Marley, Serena (2022) An examination of cognitive and psychological outcomes of a neuroeducation programme for individuals living with Mild Cognitive Impairment and their families. Masters thesis, National University of Ireland Maynooth.
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Abstract
Background
The definition of Mild Cognitive Impairment (MCI) is a cognitive decline more advanced
than one would expect based on a person’s age, but not severe enough to obtain a diagnosis
of dementia. Current literature varies on potential causes for MCI, and also on the impact
that depression, stress and anxiety may have on this neurodegenerative condition. Many
MCI patients go on to develop Alzheimer’s Disease (AD). However, research has indicated
that MCI patients can benefit from different types of intervention programmes. This study
had a number of aims including, (i) to examine the impact of a non-pharmacological
intervention, a four-week neuroeducation programme, on both patients with MCI and their
family members, on various tests of cognition, stress, depression and anxiety; (ii) to follow
up and qualitatively explore, using semi-structured interviews, the general impact and
usefulness of the neuroeducation programme; (iii) given the global impact of Covid-19, our
third aim was to examine, again using semi-structured interviews and interpretative
phenomenological analysis (IPA), the impact of the pandemic on patients with MCI and
their family members.
Methods
The study involved testing a sample of five participants, three with MCI, and two family
members (FM) who did not have MCI. This project used a mixed methods design in which
to analysis the data collected. All participants were given an initial battery of cognitive and
psychological tests including the Control Autonomy, Self-realisation and Pleasure scale
(CASP-19), the Satisfaction with Life Scale (SWLS), the Hospital Anxiety and Depression
Scale (HADS), the Community Integration Questionnaire (CIQ), the Cognitive Failures
Questionnaire (CFQ), the Montreal Cognitive Assessment (MoCA) and the Mini Mental
State Exam (MMSE). Following this, participants were provided with a 40-minute video
file weekly to watch, over a 4-week period and began in February 2021; this was conducted
online due to the Covid-19 pandemic. Weekly topics included: MCI and what it is; MCI
and its relationship to AD; MCI and life satisfaction; community integration; and MCI and
its relationship to diet and exercise. Following this four-week neuroeducation programme,
participants were asked to complete the same battery of cognitive and psychological tests
(with alternative versions where possible). Then, in a semi-structured interview,
participants were asked to provide an assessment of the programme, whether they felt that
it had had an impact, whether they found it useful and whether they would change aspects
of their lifestyle as a direct result of the programme. Finally, patients were asked to assess
the impact that Covid-19 was having on their lives, including restrictions and fear around
the disease.
Results
Results from the pre- and post-intervention battery of tests showed minimal and limited
changes in either cognitive (CFQ, MMSE, MoCA) or psychological measures (HADS,
CASP-19, SWLS). In terms of the assessing the programme itself, IPA revealed three key
themes which included Understanding, Lack of Time/Confidence and Intention to make
lifestyle changes after the intervention. Although most participants (both MCI patients and
family members) stated that they wouldn’t change their current lifestyle in terms of diet or
exercise, they understood the importance of these factors via the programme. Six common
themes emerged following our qualitative analysis on the questions relating to the impact
of Covid-19, these included: Family; Negative Emotions; Acceptance and Resilience;
Anxiety; and Restriction/Confinement. The interviews highlighted the importance of
family, social and care-networks in providing support and encouraging resilience.
However, despite this, the patients reported much anxiety around the disease itself, their
own situation (especially MCI patients), and anger due to restrictions imposed and the
limited contact allowed, brought about through the various government preventative
measures.
Discussion and Conclusions
Although the participant numbers in the current study are small, and any definitive
conclusions are difficult to make, we have shown that a neuroeducation programme may
be a useful tool to provide patients with MCI and their family members with an additional
understanding of the disorder and possible ways to improve lifestyles. In addition, the study
highlights the importance of talking to patients and family members to better understand
their worries and situation. As might be expected, Covid-19 had a particular impact that led
to anger and anxiety among all participants, but also led to a better appreciation of family
and an emerging sense of resilience. Such themes should be further explored among other
clinical populations as well as in the general society. Future research in this area should
aim to expand the numbers in both the MCI and family members, systematically compare
a neuroeducation programme to other types of interventions, and conduct follow-up
interviews that track changes in themes across time for both patients and families.
Item Type: | Thesis (Masters) |
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Keywords: | cognitive and psychological outcomes; neuroeducation programme; Mild Cognitive Impairment; families; |
Academic Unit: | Faculty of Science and Engineering > Psychology |
Item ID: | 16750 |
Depositing User: | IR eTheses |
Date Deposited: | 28 Nov 2022 12:50 |
URI: | https://mural.maynoothuniversity.ie/id/eprint/16750 |
Use Licence: | This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here |
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