Home Uncategorized Article Analysis and Evaluation of Research Ethics. 1.5 pages. * 6 Hours*

Uncategorized

Article Analysis and Evaluation of Research Ethics. 1.5 pages. * 6 Hours*

Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template.

https://doi.org/10.1155/2020/6305727 – permalink

Article attached

Article Analysis and Evaluation of Research Ethics

Article Citation and Permalink
(APA format)

Article 1

Point

Description

Broad Topic Area/Title

Problem Statement
(What is the problem research is addressing?)

Purpose Statement
(What is the purpose of the study?)

Research Questions
(What questions does the research seek to answer?)

Define Hypothesis
(Or state the correct hypothesis based upon variables used)

Identify Dependent and Independent Variables and Type of Data for the Variables

Population of Interest for Study

Sample

Sampling Method

Identify Data Collection
Identify how data were collected

Summarize Data Collection Approach

Discuss Data Analysis
Include what types of statistical tests were used for the variables.

Summarize Results of Study

Summary of Assumptions and Limitations
Identify the assumptions and limitations from the article.
Report other potential assumptions and limitations of your review not listed by the author.

Ethical Considerations

Evaluate the article and identify potential ethical considerations that may have occurred when sampling, collecting data, analyzing data, or publishing results. Summarize your findings below in 250-500 words. Provide rationale and support for your evaluation.

1/17/21, 4:58 PMGCU Li

rary Resources – All Subjects

Page 1 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Title:

Authors:
Affiliation:

Source:

Publication Type:
Language:

Major Subjects:

Minor Subjects:

Abstract:

Record: 1

The Effects of a Recollection-Based Occupational Therapy
Program of Alzheimer’s Disease: A Randomized Controlled Trial.
Kim, DeokJu
Department of Occupational Therapy, Cheongju University,
Daesung-ro, 298, Cheongwon-gu, Cheongju-si, Chungcheongbuk-
do, Republic of Korea
Occupational Therapy International (OCCUP THER INT), 8/1/2020;
1-8. (8p)
Article – research, tables/charts, randomized controlled trial
English
Occupational Therapy — Methods
Alzheimer’s Disease — Rehabilitation
Program Evaluation
Human; Randomized Controlled Trials; Cognition; Activities of Daily
Living; Depression — Prevention and Control; Male; Female; Aged;
Aged, 80 and Over; Descriptive Statistics; Data Analysis Software;
Scales; Questionnaires; T-Tests
Considering the high socioeconomic costs related to the increasing
number of dementia patients and their poor quality of life and that of
their families, it is important to identify the condition early on and
provide an appropriate intervention. This study organized a
recollection-based occupational therapy program: a
nonpharmacological intervention consisting of five categories of
activities (physical, horticultural, musical, art, and instrumental
activity of daily living; IADL) and applied it to those having a mild
stage of Alzheimer’s disease. The experimental group participated
in a total of 24 sessions––five times per week for one hour per
session––while the control group took part in regular activities
offered by the existing facilities. The experimental group presented
improved cognitive functions, reduced depression, and enhanced
quality of life; the two groups showed a statistically significant
difference in every category. This study is meaningful in that it
made a cognitive stimulation program concerning five different
categories, implemented it for people suffering mild dementia, and
confirmed positive outcomes. If a systemic version of the program

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 2 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Journal Subset:
Instrumentation:

ISSN:
MEDLINE Info:

Entry Date:
Revision Date:

DOI:
Accession Number:

Database:

is offered in dementia care facilities, it is expected to make a
considerable contribution to the care of dementia patients.
Allied Health; Europe; Peer Reviewed; UK & Ireland
Geriatric Quality of Life-Dementia (GQOL-D)
Subjective Memory Complaints Questionnaire (SMCQ)
Functional Independent Measure (FIM)
Short-Form Geriatric Depression Scale-K (SGDS-K)
Korean Mini-Mental Status Examination (K-MMSE)
0966-7903
NLM UID: 9433361
20200807
20200807
10.1155/2020/6305727
144890382
CINAHL Complete

The Effects of a Recollection-Based Occupational Therapy Program of Alzheimer’s
Disease: A Randomized Controlled Trial

1. Introduction
Considering the high socioeconomic costs related to the increasing number of dementia patients and
their poor quality of life and that of their families, it is important to identify the condition early on and
provide an appropriate intervention. This study organized a recollection-based occupational therapy
program: a nonpharmacological intervention consisting of five categories of activities (physical,
horticultural, musical, art, and instrumental activity of daily living; IADL) and applied it to those having a
mild stage of Alzheimer’s disease. The experimental group participated in a total of 24 sessions––five
times per week for one hour per session––while the control group took part in regular activities offered by
the existing facilities. The experimental group presented improved cognitive functions, reduced
depression, and enhanced quality of life; the two groups showed a statistically significant difference in
every category. This study is meaningful in that it made a cognitive stimulation program concerning five
different categories, implemented it for people suffering mild dementia, and confirmed positive outcomes.
If a systemic version of the program is offered in dementia care facilities, it is expected to make a
considerable contribution to the care of dementia patients.

