Development of Six Arts, a Culturally Appropriate Multimodal Nonpharmacological Intervention in Dementia
- 6 November 2014
- journal article
- Published by Oxford University Press (OUP) in The Gerontologist
- Vol. 55 (5), 865-874
- https://doi.org/10.1093/geront/gnu102
Abstract
There is accumulating evidence for the efficacy of nonpharmacological multimodal stimulation interventions in maintaining cognition and improving quality of life in people with mild-to-moderate dementia. However, the complex nature of these interventions limits their application in practice and research. We report here the design and development of a culturally appropriate framework, the Six Arts, to guide delivery of multimodal interventions in a Chinese community.The Six Arts are a core set of Confucian philosophy comprising 6 disciplines of rites, music, archery, charioteering, literacy, and numeracy. They correspond to major mind-body functional domains of social functioning; music and rhythm; visuospatial and fine motor skills; kinesthetic and gross motor skills; language and verbal skills; and executive function. Using Six Arts as a framework, we mapped theoretical principles and evidence-based nonpharmacological interventions of cognitive stimulation, physical exercise, and social activities against the 6 functional domains. From 2011, we field-tested the use of Six Arts in structuring intervention programs in 263 people in a dementia day center in Hong Kong.The Six Arts was operationalized through the development of an intervention activity database, a scoring system for intensity level, and a service delivery model for application in dementia day centers.Six Arts can be used as framework for structuring nonpharmacological group intervention programs in dementia day center in a metropolitan Chinese city. Its cultural appropriateness may facilitate communication and shared decision making with families with dementia in communities influenced by Confucian philosophy.Keywords
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