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Effectiveness of a Relaxation Technique to Decrease the Memory and Behavior Problems of Alzheimer's Patients Stella Maris Verna

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Effectiveness of a Relaxation Technique to Decrease the Memory and Behavior Problems of Alzheimer's Patients Stella Maris Verna Walden University ScholarWorks Walden Dissertations and Doctoral Studies Frank Dilley Award for Outstanding Doctoral Study Collection 2002 Effectiveness of a relaxation technique to decrease the memory and behavior problems of Alzheimer's patients Stella Maris Verna Follow this and additional works at: http://scholarworks.waldenu.edu/dilley This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Frank Dilley Award for Outstanding Doctoral Study by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6” x 9* black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. ProQuest Information and Learning 300 North Zeeb Road, Ann Arbor, Ml 48106-1346 USA 800-521-0600 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. EFFECTIVENESS OF A RELAXATION TECHNIQUE TO DECREASE THE MEMORY AND BEHAVIOR PROBLEMS OF ALZHEIMER'S PATIENTS by Stella Maris Verna Dissertation Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Philosophy Psychology Walden University May 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 3027921 Copyright 2002 by Verna, Stella Maris All rights reserved. __ ® UMI UMI Microform 3027921 Copyright 2002 by Beil & Howell Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. Bell & Howell Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. DOCTOR OF PHILOSOPHY DISSERTATION OF STELLA MARIS VERNA APPROVED: CAROLE A. BEERE VICE PRESIDENT FOR ACADEMIC AFFAIRS WALDEN UNIVERSITY 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University PSYCHOLOGY This is to certify that I have examined the doctoral dissertation by Stella Maris Vema and have found that it is complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Dr. V. Wayne Leaver, Committee Chair Professional Psychology Faculty /fj/dL/A'U ^PnA,*/7Ph.D- / Signature _ olS) Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University PSYCHOLOGY This is to certify that I have examined the doctoral dissertation by Stella Maris Vema and have found that it is complete and satisfactory in all respects. Dr. Brent L. Maguire, Committee Member Professional Psychology Faculty Signature l| z z/ o ( Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University PSYCHOLOGY This is to certify that I have examined the doctoral dissertation by Stella Maris Vema and have found that it is complete and satisfactory in all respects. Dr. Morton Wagenfeld, Committee Member Health Services Faculty Signature \ Z ~ li-of Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Walden University PSYCHOLOGY This is to certify that I have examined the doctoral dissertation by Stella Maris Verna and have found that it is complete and satisfactory in all respects. Dr. James T. Brown, Faculty Representative Applied Management and Decision Sciences Faculty Signature Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Abstract EFFECTIVENESS OF A RELAXATION TECHNIQUE TO DECREASE THE MEMORY AND BEHAVIOR PROBLEMS OF ALZHEIMER'S PATIENTS by Stella Maris Verna Dissertation Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Philosophy Psychology Walden University May 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Abstract This study explored the effects of instruction in a relaxation technique on patients diagnosed with mild to moderate Alzheimer's disease (AD). The two-group pretest- posttest quasi-experimental design was implemented with 34 pairs of AD patients and caregivers in a group setting. It was hypothesized that treatment patients, compared with controls, would show (a) increased mental functioning, measured by their scores on the Annotated Mini-Mental State Examination (AMMSE) (Folstein, Folstein, & McHugh, 1975); and (b) decreased memory and behavior problems, measured by caregivers' scores on the memory and Behavior Problems Checklist (MBPC) (Zarit, Orr, & Zarit, 1985). Treatment subjects were instructed in a 5-week course (Benson, 1975, 1997), and controls followed normal activities. Results of t-tests and MANCOVA supported both research hypotheses. Treatment subjects showed significantly higher AMMSE gain scores on four of nine measures, and a significantly higher mean posttest score (treatment, M * 24.00; control, M = 20.59) (F = 86.62, £ < .01). Treatment subjects showed significantly lower MBPC gain scores on 17 of 32 items, and a significantly lower mean posttest score (treatment, M » 33.88; control, M » 51.94) (F = 75.98, £ < .01). Thus, results of this study showed that instruction in a relaxation technique can help mild to moderate AD sufferers to increase their mental functioning and decrease their memory and behavior problems. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS List of Tables vii CHAPTER 1: INTRODUCTION TO THE STUDY 1 Background of the Problem 4 Problem Statement 8 Purpose of the Study 8 Significance of the Study 9 Research Questions and Hypotheses 11 Rationale 12 Definition of Terms 15 Assumptions of the Study 19 Limitations of the Study 20 Summary 21 CHAPTER 2: LITERATURE REVIEW 24 Introduction 24 Alzheimer's Disease 25 Definition 25 Prevalence 26 Etiology 27 Risk Factors 28 Stages 30 Symptomatology 31 Diagnosis 32 Pharmacological Treatments 34 Nonpharmacological Treatments 36 Substances 36 ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 2 (Continued) Recreational and educational modalities 38 Psychosocial modalities 39 Psychotherapeutic behavioral modalities 40 The Mind/Body Perspective 45 Increasing Acceptance by the General and Medical Communities 45 The Mind/Body Linkage Explained 48 The Relaxation Response and Related Techniques: Description 51 The Relaxation Response and Related Techniques: Research Studies 57 Studies by Benson 57 Studies by Others 60 Children and young adults 60 Range of adults 61 The workplace 65 Special contexts 66 Nondemented older adults 68 Alzheimer's Patients and Mind/Body Techniques 73 Summary 79 CHAPTER 3: METHOD 82 Design of the Study 84 Participants 84 Population and Sample 84 Inclusion Criteria 87 iii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 3 (Continued) Sample Size 88 Setting 90 Instruments and Materials 93 The Demographic Instruments 93 Description 93 Reliability and validity 93 The Annotated Mini-Mental State Examination (AMMSE) 94 Description 94 Reliability and validity 95 The Memory and Behavior Problems Checklist (MBPC) 96 Description 96 Reliability and validity 98 Course Materials 98 Procedure 99 Announcement of the Study 99 The Pilot Study 100 Pilot practice sessions 102 The Intervention 103 Data Collection and Confidentiality 107 Data Analysis 110 CHAPTER 4: RESULTS 112 Description of the Sample 112 Patients 112 Caregivers 117 Descriptive Statistics: AMMSE 123 iv Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. CHAPTER 4 (Continued) Descriptive Statistics: MBPC 129 Research Hypothesis 1: AMMSE 137 Research Hypothesis 2: MBPC 140 Research Hypotheses 1 and 2: Multivariate Analysis 143 Summary 144 CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS 148 Summary of the Study 148 Conclusions 149 Demographic Components 149 Patients 149 Caregivers 150 Research Hypothesis 1: AMMSE 150 Research Hypothesis 2: MBPC 155 Implications
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