Population aging has become a grave social issue globally. Korea, in particular, is seeing the fastest
population aging among OECD member countries; it became an aged society in 2018 with the old
accounting for 14.3% of the entire population and is estimated to enter a superaged society in 2026 with
the figure reaching 20.8% [[ 1]]. Physical function, along with cognitive abilities (including memory),

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 3 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

deteriorates with age. In particular, Alzheimer’s disease (AD) poses as a serious threat for overall
cognitive function [[ 2]]. According to reports from the Korean National Institute of Dementia, the
prevalence of AD has sharply increased as the population has aged, with a national estimate of
approximately 75,000 AD patients aged over 65 in 2018, making up about one-tenth of the overall senior
population [[ 3]].

Alzheimer’s disease (AD) is the most frequent cause of dementia in the older population. AD consists of
progressive cognitive decline, frequently presenting initially as short-term memory impairment and
affecting judgment, decision making, and orientation skills. Later stages of the disease also present with
behavioral disturbances and language abnormalities [[ 4]]. Socioeconomic costs following an increase in
AD should be reduced, and the prevalence of AD must be decreased through early diagnosis and
treatment so as to improve the quality of life of patients and caregivers. In order to do so, social support
measures should be in place. Nonpharmacological interventions are most frequently used to prevent and
treat AD. Pharmacological intervention helps slow the progress of AD and partially releases cognitive and
mental behavioral symptoms, yet it largely preserves the existing symptoms and its side effects, which
may occur after taking the medicine for a long period of time, can make AD patients feel frustrated, and
can leave their family anxious and helpless [[ 5]]. Hence, nonpharmacological interventions are attracting
more attention as preventive and therapeutic measures. They include cognitive stimulation activities,
which help people live independently while maintaining a high quality of life; improve cognitive, physical,
and sensory functions; and develop social skills through various activities and programs [[ 6]]. Meanwhile,
AD patients are currently participating in activities at home or in adult daycare centers that are randomly
selected by program instructors. Such activities, however, present some issues. Face-to-face cognitive
stimulation training provides a good example. While there is a booklet that introduces the training,
detailed explanation about how it works are missing. Moreover, the training itself mostly consists of
written tasks, so it is ineffective in encouraging physical movement. As for computerized cognitive
training, it cannot be offered when there is no computer program. In this respect, a systemically
organized cognitive program should be provided that addresses those drawbacks.

Depression is one of the most prevalent psychological diseases in old age, along with the increased
incidence of AD. The onset of depression can occur in the early stages of cognitive dysfunction and has
been reported to increase the risk of AD by increasing the rate of progression of cognitive dysfunction. As
such, depression may be a prodromal symptom or may increase the rate of the onset of AD [[ 7]]. One of
the positive functions of recollection is that it reinterprets and reunifies the unresolved matters of the past,
resolves psychological conflict, cognitively reconstructs various senses of defeat, and gives new meaning
to life, thereby helping overcome a depressing reality and boosting self-integration [[ 8]]. Recollection
activities recover forgotten personal experiences and memories, allowing the subject to experience
emotions linked to past experiences. Familiar objects, media (such as pictures), and songs can be used
for recollection [[ 9]]. It is also an activity of locating oneself in the present by using the intact long-term
memory of the past and is rarely affected by the subject’s education or severity of the symptoms [[10]].

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 4 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Previous studies mostly depended on story-telling, films, images, and picture books for recollection
activities, but some reports suggest that a recollection method accompanied by occupational activity is
more effective than using just auditory or visual stimuli, and a program focused on activities that the
subject used to perform in the past is better in terms of boosting memory, self-esteem, and interaction
[[11]].

Taking these factors into consideration, the researchers referred to the AD prevention program offered by
local dementia support centers and adult daycare centers in Seoul [[13]]. In an effort to determine the
efficacy of reconstructed occupational therapy programs, these programs integrated recollection
throughout the five categories of activities identified in previous research as being beneficial to cognitive
function (physical, horticultural, musical, artistic, and IADL).

2. Methods

2.1. Participants
This study examined AD patients with a mild stage of AD who visited A and B adult daycare center
located in P city from February to March, 2019. The detailed recruitment criteria were as follows: ( 1)
seniors aged 65 or older. ( 2) those who did not have a brain disorder other than dementia, ( 3) those who
were diagnosed with mild AD, ( 4) those who were able to follow instructions and did not have any
auditory or visual impairment, and ( 5) those who were informed of the purpose and the methods of the
study and agreed to participate. The exclusion criteria were as follows: ( 1) those who had difficulty in
identifying objects due to poor eye sight or a visual perception issue, ( 2) those who had a serious
physical disorder, ( 3) those who suffered a brain injury apart from dementia, and ( 4) those who were
unable to concentrate on an activity because of an unstable vital sign.

