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Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study

Wong, GHY; Yek, OPL; Zhang, AY; Lum, TYS; Spector, A; (2018) Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study. International Journal of Geriatric Psychiatry , 33 (6) pp. 841-848. 10.1002/gps.4663. Green open access

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Abstract

OBJECTIVE: Ageing of the Chinese population will drive a continued surge in dementia prevalence. Empirically tested non‐pharmacological interventions developed in western cultures may be implemented in Chinese. Cognitive Stimulation Therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in people with dementia. We investigated the feasibility and cultural appropriateness of CST in Hong Kong Chinese (CST‐HK). METHODS: Mixed methods research was conducted following the formative method for adapting psychotherapy. A culturally adapted CST‐HK, developed involving multidisciplinary stakeholders, was tested in a pilot multicentre study in people with mild dementia (n = 30) receiving community or residential care. Changes in cognition and quality of life were measured. Opinions from family caregivers and group facilitators (n = 25) were collected through focus groups and in‐depth interviews for understanding the appropriateness of CST‐HK. Feasibility was explored. RESULTS: After receiving CST‐HK, 54% of participants achieved outcome of no cognitive deterioration, and 23% showed clinically meaningful improvement. Family caregivers and group facilitators expressed good acceptance of CST, with a low attrition (13%) and high attendance rate of CST‐HK sessions (92%). Key cultural issues identified are (i) less active opinion sharing in group discussions due to conservatism/cautiousness and (ii) preference of practical activities with reward/recognition over pure discussion due to pragmatism. CONCLUSIONS: The CST‐HK is feasible and culturally appropriate in Hong Kong Chinese. Further amendments can be made to ensure language use and enjoyment, with potential implications on effectiveness. We have provided a systematically developed, culturally adapted protocol for larger‐scale implementation and research in Chinese populations.

Type: Article
Title: Cultural adaptation of cognitive stimulation therapy (CST) for Chinese people with dementia: multicentre pilot study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/gps.4663
Publisher version: http://dx.doi.org/10.1002/gps.4663
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: cultural competency, psychotherapy adaptation and modification framework, CST, Chinese, formative research
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1571039
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