A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol
Abstract
:1. Introduction
1.1. Dementia as a Social Disease: The Impact of Dementia on Informal Carers’ Health and Social Life
1.2. The Contest of Dementia Diagnosis and Formal Care: A Snapshot of Italy and Mexico
1.3. Psychological Support and Psychotherapy Interventions: Gestalt Therapy View on Dementia and on Depression
1.4. Selection of the Research Design: Single-Case Experimental Design
1.5. Proposed Research Aims and Objectives
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- To assess if there is a pre/post improvement and, if so, how great this is (clinical significance), according to the outcome variables rates, as well as whether it can be attributed to the therapy intervention.
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- To assess if study participants suffer with loneliness.
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- To assess if loneliness is mitigated by the regular contact with the therapist.
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- To assess if the regular contact with the therapist affects the level of depression.
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- To assess if a clinical improvement of depression symptoms has an indirect effect on the level of family carers’ burden.
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- To assess if a clinical improvement has an indirect effect on the mutuality of the relationship between the patient and the family carer.
- Is there any pre/post treatment improvement?
- If the answer to question 1 is yes, is the change clinically significant (reduction of symptoms by 50%)?
- If loneliness is a factor, is the improvement solely due to the social contact with the therapist? OR
- Can the improvement be attributed to the therapy intervention?
- Can the improvement of the patient also have an impact on the caregiver’s burden and level of mutuality?
2. Materials and Methods
2.1. Research Design
2.2. Study Setting and Intervention
2.3. Sample and Recruitment
2.4. Measures and Data Collection Tools
2.5. Data Analysis
3. Discussion
4. Limitations and Challenges of the Research Protocol
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Instrument | Variable | Point of View | When It Is Used |
---|---|---|---|
Neuropsychiatric inventory (NPI) | Neuropsychiatric symptoms (patient) and caregiver distress | Expert judge interviews caregiver | Session “0” |
Clinical dementia rating (CDR) | Cognitive symptoms and dementia diagnosis | Expert judge interviews patient | Session “0” and follow-up |
Geriatric depression scale (GDS) | Depressive symptoms | Patient self-report | Session “0”, final session and follow up |
Anxiety indicated by an NPI-A score of 4 or more | Anxiety symptoms | Expert judge interviews Caregiver | Session “0”, final session and follow up |
Target complaints (TC) | Specific results of therapy | Patient self-report (after co-construction of instrument with a therapist) | Co-constructed at session “0” Client completes questionnaire every day after that until follow up session |
UCLA-LS3 | Loneliness | Patient self-report | Session “0”, final session and follow up |
QOL-AD | Quality of life | Expert judge interviews patient and family caregiver self-report | Session “0”, final session and follow up |
Ad-hoc common assessment tool | Level of care | Family member self-report | Session “0” |
Zarit burden inventory | Caregiver level of stress | Family member self-report | Session “0”, final session and follow up |
The mutuality scale | Mutuality of relationship | Patient and caregiver self-report | Session “0”, final session and follow up |
CORE–OM | Overall results of therapy | Patient self-report | Session “0”, final session and follow up |
Gestalt therapy fidelity scale (GTFS) | Treatment fidelity | Expert judge observes therapy sessions | End of first therapy treatment |
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Merizzi, A.; Biasi, R.; Zamudio, J.F.Á.; Spagnuolo Lobb, M.; Di Rosa, M.; Santini, S. A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol. Int. J. Environ. Res. Public Health 2022, 19, 3260. https://doi.org/10.3390/ijerph19063260
Merizzi A, Biasi R, Zamudio JFÁ, Spagnuolo Lobb M, Di Rosa M, Santini S. A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol. International Journal of Environmental Research and Public Health. 2022; 19(6):3260. https://doi.org/10.3390/ijerph19063260
Chicago/Turabian StyleMerizzi, Alessandra, Rosanna Biasi, José Fernando Álvarez Zamudio, Margherita Spagnuolo Lobb, Mirko Di Rosa, and Sara Santini. 2022. "A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol" International Journal of Environmental Research and Public Health 19, no. 6: 3260. https://doi.org/10.3390/ijerph19063260
APA StyleMerizzi, A., Biasi, R., Zamudio, J. F. Á., Spagnuolo Lobb, M., Di Rosa, M., & Santini, S. (2022). A Single-Case Design Investigation for Measuring the Efficacy of Gestalt Therapy to Treat Depression in Older Adults with Dementia in Italy and in Mexico: A Research Protocol. International Journal of Environmental Research and Public Health, 19(6), 3260. https://doi.org/10.3390/ijerph19063260