2.2. Study Design
For this study, 35 dementia patients with a mild stage of AD who were attending an adult daycare center
were recruited and then randomly divided into the experimental and control groups. The majority of the
users for both institutions were AD patients, as were the selected subjects. Before the intervention, the
two groups’ general characteristics and cognitive functions were first examined to confirm homogeneity.
All assessments and interventions were performed by a therapist who had over five years of occupational
therapy experience. The experimental group joined a recollection-based occupational therapy program
constructed by the author where they were asked to engage in one activity every day from Monday to
Friday. By contrast, the control group participated in the regular activities provided by their existing
daycare centers. Regular activities included physical and recreational activities, arts and crafts, music
activities, and rest and are listed in detail in Table 1. The program for the experimental group was offered
for a total of 24 sessions, five times per week for an hour per session, and the initial evaluation and
reevaluation were conducted prior to and after the intervention, respectively. The program was offered in
both institutions, but at different times in order to avoid overlap. The process is depicted in Figure 1.

https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c@sessionmgr4008&vid=6&ReturnUrl=https://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=5&sid=41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008%23toc

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 5 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Table 1 Typical activities at the adult day care center (provided to the control group).

Category Task Examples of activities

Physical
activity

Strength training Raises using light weights, knee bends

Physical
activity

Balance exercise Balancing on one leg without support, maintaining standing position on a
balance board

Physical
activity

Flexibility training Upper- and lower-body stretches

Physical
activity

Cardiovascular
exercise

Walking a set distance

Recreation Games Throwing darts, balloon volleyball, bowling, Yut-Nori (folk game)
Arts and
crafts

Hands-on creations Origami, clay art, knitting

Musical
activity

Folk sing alongs Singing along folk songs

Rest Watching TV TV program of choice
Graph: Figure 1 Study process.

2.3. Recollection-Based Occupational Therapy Program
The program was developed by referring to dementia prevention programs that were actually provided in
dementia support centers and community welfare centers in Seoul. Activities that many studies found
effective in preventing dementia through improved cognitive functions were divided into five categories
and adopted to the program developed [[15]–[17]]. The program was made over a year, from January
2018 to December 2018. Expert advice was sought from “an occupational therapist with at least five
years of experience in senior occupational therapy” when selecting the final program to adopt in the
study. As previous research identified the need for at least 10 experts for the Delphi technique [[18]], 10
experts were consulted using the Delphi survey. Initially, 20 programs for each of the “physical,
horticultural, musical, artistic, and IADL” categories of activities were made for a total of 100 programs.
Further, nine programs for each activity, resulting in a total of 45 programs, were finalized following three
sessions of expert consultation. Each program was further divided by content into the recollection of
childhood, adulthood, and late adulthood. As a reference for the program instructor, a manual for the
entire program was produced that contained images of what to prepare for in each session and how
activities should be done consecutively to offer detailed information on which functions could be improved
through such activities (see Table 2).

Table 2 Contents of the program (provided to the experimental group).

Category Stage of lifeTask What to recall (or to do) Difficulty
Physical Childhood (i) Make a Yut board and (i) Memories of enjoying fun activities with family Easy

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 6 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

activity play Yut(ii) Make Tuho
with newspaper and play
Tuho(iii) Play cloth
Jegichagi

during holidays(ii) Memories of playing Tuho with
friends in the town(iii) Memories of playing
Jegichagi in the childhood

Easy

Adolescence
adulthood

(i) Play bowling with
plastic bottles(ii) Play blue
flag white flag game(iii)
Play darts

(i) Memories of play bowling with co-workers and
having fun(ii) Memories of attending a sports day at
their child’s school(iii) Memories of playing darts
with their child

Medium
Medium
Hard

Late middle
age

(i) Play the fruit basket
game(ii) Give massage(iii)
Play the “dance with fun,
then stop” game

(i) Memories of harvesting crops and fruits in the
autumn(ii) Memories of getting massage from a
grandchild(iii) Memories of dancing with a
grandchild and having fun

Medium
Medium
Hard
Musical
activity

Childhood (i) Point to a body part(ii)
Make a pipe out of a
straw and play it(iii) Play
the handbell

(i) Memories of pointing to a body part with friends
and singing a song in childhood(ii) Memories of
making a pipe with leaves found in the roadside
and playing with it in childhood(iii) Play the handbell
to an easy song such as “twinkle, twinkle, little star”

Easy
Easy
Medium

Adolescence
adulthood

(i) Sing a song associated
with a given word(ii)
Listen to the intro of a
song and guess what
song it is(iii) Beat time to
traditional music

(i) Memories of songs that they enjoyed and sang
often in adulthood(ii) Listen to the intro of a
children’s song that they used to sing for their child
and give its correct title(iii) Memories of attending a
town festival with their child and singing songs
together

Medium
Hard
Hard

Late middle
age

(i) Sing songs in different
beats and beat time(ii)
Sing a song about
hometown(iii) Listen to a
traditional children’s song
and do a mask dance

(i) Sing along songs with 2/4, 3/3, and 4/4 beats,
and beat time by lightly tapping their fingers on the
table(ii) Sing a song that can help bring up
memories of their hometown such as “spring in my
hometown” or “Santa Lucia”(iii) Memories of
dancing at a festival in town wearing a mask

