Authors (including presenting author) :
LEE SC, TANG VYM, WONG LP, LAM MY, CHEUNG C Y, MOK HT, SUEN LF, FONG KY, LUI N, LI WH, HUI SL
Affiliation :
Community Nursing Service, Kowloon Hospital
Introduction :
As the aging trend intensifies, elderly with chronic health issues is increasing trend in Hong Kong. Apart from physical health conditions, cognitive impaired elderly suffer from impaired memory, behavior and cognitive function, causing emotional distress and agitation are common. Caring for the elderly with cognitive impairment at home poses several challenges. If these elderly have nursing care needs at home, but together with challenge behaviors, such as non-compliant to medication management, un- intention to pull out urinary catheter or tear away wound dressing, these problems may lead to cause health risks and generate increased the burden of caregivers. Multiple studies have evidenced doll therapy was found to demonstrate several benefits, including increasing ability to receive care and fewer negative verbal, happiness level, social interaction and expressions. Doll therapy is a non-pharmacologic way to address challenging emotions and behaviors for the cognitive impaired elderly. In this connection, Community Nursing Service of Kowloon Hospital launched a program on “ Doll Therapy- Bring Happiness to Life in the Community’.
Objectives :
1. Improve the quality of life of cognitive impairment patients in the community
2. Promote compliance with nursing care needs in the community
Methodology :
1. Assess patients’ needs
I.Assess patients for any challenges behaviors and or non-compliant to nursing
care. Includes patients with AMT less than 6/10 and or cognitive impairment
history
II.Identify targeted patients who interest with doll to enhance engagement
2. Select appropriate dolls, e.g boy or girl to cater personal preferences
3. Provide dolls and accessories, including clothing, props and blankets for dolls
4. Introduce the dolls to patients and his/her caregivers
5. Engagement activities
I. Teach patients and train the caregivers to play and interact with dolls
II. Adjust the approach regarding the feedback and observations to better individuals’ responses
6. Monitor the influence on participants’ responses to nursing care needs
7. Participants are followed for 3 months or till treatment was completed
Result & Outcome :
The program was commenced from mid-2023 to end 2024. A total of 14 patients were recruited. All of them were female patients. Average age was 84.1. Majority of participants have medical history of Hypertension 66.7% (n=8), Dementia 50% (n=5) and diabetes mellitus 35.7% (n=5). Participants were recruited for poor drug compliance (n=3), non-compliant to keep dressing intact (n=3), irritable behaviors during wound dressing (n=4), unintentional to pull away urinary catheter (n-1) and sustained wound dressing pain (n=4) . Regarding drug compliance, community rated the compliance rate from 2.53 out of 5 to 4.13 out of 5 after the program. For willingness in receiving wound care, the compliance rate was from 2.33 out of 5 to 4.19 out of 5 after the program. Community nurses also observed 91.0 % of participants more relaxed when receiving wound care during the program. 66.7% community nurses agreed the program improved patient’s compliance to urinary catheter care. 91.6% of participants showed mood improvement and 87.5% of participants enhanced their interactions with caregivers. Community nurses rated the program 4.33 out of 5.
The program gained a positive result, that doll therapy showed being a valuable tool for enhancing treatment compliance, emotional well-being and fostering connection with every party. The program also created a supportive environment for the patients and caregivers when they suffer from illness.
