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Japan is an aged society, therefore to consider measures against the elderly with dementia who are increasing with increasing rate of aging is high priority for nursing. There are a variety of rehabilitation methods for the elderly with dementia. Among them, near infrared spectroscopy (NIRS) is one of therapies which nurses can perform. Many reports have indicated effects of the NIRS, and these effects have been determined by the Mini Mental State Examination (MMSE) or Hasegawa's Dementia Scale (HDS). However, few reports have used physiological indicators in order to evaluate them. In addition, reminiscence therapy is a complementary and alternative therapy, therefore nurses do not have such knowledge generally and few studies demonstrated its effects. Therefore, to establish the evidence of reminiscence therapy as a nursing care is required. The aim of this study is to clarify whether reminiscence therapy can be used to improve dementia as a nursing care. In order to prove it, I performed an intervention using personal reminiscence therapy in the elderly with dementia, and evaluated its effect by using brain waves and a set of optical encephalography. Reminiscence therapy is one of therapies which nurses can perform as an approach to the elderly with dementia. Many reports have indicated its effects, however, few reports in nursing have demonstrated the effects by using physiological indicators. The aim of this study is to clarify whether reminiscence therapy can be used to stimulate the brain as a nursing care by using a set of optical encephalography.
Methods:
1) Participants: 20 healthy adults aged 20 to 39.
2) Measurements
(1) Basic data: age, underlying diseases
(2) NIRS data (hemoglobin in the frontal lobe): Changes in blood flow was measured by the NIRS. The set of optical encephalography (Spectratech, Inc., OEG-16) was used to measure it. This device is noninvasive and can measure the activity of the frontal lobe.
(3) Arousal level data: I asked to the participants when they were most arousal (stimulus images, control images, or a conversation).
3) Measurement methods: I prepared reminiscence images (which described trends when the participants were childhood and were considered to recall the participants’ memories) and control images (abstracts images such as a landscape), and show these images to the participants. I prepared 40 reminiscence images and 40 control images (required time: total 10 minutes), and showed each images to the participants for 15 seconds per image. Subsequently, each participant had a conversation with a researcher for 10 minutes with the reminiscence images.
4) Methods: NIRS data can be measured by this device through 16 channels, but 4 channels were excluded (the rightmost and leftmost channels which caused remarkable noises, and the central 2 channels which could not be divided into the right and left brain). Therefore, I analyzed data for 12 channels (right 6 channels and left 6 channels). I compared the data between the right brain and the left brain for oxyhemoglobin (ΔOxy-Hb) for the reminiscence images and control images. Furthermore, simple tabulation was performed the subjective survey.
5) Ethical Consideration: This study was approved by the Research Ethics Committee of the university which the researcher belongs to. I recruited participants from the public, and I explained the study to candidates in verbal and written forms. After that, I obtained their written consent individually.
Results:
1) Participants: Average age, 21.9±2.7; 8 males and 12 females.
2) NIRS data: Concerning ΔOxy-Hb, all values of the left brain were significantly higher in 10 out of 12 channels for the stimulus images. In addition, all values of the left brain were significantly higher in 9 out of 12 channels for the control images. In the conversation, all channels except one channel whose data showed significantly higher value of the left brain revealed no significant difference between the right and left brain.
3) Subjective data: In the subjective survey, 15 out of 20 participants answered that they were more arousal when they saw the reminiscence images than control images. In addition, all participants answered that they were most arousal during the conversation. Furthermore, most participants answered that the conversation was fun.
Conclusion:
A comparison of ΔOxy-Hb levels revealed that there were differences in the activity of the right and left brain when the participants saw the reminiscence images and the control images. Some reports have indicated that the right brain is dominant to process visual information, however, the values in the left brain was higher than the right brain in this study. I intend to perform more detailed data analysis in future. I presume that the participants use both of the right and left brain during the conversation based on the fact that there were not much differences between the right and left brain in the conversation. Furthermore, subjective arousal level was highest during the conversation. I presume that the reason was that the frontal lobe was activated by the conversation. For ΔOxy-Hb levels, the right and left brain also showed their activity, indicating that the entire frontal lobe was used for reminiscence. From these results, I conclude that reminiscence therapy through a conversation with a subject can be used as a nursing care to activate the brain. Further investigation in the elderly participants will be required.
* This study was performed subsidized by Grants-in-Aid for Scientific Research (Basic Research C) by Japan Society for the Promotion of Science.