Medium
Medium
Easy

Art activity Childhood (i) Draw a fingerprint(ii)
Make a refrigerator
magnet(iii) Make a crystal
snowflake

(i) Memories of stamping a seal using their
fingerprint in the childhood(ii) Remember animals or
fruits they saw in the past(iii) Memories of having a
snowball fight with friends in the childhood

Medium
Medium
Hard
Adolescence
adulthood

(i) Make a miniature
folding screen(ii) Dye a
cloth bag(iii) Make a
household ledger

(i) Memories of preparing for ancestral rites(ii) Dye
a bag while recalling memories of going grocery
shopping with their child(iii) Make a household
ledger while remembering younger days when they
managed family finances

Hard
Medium
Medium

Late middle
age

(i) Draw and decorate the
Korean flag(ii) Make a

(i) Recall how Korea used to be in the past and
compare it with the present(ii) Make a humidifier to

Easy
Easy

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 7 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

humidifier using felt
cloth(iii) Dye a T-shirt

protect their skin from getting drier while recalling
younger days when they had good skin(iii)
Decorate a T-shirt to give their grandchild as a gift

Easy

Horticultural
activity

Childhood (i) Make a name tag using
pressed flower(ii) Make a
frame using beans(iii) Dye
fingernails with garden
balsams

(i) Remember their name and find out who they
are(ii) Remember their mother(iii) Memories of
dying fingernails with garden balsams and running
around in the field in childhood

Medium
Medium
Easy
Adolescence
adulthood

(i) Make a dish garden(ii)
Make a topiary face(iii)
Grow buds

(i) Memories of their family living in a small space
harmoniously(ii) Memories of their youth(iii) Hard
but fun memories of raising their child

Medium
Hard
Easy

Late middle
age

(i) Make a grass doll(ii)
Make a potpourri(iii) Make
a flower basket

(i) Recall what their grandchild looks like(ii)
Memories of darning blankets and sewing in the
past(iii) Memories of receiving flowers from their
child as a gift

Medium
Hard
Easy

IADL
activity

Childhood (i) Play the chopstick
game(ii) Make rice
balls(iii) Do sand play

(i) Pick and move stuff using chopsticks while
recalling the memories of learning how to use
chopsticks in childhood(ii) Make rice balls while
recalling ones they ate during the Korean war(iii)
Memories of playing with earth with friends in
childhood (feel what earth is like)

Hard
Medium
Medium
Adolescence
adulthood

(i) Hang the laundry(ii)
Sew(iii) Flip holiday food

(i) Memories of washing their young child’s clothes
and hanging them on a clothesline(ii) Try sewing
using a thick thread and felt cloth, and recall
mending their child’s clothes(iii) Try flipping through
printed images of holiday food and recall preparing
for holidays

Easy
Medium
Easy

Late middle
age

(i) Walk on a balance
board(ii) Draw a rough
map(iii) Make my own
calendar

(i) Practice maintaining balance on a balance
board(ii) Draw a rough map while recalling their
current house and former houses(iii) Write down
important family events

Medium
Hard
Easy

2.4. Measurements

2.4.1. Functional Independent Measure (FIM)
This well-known assessment tool was developed in 1983 by Ganger et al. for objective functional
assessments of ADLs. Each domain is rated by a score ranging between 1 and 7, depending on the level
of independence, with a score of 1 indicating total dependence, and where a score of 7 indicates total
independence. The assessed domains include self-care, sphincter control, transfer, locomotion,
communication, and social cognition. Achievable scores range from 18 to 126, with higher scores
indicating higher ADL function [[19]].

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 8 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

2.4.2. Korean Mini-Mental Status Examination (K-MMSE)
This is an assessment tool that has been translated into Korean and standardized by Kang et al. [[20]]. It
contains a total of six categories and 27 items consisting of orientation to time, orientation to place,
registration, attention and calculation, recall, language, and visuospatial composition ability. The
maximum score is 30, with scores higher than 24 indicating normal, 20–23 points indicating mild cognitive
impairment, 10–19 points indicating moderate cognitive impairment, and scores of 9 or less indicating
severe cognitive impairment [[21]].

2.4.3. Subjective Memory Complaints Questionnaire (SMCQ)
This questionnaire has 14 items and is designed to evaluate old people’s subjective memory
deterioration. All items are rated on a 2-point scale of either “yes” or “no,” and the optimal articulation
point for dementia is 5/6. The factors are divided into three types: overall, everyday life, and subjective
memory complaints [[22]].

2.4.4. Short-Form Geriatric Depression Scale-K (SGDS-K)
While the original Geriatric Depression Scale (GDS) was developed by Yesavage et al. [[23]] as a 30-item
self-report depression scale, it was later simplified to a 15-item scale (SGDS) by Sheikh and Yesavage
[[24]] as it took too much time to fill in the 30 items. In this study, the 15-item SGDS-K, the Korean version
of SGDS translated and standardized by Cho et al. [[25]] was employed to measure the participants’
depression. With an articulation point of 8, this tool is widely used by local communities when identifying
depression disorders.

