The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

Author(s):  
Alaine E Reschke-Hernández

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

2014 ◽  
Vol 9 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Mary Beth Zwart ◽  
Bernadette Olson

Context It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding EBP concepts across the curriculum, a modified critical appraisal assignment was developed to teach therapeutic modality concepts. Objective The purpose of this action research project was to demonstrate how a modified critical appraisal assignment can be used to introduce the process and aspects of critical appraisal and begin scaffolding the development of critical appraisal skills over time. The objectives of this study were to evaluate the students' ability to (1) successfully locate relevant research needed to answer clinical questions and (2) successfully appraise the literature according to basic EBP strategy. From a program perspective, the modified critical appraisal assignment was a starting point from which to include EBP principles into didactic coursework. Design Seventeen athletic training students completed 3 modified critical appraisal assignments pertaining to the use of therapeutic modalities. Each paper included 5 sections: (1) clinical question, (2) key clinical findings, (3) clinical applicability based on information from the appraisal and significance of results, (4) article comparison table, and (5) implications for clinical practice, patient education, and future research. The instructor evaluated the assignments blind. Conclusions Students were generally able to complete the critical appraisal assignment; however, students had difficulty locating research that answered the clinical question. Students struggled to relate the key clinical findings of the research articles and implications for clinical practice to the given clinical question. Findings from this study have informed faculty teaching, including introducing EBP skills earlier in the curriculum and inserting assignments that stress various aspects of the critical appraisal process.


2021 ◽  
pp. 96-109
Author(s):  
Hafidz Triantoro Aji Pratomo

Background: Evidence Based Practice (EBP) is an important component in clinical practice of a Speech Therapist. Students can develop critical thinking pattern using credible literature. The sustainable implementation of EBP can improve practical quality of Speech Therapist, particularly in clinical decision making. EBP use in speech therapy clinical setting has been unknown in Indonesia. This research aims to identify the implementation of EBP by speech therapy students in clinical setting. Methods: The respondents employed in this study consisted of 35 students. The research was conducted using survey method. Survey was distributed online using Google form application. Sample comprised last-year students of Speech and Language Therapy Applied Bachelor Study Program. The students were those who have undertaken clinical practice in hospital, clinical, or other healthcare service facilities. Analysis was conducted descriptively with correlational analysis technique. Results: Descriptive analysis shows that students’ perceptions are varying. Inter-variable cororelation was analyzed using correlation test. The result of analysis shows coefficient of correlation (r) > 0.2, meaning that there is a correlation between case experience, EBP level knowledge, knowledge on EBP, speech therapist’s attitude and role, and EBP implementation Conclusion: Survey informs that scientific literacy culture is still weak. This study found the correlation between experience, knowledge, attitude, and EBP implementation. In-depth investigation is required on the different data appearing.


2004 ◽  
Vol 12 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Cláudio Rodrigues Leles ◽  
Maria do Carmo Matias Freire

A critical problem in the decision making process for dental prosthodontic treatment is the lack of reliable clinical parameters. This review discusses the limits of traditional normative treatment and presents guidelines for clinical decision making. There is a need to incorporate a sociodental approach to help determine patient's needs. Adoption of the evidence-based clinical practice model is also needed to assure safe and effective clinical practice in prosthetic dentistry.


2019 ◽  
Author(s):  
Jessica Paynter ◽  
Sarah Luskin-Saxby ◽  
Deb Keen ◽  
Kathryn Fordyce ◽  
Grace Frost ◽  
...  

Background. Continued use of practices not supported by empirical evidence is an ongoing challenge in the field of autism spectrum disorder (ASD). Knowledge and individual attitudes to evidence-based practice, as well as accuracy of categorization of practices on their evidence base, have been linked to practice selection in allied health professionals. This study aimed to extend this research to early intervention staff, and investigated perceived evidence base of practices, and links to intended future use, along with individual attitudes and sources of information accessed.Method. Participants included 86 early intervention staff who completed an online survey. They rated the evidence base of six ASD intervention practices (three unsupported by research, three empirically supported), along with current and intended future use of these, as well as attitudes to research and to evidence-based practice. Results. At a group level, participants reported using, and intending to use in future, the empirically supported practices more than unsupported practices, and generally accurately reported a higher evidence base for the empirically supported practices. However, a number of individual participants showed inaccuracy in ratings varying by practice. Perceived evidence was linked to greater intention to use practices in the future, while few links to individual attitudes were found. Conclusions. Our findings point to the influence of perceived evidence on intended use of practices. Perceived evidence may be impacted by lack of awareness and/or misinformation regarding the evidence base of practices. The need for accurate information about both empirically supported and unsupported practices, as well as strategies to seek and evaluate information are highlighted. Limitations of the self-report methodology, and future research directions including broader clinical decision-making processes are overviewed.


Author(s):  
Rachel J. Hinrichs

Objective: This study explored dietetic interns’ perceptions and knowledge of evidence-based practice (EBP), their use and observation of EBP principles during their clinical rotations, and their intentions to use EBP in their careers.Methods: A mixed methods design combining a survey and focus group was employed. Dietetic interns (n=16) from a large Midwestern university were recruited in person and via email to participate in the survey, focus group, or both. Perceptions and experiences of EBP were analyzed through the focus group (qualitative), and EBP knowledge and clinical practice behaviors were analyzed through the survey (quantitative). The focus group discussion was recorded, transcribed, and analyzed using thematic analysis.Results: Four major themes emerged from the focus group data: (1) observations of EBP in clinical practice, (2) use of EBP during clinical rotations, (3) barriers to EBP, and (4) perceived use of EBP as future registered dietitians. Interns considered EBP important for their profession and future careers. They struggled, however, with the discrepancies between current research and practice, and highlighted differences that they observed and barriers that they experienced across different clinical settings.Conclusions: This exploratory study is the first to examine dietetic interns’ perceptions of and experiences with EBP in the clinical setting. Future research is needed to identify how dietetics educators, librarians, and preceptors can address the barriers that interns perceive in applying EBP in their internships.


2020 ◽  
Vol 25 (1) ◽  
pp. 6-9
Author(s):  
Catriona Kennedy ◽  
Mokholelana Margaret Ramukumba

Ease of access to vast amounts of information presents significant opportunities and challenges for nurses in the community as they seek to base their practice on the best available evidence. Growing expectations around evidence-based practice have developed alongside developments in evidence synthesis, which adopts robust approaches to identifying, appraising and synthesising key evidence for clinical decision-making. The context in which evidence-based practice occurs is key, and this article discusses the skills and knowledge needed for community nurses to discern how evidence and information should influence their decisions to review and change approaches to clinical practice. Importantly, if nurses understand the status of evidence underpinning areas of practice, they can ensure that the preferences and needs of patients and families are met.


2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


Author(s):  
Wendy Bowles ◽  
Jacalyn Buck ◽  
Bevra Brinkman ◽  
Brenda Hixon ◽  
Jinhong Guo ◽  
...  

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