Australian College of Nursing - PICO Question and Search Strategy

This assignment, submitted by Satinderpal Kaur Kaler, presents a PICO question and search strategy focused on the use of music therapy to reduce agitation in elderly patients with dementia residing in nursing homes. The introduction highlights the prevalence of dementia and the challenges associated with managing behavioral symptoms like agitation, emphasizing the limitations of pharmacological interventions and the potential benefits of non-pharmacological approaches such as music therapy. The PICO question is: "In elderly residential/nursing home patients with dementia, does exposure to music therapy, in comparison with regular treatment, reduce agitation?" The assignment details the search strategy employed, including the use of Nursing Reference Centre Plus and Cochrane databases, the selection of journal articles, and the time frame and keywords used to ensure the inclusion of recent and relevant literature. The assignment concludes with a reference list of supporting literature.

Satinderpal Kaur Kaler
Student ID number 258800
1
PICO QUESTION AND SEARCH STRATEGY
by Satinderpal Kaur Kaler
Student ID number 258800
Cohort Code172
Suman Kumar
Australian College of Nursing
Sydney (NSW), Australia
18th May2019

Satinderpal Kaur Kaler
Student ID number 258800
2
PICO Question and Search Strategy
Introduction
It is estimated that about 35-48 million people across the globe are living with dementia
(Shibazaki & Marshall, 2015). Attributable to the aging of the populace and the incrementing
frequency of dementia, provisioning for care, consideration and restoration to people with
dementia is comprehensive task for the healthcare frameworks and the public (Davison et al.,
2016). As dementia progresses, a scope of mental capacities perpetually reduces. The ability to
do fundamental activities reduces, changes in identity and behaviour, expanded levels of stress
and in some cases, agitation become increasingly obvious among patients with dementia
(Shibazaki & Marshall, 2015). Behavioural symptoms of dementia mirror a decrement in the
elderly patients’ prosperity, quality of life and results in extensive adverse effect on their family
carers (Kwak, Anderson & O’Connell Valuch, 2018). Pharmacological intercessions are
accessible; yet, they have restricted capacity to treat a significant number of the symptom
manifestations. Pharmacological treatment can ensure unobtrusive transient impacts; however,
the outcomes are minimal from a long-term perspective (Shibazaki & Marshall, 2015). However,
there is extant research that demonstrates that nonpharmacological treatment methodologies, for
example, music therapy can successfully improve pertinent results (Kwak, Anderson &
O’Connell Valuch, 2018).
Two primary kinds of music-based helpful mediations can be recognized - open and
dynamic music therapy - and these are regularly consolidated (Kwak, Anderson & O’Connell
Valuch, 2018). Open restorative mediations comprise of tuning in to music a mediator who
sings, plays or chooses pre-recorded music for the patients (Kwak, Anderson & O’Connell

Satinderpal Kaur Kaler
Student ID number 258800
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Valuch, 2018). In dynamic music treatment, the patients are effectively associated with the
music-production, by playing small instruments such as drums, flute and many more (Kwak,
Anderson & O’Connell Valuch, 2018). Through music therapy, researchers have exhibited that
individuals with dementia demonstrate a dynamic decrease in their stress levels (Shibazaki &
Marshall, 2015). Agitation and atypical motor behavioural conducts regularly result when their
anxiety limits are surpassed, which could mirror hidden inconvenience, loss of control, or
responses to ecological clamours (Kwak, Anderson & O’Connell Valuch, 2018). With its
consistently expanding predominance, dementia has turned into a significant reason for inability
and reliance among the elderly individuals. Since it is useful in treating patients with dementia, it
can be hypothesized that music therapy will be beneficial in reducing agitation among elderly
residential/nursing home patients with dementia.
PICO Question
Table 1: PICO table for the proposed research
In elderly residential/nursing home patients with dementia, does exposure to music therapy, in
comparison with regular treatment, reduce agitation?

Satinderpal Kaur Kaler
Student ID number 258800
4
Search Strategy
A search strategy in two different health databases Nursing Reference Centre Plus and Cochrane
was performed using keywords such as behaviour, dementia and music. The databases were
limited to ‘journal articles’ ‘in English’, with 20 resources per database, with time-period limited
to five years (2015-2019) to ensure the integration of recent literature. Further, only ‘full-texts’
research articles were included to ensure that information was available for further critical
review and assessment. All the global studies related to the proposed PICO question were
integrated in the study. A screen-shot of the search database histories for Nursing Reference
Centre Plus and Cochrane is provided in figures 1 and 2 in pdf attachment respectively.

Satinderpal Kaur Kaler
Student ID number 258800
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Reference List
Davison, T. E., Nayer, K., Coxon, S., de Bono, A., Eppingstall, B., Jeon, Y.-H., … O’Connor, D.
W. (2016). A personalized multimedia device to treat agitated behavior and improve
mood in people with dementia: A pilot study. Geriatric Nursing, 37(1), 25–29.
doi:10.1016/j.gerinurse.2015.08.013
Kwak, J., Anderson, K., & O’Connell Valuch, K. (2018). Findings from a prospective
randomized controlled trial of an individualized music listening program for persons with
dementia. Journal of Applied Gerontology, 00(0), 1-14. doi:10.1177/0733464818778991
Shibazaki, K., & Marshall, N. A. (2015). Exploring the impact of music concerts in promoting
well-being in dementia care. Aging & Mental Health, 21(5), 468–476.
doi:10.1080/13607863.2015.1114589