# data[].attributes.body
P = Elderly patients with dementia
I= Incorporating doll therapy in care
C= Standard level of care
O= Reduced aggression

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Boolean operators - [doll therapy OR empathy doll] AND [dementia or dementia care] AND [aggression or agitation]
PubMed search = 38 before adding 5 year filter
38 papers in total
35 not relevant to our search
3 suited our question
2 were sufficient
Trip medical = 0
Sage journal= 0
Cochrane= 0

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Therapy or intervention as the doll is the therapy being provided to the patients

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Can lifelike baby dolls reduce symptoms of anxiety, agitation, or aggression for people with dementia in long-term care? Findings from a pilot randomised controlled trial

Strengths

Pilot, mixed-methods, parallel, randomised controlled trial, with follow-up semi-structured interviews.

Behavioural scales OERS (asses 5 emotions) used CMAI-SF (used to asses 14 behaviours).

The title is descriptive and focuses on the results.

Residents assigned to the intervention group with the realistic baby doll spent 30 minutes with the doll on their own, three times a week (Monday, Wednesday, and Friday) for three weeks. These sessions were not supervised.

Intervention used work from previous companion robot intervention protocol and adapted to fit doll therapy.

P value >0.05

From the start, residents of the two groups were comparable to one another.

Only one withdrew from the intervention due to injury.

Facility care staff interviews regarding the participants' perspectives on doll therapy the completion of the three-week intervention session.

Written informed consent- next of kin or personal was obtained in all residents participating in the RCT.

Every intervention session with a realistic baby doll began with a request for verbal consent from each resident.

Concluded doll therapy has the potential to provide some residents a source of delight and meaningful interaction.

Life-like, weighted dolls. (gender, ethnicity and facial expressions).

Author declares no conflict of interest.

Weakness

Small sample size of residents participating in the RCT (n=36) from 5 facilities. Didn't meet their sample size.

Power calculation showed 76 people, paper is underpowered due to the small sample size.

All females participating.

All interviewees were female, 5 in total and had a range of experience.

The individuals were employed at their respective establishments for a duration ranging from 4 months to 15 years.

Additional study is required to prioritise the understanding of the specific attributes and situations in which inhabitants get the greatest advantages.

Only one RA assistant to code all video data. Would of been more beneficial to have more.

Interviews conducted over the telephone.

No blinding.

Risk of bias due to gate keeper.

Intention to treat was initially noticed, however, wasn't followed through due to two withdrawals.

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Effect of Doll Therapy in Behavioral and Psychological Symptoms of Dementia: A Systematic Review

Strengths

Comprehensive review using peer reviewed work over 8 databases with no limits of date, language or study design in order to increase number of registered.

Large search strategy and boolean operator to ensure relevant papers.

Articles reviewed were published between 2006 and 2020, over a large period of time.

Risk of bias tables included in the systematic review. Cochrane bias tool was used.

Four of the studies reported the use of dolls for the purpose of offering emotional support has been documented with several purported advantages.

Gold standard review.

Quality assessment was done.

Two independent reviewers (JJCA and VFM) were in charge of the assessment of risk of bias.

Two independent reviewers (AMG and AICS) reviewed the titles, abstracts and full text.

Used different outcome measures in each the review of each paper.

First updated systematic review that has selected clinical trails.

Our systematic review gathered data from trials that adhered to rigorous criteria such as randomisation and objective assessment of outcomes.

Authors declared no conflict of interest.

Weakness

The variability in the quality of the investigations is evident.

Age of participants varies.

No follow up interviews.

The clarity of the randomisation sequence and concealment was only evident in 50% of the experiments.

The clarity of blinding in the assessment was insufficient in all of the studies.

There are higher estimates on the actual impact of doll treatment on psychological and behavioural problems associated with dementia.

Didn't complete a meta analyse. No overall P value.

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Based on the facts presented, does doll therapy really reduce aggression in elderly patients with dementia? 

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Based on the facts presented, does doll therapy really reduce aggression in elderly patients with dementia? 

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Table 1 presents an overview of the key characteristics of the studies that were included in the systematic review.

From this the results identify from one RCT (Moyel et al., 2018) that doll therapy significant increases in the well-being of residents were seen when comparing the intervention group with the control group receiving routine care. However, there were no observed advancements in the indications of anxiety, agitation, and aggression.

The other 6 papers results indefinitely agreed that doll therapy was a positive intervention. One stating that "significant decrease in the use of swear words, shouts, aggressive episodes, and less obsessive behaviours" (shin et  al., 2015). Moreover, a second RCT explained they discovered that doll therapy reduced agitation and behavioural issues significantly (Yilmaz et al., 2020).

However, we agreed we could question the fact why isn't this intervention not standardised to males in a manner comparable to females.

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How are we going to answer this question? 

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How are we going to answer this question? 

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Firstly, we have the benefit for looking at a systemic review that was of a high standard. This paper facilitated the simultaneous examination of several documents, enabling us to assess the information and evaluate the evidence.

The intervention resulted in greater emotional well-being, less disruptive behaviours, and improved environmental communication among those diagnosed with dementia. We came to the conclusion as a group that yes doll therapy does work within practice.

However,  it is important to conduct randomised studies that possess a larger sample size and exhibit methodological rigour. Additionally, the implementation of follow-up procedures is necessary to validate and reinforce the findings obtained from these research.

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Outcomes and key findings of systemic review 

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Outcomes and key findings of systemic review 

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Outcomes

Reduced behavioural issues

Improved well-being

Enhanced communication

Key findings

No follow up after intervention,

Majority female,

Future studies must include randomisation and blinding of the assessment to increase methodological.

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Outcome

Residents received some level of enjoyment from the intervention

Changes in some level of anxiety, agitation and aggression

Key findings

Possible ethical concerns raised due to encouragement of false belief.

Resident were excluded if they were already using dolls or plush dolls at their LTC facility.