2.4.5. Geriatric Quality of Life-Dementia (GQOL-D)
This tool consists of 15 items––13 on dementia patients’ physical health, psychological health, social
relationships, and environment; one on overall health; and one on life satisfaction––and is useful in
evaluating dementia sufferers’ quality of life [[26]].

2.5. Data Analysis
For statistical analysis, the program SPSS window version 23.0 was used. The significance level was set
at ! < 0.05 . General characteristics of the participants were analyzed for frequency using descriptive statistics. Paired and independent " -tests were carried out to compare the two groups pre-and postintervention and to compare intergroup differences, respectively.

3. Results

3.1. Demographics and Baseline Characteristics
The total of 35 participants consisted of nine men and 26 women. The experimental group was
80.6 ± 5.12 years old on average, while the control group was 77.88 ± 5.49 . Educational years of the
experimental group was 6.62 ± 3.64 and that of the control group was 7.19 ± 3.48 . Functional
Independence Measure (FIM) scores of the experimental group was 78.82 ± 11.42 ; the control group

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 9 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid=…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

registered scores of 79.27 ± 12.98 . In terms of demographic characteristics, the two groups presented no
statistically significant difference, thereby confirming homogeneity (Table 3).

Table 3 Characteristic of participants.

Experiment group (
## = 18
)

Control group (
## = 17
)

Gender,
#
(%)
Male 3 (16.7) 6 (35.3) 0.223
Female 15 (83.3) 11 (64.7)
Age (years) 80.6 ± 5.12 77.88 ± 5.49 0.138
Education (years) 6.62 ± 3.64 7.19 ± 3.48 0.211
FIM 78.82 ± 11.42 79.27 ± 12.98 0.237
1 FIM: Functional Independent Measure.

3.2. Test for Homogeneity in Preintervention Cognitive Functions, Depression, and Quality of…
Before the intervention, the homogeneity of the experimental and control groups was tested in terms of
cognitive functions, depression, and quality of life. There was no statistically significant difference
between the groups, thus proving the homogeneity (Table 4).

Table 4 Homogeneity test of dependent variables.

Experiment group (
## = 18
)
Control group (
## = 17
)
!!

SMCQ 5.83 ± 3.68 5.52 ± 2.03 0.802
K-MMSE18.70 ± 1.68 18.10 ± 1.58 0.661
SGDS-K 6.55 ± 3.50 7.05 ± 3.30 0.665
GQOL-D 30.11 ± 7.06 28.64 ± 6.50 0.291
2 SMCQ: Subject Memory Complaint Questionnaire; K-MMSE: Korean Mini-Mental Status Examination;
SGDS-K: Short-Form Geriatric Depression Scale-K; GQOL-D: Geriatric Quality of Life-Dementia.

3.3. Comparison before and after Recollection-Based Occupational Therapy Program
The results of the ex-ante and ex-post analysis of recollection-based occupational therapy program as
well as the comparison of the experimental and control groups are as follows. In terms of subjective
memory deterioration measured by SMCQ, the experimental group’s average score went from 5.83 ± 3.68
to 4.16 ± 2.09 after the program, presenting a statistically significant improvement ( ! < 0.05 ), whereas the control group showed no significant change. When the postintervention outcomes of the experimental

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 10 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

and control groups were compared, there was a significant difference between the two groups ( ! < 0.05 ). Meanwhile, concerning changes in cognitive functions examined via K-MMSE, the experimental group, who scored 18.70 ± 1.68 before the program, afterwards scored 19.56 ± 2.17 , for a statistically significant change ( ! < 0.05 ), but such improvement was not observed in the control group. The post hoc comparison showed a significant gap between the two groups ( ! < 0.01 ).

Regarding changes of depression measured via SGDS-K, depression of the experimental group
decreased significantly from 6.55 ± 3.50 before the program to 4.10 ± 3.66 after ( ! < 0.05 ), whereas there was no significant change in the control group. When compared after the program, the experimental and control groups presented a significant difference from each other ( ! < 0.05 ). Finally, with regard to changes of quality of life assessed via GQOL-D, there was a statistically significant improvement for the experimental group as their score rose from 30.11 ± 7.06 to 33.50 ± 7.22 after the intervention ( ! < 0.01 ), but such change was not found in the control group. The post hoc comparison suggested a significant difference between the two groups ( ! < 0.05 ). Of the cognitive functions, depression and quality of life presented the biggest changes in the quality of life to the participants (Table 5).

Table 5 Change in outcome measurements after intervention.

