Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 11, 2023
Date Accepted: Jun 7, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Intergenerational reminiscence approach in improving emotional well-being of older Asian Americans in early-stage dementia using virtual reality: Protocol of an explanatory sequential mixed methods study design
ABSTRACT
Background:
After a dementia diagnosis, Asian Americans experience anxiety, feelings of shame, and other negative effects. However, they seek fewer formal services for support compared to White counterparts, leading to negative mental health outcomes. Emotional well-being is not only an important aspect of mental health, but also a quality of resilience that helps people bounce back faster from difficulties. However, few studies have addressed issues in developing, implementing, and testing intervention strategies to promote emotional wellbeing among older adults. Intergenerational solidarity between grandparents and grandchildren has been emphasized in Asian families and is beneficial for the health of persons with dementia. Reminiscence and life review have been identified as potentially effective intervention strategies for helping depression and emotional well-being for older adults.
Objective:
This proposed study aims to develop and evaluate the potential feasibility and effectiveness of an intergenerational reminiscence approach in improving the emotional well-being of Asian American older adults who have a recent dementia diagnosis.
Methods:
An explanatory sequential mixed methods design will be utilized in which quantitative data will be first collected and analyzed to identify subsamples of participants who reported the greatest and least change in emotional well-being, and then interview these subsamples to further understand why or why not this intervention works for them. Older adults will receive 6 sessions of life-review with grandchildren virtually (1-1.5 hours each week for 6 weeks), aided by pictures and virtually traveling to important places in their life using Google Earth to look around at those places and remember important times. Quantitative survey data will be collected at pre-, post-, and 3-month follow-up the intervention. Qualitative interviews with selected participants will also be integrated into the study design. The quantitative data from surveys will be entered to SPSS and analyzed using descriptive analyses, Fisher exact tests, Pearson chi-square tests, non-parametric independent samples t-tests, and repeated-measure Analysis of Variance (ANOVA). The qualitative data will be transcribed by research assistants and coded by the investigators independently, and then analyzed with guidance of content analysis using Atlas.ti software.
Results:
Project was delayed due to the COVID-19 pandemic. Data collection started in late 2021 and 26 participants were recruited as of December 2022. The respondence rate was approximately 72%. While we are still cleaning and analyzing quantitative data, the qualitative interview showed promising results of this intergenerational reminiscence approach in improving emotional well-being of Asian American older adults who have cognitive impairments.
Conclusions:
Intergenerational reminiscence provided by grandchild offers promising in improving the emotional well-being of grandparents. VR Technology is likely to be accepted by older adults. Future research may consider scaling up this pilot into a trackable, replicable model that includes more participants and develops a more rigorous study design with control groups to test the effectiveness of this intervention for older adults with dementia. Clinical Trial: NA
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