comparing disparate task types. In three experiments, we tested this hypothesis using analogous paradigms across settings, with event-based, time-of-day, and time-interval cued PM tasks. Experiment 1 compared young (n = 40) and older (n = 53) adults on a laboratory paradigm that measured PM tasks embedded in a virtual, daily life narrative; and on a conceptually parallel paradigm using a customized smartphone application (MEMO) in actual daily life. Results revealed that on the MEMO, older adults outperformed young adults on the time-of-day tasks but did not differ on the time-interval or event-based task. In contrast, older adults performed worse than young adults in the laboratory. Experiment 2 compared PM performance in young-old (n = 64) and old-old (n = 40) adults using the same paradigms. Young-old outperformed old-old adults in the laboratory; however, group differences were not evident in daily life. Experiment 3 compared young (n = 42) and older (n = 41) adults, and largely replicated the findings of Experiment 1 using a more demanding version of MEMO. These findings provide novel and important insights into the limiting conditions of the age-PM paradox and the need for a finer theoretical delineation of time-based tasks.

The Wisdom to Know the Difference.

The ability to regulate emotions is central to well-being, but healthy emotion regulation may not merely be about using the "right" strategies. According to the strategy-situation-fit hypothesis, emotion-regulation strategies are conducive to well-being only when used in appropriate contexts. This study is the first to test the strategy-situation-fit hypothesis using ecological momentary assessment of cognitive reappraisal-a putatively adaptive strategy. We expected people who used reappraisal more in uncontrollable situations and less in controllable situations to have greater well-being than people with the opposite pattern of reappraisal use. Healthy participants ( n = 74) completed measures of well-being in the lab and used a smartphone app to report their use of reappraisal and perceived controllability of their environment 10 times a day for 1 week. Results supported the strategy-situation-fit hypothesis. Participants with relatively high well-being used reappraisal more in situations they perceived as lower in controllability and less in situations they perceived as higher in controllability. In contrast, we found little evidence for an association between greater well-being and greater mean use of reappraisal across situations.