Pretest Posttest !!
SMCQ
Experiment group5.83 ± 3.68

†
4.16 ± 2.09a $ 0.012b $

Control group 5.52 ± 2.03 6.05 ± 2.10
K-MMSE
Experiment group18.70 ± 1.6819.56 ± 2.17 $ 0.005 $ $

Control group 18.10 ± 1.58 17.68 ± 1.64
SGDS-K
Experiment group 6.55 ± 3.50 4.10 ± 3.66 $ 0.048 $

Control group 7.05 ± 3.30 7.05 ± 4.16
GQOL-D
Experiment group30.11 ± 7.0633.50 ± 7.22 $ 0.003 $ $

Control group 28.64 ± 6.50 26.88 ± 4.68
3 Mean ± SD , $ ! < 0.05 , $ $ ! < 0.01 . A significant difference from baseline after intervention in each group using paired " -test. A significant difference between the 2 group using independent " -test. SMCQ: Subject Memory Complaint Questionnaire; K-MMSE: Korean Mini-Mental Status Examination; SGDS-K: Short-Form Geriatric Depression Scale-K; GQOL-D: Geriatric Quality of Life-Dementia.

4. Discussion
In this study, recollection-based occupational therapy program was reconstructed to apply to mild AD
patients and its effects were investigated. The program was made up of five-category activities of

† a

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 11 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

physical, horticultural, musical, art, and ADL, and each category used themes whereby the subjects could
recall their childhood, adulthood, and late middle age. After about a year of composition, it is then applied
to AD patients to assess its effects.

To investigate the program’s effects, both SMCQ and K-MMSE were used, which showed that the
experimental group showed a statistically significant reduction in SMCQ compared to the control group
and also showed improvement in K-MMSE. This corresponds to the results of previous research that
found recollection is effective in maintaining and improving AD patients’ cognitive functions because it
helps in clarifying blurred memories [[26]]. Moreover, the improved cognitive functions observed in this
study seem attributable to the fact that the participants engaged in the program more actively as they
recalled the past and engaged in activities that were familiar to them; in the process, they also utilized
procedural memories remaining in their long-term memory, thereby revitalizing the brain and encouraging
active participation [[27]].

The experimental group also showed reduced levels of depression after the program, and according to
Eom [[28]], senior citizens under a group recollection therapy can alleviate distress and experience
feelings of support by sharing their memories with others; they also experience a positive change in
emotions by bringing good emotions of the past to the present. Geriatric depression is characterized by
losing interest in one’s surroundings, frequently feeling fatigue, having difficulty in waking up early in the
morning, and often feeling helpless about death [[29]]. In this study, however, AD patients presented a
significant decrease in depression after participating in the recollection-based cognitive stimulation
program and are expected to regain vitality in daily living.

This study found that the recollection-based occupational therapy program is effective in boosting quality
of life as well. This is because the therapy helps AD patients not only improve their cognitive functions but
also speak and make nonverbal expressions more frequently; alleviating problematic behavior, feel stable
emotions, and increase social exchange, thereby being able to lead to a better life [[30]]. It was found that
the quality of life of people suffering dementia is significantly related to negative emotions like anxiety and
depression, which have a tremendous impact on their mental status [[31]]. Butler [[32]] claimed that
people who recall their past and look back on their life can make an assessment of how they have lived
and thereby find new value in living. In this sense, it seems that the recollection program used in this
study gave the participants an opportunity to remember the good old days while enjoying fun activities.
By taking part in activities linked to different life stages––childhood, adulthood, and late middle age––and
sharing common experiences with others from the same generation, the participants formed greater
bonds with each other, improved social skills, and as a result, felt better about their lives.

The recollection-based occupational therapy program consists of art, music, and horticultural activities
where the subjects can make a piece of art or enrich their emotions through music, as well as engage in
physical activities. One of the merits of art activities is that they reinforce the subjects’ visuospatial
aspects and induce positive emotions [[26]]. By participating in art activities, AD patients, who have

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 12 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

deteriorated physical and cognitive functions and thus are unable to articulate their emotions, can release
energy and express their emotions or thoughts while reducing defensiveness or self-control [[33]]. It has
been proven that horticultural activities are highly effective in promoting positive thoughts, refreshing the
mood, easing stress, and stabilizing emotions by having the subjects take care of plants thereby
stimulating the five senses [[34]]. This is why horticultural therapy is being adopted by many facilities for
AD patients these days. As for ADL, daily life activities that AD patients usually do at home were
reconstructed for the program. This was because they tend to feel less pleasure and satisfaction with
themselves when performing unfamiliar activities [[35]]. By participating in ADL that they were familiar
with and good at in their daily lives, the participants in this study experienced a sense of their own
existence and self-efficacy, thereby becoming pleased and satisfied.

This study is not without limitations. First, it is difficult to generalize the results to the general public as
this study examined a small number of people. Moreover, there was no follow-up inspection to check
whether the participants maintained the improved functions after the program. Despite these limitations,
there is significance in the fact that programs involving the five activities—which were proven to be
effective for AD patients—were reconstructed throughout this study and that positive outcomes were
obtained from successful real-life applications of the programs to AD patients.

5. Conclusion
This study organized recollection-based occupational therapy program and applied it to dementia patients
suffering mild AD to investigate its effect. It was found that the intervention was effective in improving
cognitive functions, reducing depression, and enhancing the patients’ quality of life. If a more systemic
and organized program is introduced in long-term care facilities and dementia relief centers, it is expected
to make a great contribution in terms of policymaking.

Data Availability
( 1) The data used to support the findings of this study were supplied under license and so cannot be
made freely available. Requests for access to these data should be made at dj7407@cju.ac.kr. ( 2) The
data used to support the findings of this study are currently under embargo while the research findings
are commercialized. Requests for data, 12 months after publication of this article, will be considered by
the corresponding author. ( 3) The data used to support the findings of this study may be released upon
application to Dr. Kim, who can be contacted at dj7407@cju.ac.kr.

Conflicts of Interest
The author declares no conflicts of interest.

Acknowledgments
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the
Korea government (MSIT) (No. 2017R1C1B5076441).

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 13 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

REFERENCES
1 Korea S. Senior Statistics. 2014

2 Park Y.-S., Jee Y.-J., Bae S.-H. Effects of a dementia family support program on families’ attitude
towards dementia, desire for institutionalization, caregiving behavior and caregiving burden. Asia-Pacific
Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2017; 7(8): 781-793

3 Korea Central Dementia Center. National Institute of Dementia. annual report. Korean dementia
observatory 2017. 2017

4 Galimberit D., Scarpini E. Progress in Alzheimer’s disease. Journal of Neurology, Neurosurgery &
Psychiatry. 2011; 259(2): 201-211

5 Koo S. K., Park H. Y., Park J. H. A systematic review of nonpharmacological interventions on activities
of daily living with dementia. The Korean Gerontological Society. 2017; 37(2): 445-459

6 Han Y. R., Song M. S., Lim J. Y. The effects of a cognitive enhancement group training program for
community-dwelling elders. Journal of Korean Academy of Nursing. 2010; 40(5): 724-735,
10.4040/jkan.2010.40.5.724, 2-s2.0-78650717085, 21157174

7 Kim K.-J., Noh D.-h., Han S.-H., Cha Y.-J., Kam K.-Y. Correlation between depression and memory
according to apolipoprotein E genotype in elderly with Alzheimer’s dementia. The Korea Academia-
Industrial cooperation Society. 2020; 21(1): 477-486

8 Kim H. J., Song Y. H. The effect of reminiscence-oriented sand play for ego-integrity of the elderly.
Korean Journal of Play Therapy. 2014; 18(1): 73-87

9 Lim S.-h., Shin J.-i. A systematic review of reminiscence therapy interventions applied to patients with
in dementia. Society of Occupational Therapy for the Aged and Dementia. 2019; 13(2): 77-88,
10.34263/jsotad.2019.13.2.77

Wang J. J., Yen M., OuYang W. C. Group reminiscence intervention in Taiwanese elders with dementia.
Archives of Gerontology and Geriatrics. 2009; 49(2): 227-232, 10.1016/j.archger.2008.08.007, 2-s2.0-
67649987679, 18930560

Yim K. M., Park J. H. The effects of occupational reminiscence therapy applied to the elderly with
dementia: a pilot study. Journal of Korean Society of Occupational Therapy. 2013; 21(2): 1-12

Park J. K., Kim J. M., Nam H. J. The effects of group reminiscence counseling on ego integrity,
depression, death anxiety of the elderly. Journal of the Korea Gerontological Society. 2011; 31(1): 49-61

Lee J. H. The effect of shelter of dementia on cognitive function and depression level in elderly people in

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 14 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

community. The Journal of Occupational Therapy for the Aged and Dementia. 2016; 10(2): 1-9

Kim S. Y., Kim Y. S., Nam Y. H., Kim H. Task-oriented approach program on self-efficacy scale and
activities of daily living, geriatric quality of life in dementia patients. Society of Occupational Therapy for
the Aged and Dementia. 2018; 12(1): 21-33, 10.34263/jsotad.2018.12.1.21

Jung B. H. The effect of cognitive occupational therapy in community living elders with mild cognitive
impairment and dementia. The Society of Digital Policy and Management. 2013; 11(3): 317-325

Shin S. J., Lee J. S. The impact of cognitive behavioral therapy on wandering and care burdens for
patient with dementia. The Journal of Occupational Therapy for the Aged and Dementia. 2013; 5(1): 33-
45

Yim J. Z. Cognitive rehabilitation “dementia prevention program” operation case. Korean Academy of
Rural Health Nursing. 2010; 1(1): 1-36

Ewing D. M. Future competencies needed in the preparation of secretaries in the State of Illinois using
the Delphi technique. 1992; Dissertation, University of Iowa

Hamilton B. B., Granger C. V., Sherwin F. S., Zielezny M., Tashman J. S. A uniform national data system
for medical rehabilitation. 1987: Brooks; Baltimore

Kang Y. W., Na D. R., Han S. H. A validity study on the Korean mini-mental state examination (K-MMSE)
in dementia patients. Journal of the Korean Neurological Association. 1997; 15(2): 300-308

Han T. R., Shin H. I., Kim S. J. The effect of prism treatment in patients with stroke with unilateral
ignorance – preliminary study. Annals of Rehabilitation Medicine. 2011; 25(3): 412-417

Lee J. S., Lee W. K., Park E. M. Subjective memory complaints and objective cognitive functions of the
elderly living in the institution. Korean Journal Psychopathology. 2006; 15, 27-36

Yesavage J. A., Brink T. L., Rose T. L., Lum O., Huang V., Adey M., Leirer V. O. Development and
validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatry Research.
1982; 17(1): 37-49, 10.1016/0022-3956(82)90033-4, 2-s2.0-0020286558, 7183759

Sheikh V. I., Yesavage V. A. Brink T. L. Geriatric depression scale (GDS): recent evidence and
development of shorter version. Clinical Gerontology; a Guide to Assessment and Intervention. 1986:
New York; Haworth Press

Cho M. J., Bae J. N., Suh G. H. Validation of Geriatric Depression Scale, Korean version (GDS) in the
assessment of DSM-III-R major depression. Journal of the Korean Neurological Association. 1999; 38,
48-63

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 15 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Kim M. J., Oh M. The effect of reminiscence-oriented group arts therapy on the ego integrity, depression
and quality of life for the elderly patients with dementia in a nursing home. Journal of Arts Psychotherapy.
2018; 14(1): 249-271, 10.32451/KJOAPS.2018.14.1.249

Huang S.-L., Li C.-M., Yang C.-Y., Chen J.-J. J. Application of reminiscence treatment on older people
with Dementia. Journal of Nursing Research. 2009; 17(2): 112-119, 10.1097/JNR.0b013e3181a53f1b, 2-
s2.0-70249111229, 19516105

Eom M. Y. In a social welfare center for the elderly = evaluating the effects of a reminiscence group
therapy for the elderly with stroke. Journal of the Korea Gerontological Society. 2000; 20(1): 21-35

Joo A. R., Park S. H. The relationship between cognitive function and depression in elderly people in
rural areas. Journal of Korean Gerontology Nurse. 2004; 6(1): 27-37

Kim S. Y., Kim Y. S. Effects of occupational reminiscence therapy applied on depression, memory and
behavioral problems in the elderly with dementia. The Journal of Occupational Therapy for the Aged and
Dementia. 2014; 8(2): 1-10

Banerjee S., Smith S. C., Lamping D. L., Harwood R. H., Foley B., Smith P., Murray J., Prince M., Levin
E., Mann A., Knapp M. Quality of life in dementia: more than just cognition. An analysis of associations
with quality of life in dementia. Journal of Neurology, Neurosurgery & Psychiatry. 2006; 77(2): 146-148,
10.1136/jnnp.2005.072983, 2-s2.0-32344443521, 16421113

Butler R. N. The life review: an interpretation of reminiscence in the aged. Psychiatry. 2016; 26(1): 65-76,
10.1080/00332747.1963.11023339

Ha H. M., Choi E. Y., Jeon J. K. Effects of group art treatment reflecting reminiscence therapy on the
quality of life of the elderly with mild dementia living in health care centers. Korean Journal of Art
Therapy. 2012; 19(2): 405-421, 10.35594/kata.2012.19.2.011

Kim H. N., Park W. K. The effects of horiticultural activities program on depression of the dementia elderly
at the facility. Journal of Korean Aging Friendly Industry. 2015; 7(2): 13-20

Chung J. C. C. Activity participation and well-being of people with dementia in long-term-care settings.
OTJR: Occupation, Participation and Health. 2016; 24(1): 22-31, 10.1177/153944920402400104, 2-s2.0-
0347087365

~~~~~~~~
By DeokJu Kim

Reported by Author

1/17/21, 4:58 PMGCU Library Resources – All Subjects

Page 16 of 16https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/delivery?sid…26sid%3d41b3e0cd-05c1-4d4b-a8b4-fb8d3535f12c%2540sessionmgr4008

Turn in your highest-quality paper
Get a qualified writer to help you with

“ Article Analysis and Evaluation of Research Ethics. 1.5 pages. * 6 Hours* ”

Get high-quality paper

NEW! AI matching with writer

Hire a Writer

Client Reviews

4.9

Sitejabber

4.6

Trustpilot

4.8

Our Guarantees

100% Confidentiality

Information about customers is confidential and never disclosed to third parties.

Original Writing

We complete all papers from scratch. You can get a plagiarism report.

Timely Delivery

No missed deadlines – 97% of assignments are completed in time.

Money Back

If you're confident that a writer didn't follow your order details, ask for a refund.

New to Your Trusted Assignment Help Service? Sign up & Save

Calculate the price of your order

Type of paper needed:

Pages:

You will get a personal manager and a discount.

Academic level:

We'll send you the first draft for approval by at

Total price:

$0.00

Power up Your Academic Success with the
Team of Professionals. We’ve Got Your Back.

Power up Your Study Success with Experts We’ve Got Your Back.

Order Now Order Now