• Digital interventions to promote self-management in people with osteoarthritis: systematic review and meta-analysis - Study protocol

      Safari, Reza; Jackson, Jessica; Dhadda, Buk; Watkins, Merryl; Sheffield, David; Anthony, Denis; Ward, Derek; University of Derby; NHS Southern Derbyshire; Lincolnshire County Council (National Health Service (NHS), 2018-05-11)
      The proposed research is a systematic review and meta-analysis of available randomised controlled trials of digital interventions to promote self-management in people with osteoarthritis. The effects of self-management programs, on patient outcomes such as pain, disability, function and quality of life will be analysed in direct pairwise meta-analysis. The health service outcomes and cost effectiveness data will also be extracted if reported in the papers and will be synthesised narratively.
    • Digital-based self-management interventions for people with osteoarthritis: Systematic review with meta-analysis

      Safari, Reza; Jackson, Jessica; Sheffield, David; University of Derby (JMIR Publications Inc., 2020-06)
      Osteoarthritis (OA) is not curable but the symptoms can be managed through Self-management programmes. Due to the growing burden of arthritis to the health system, and the need to ensure high quality integrated services, delivering Self-management programmes through digital technologies could be an economic and effective community-based model of care. To analyze the effectiveness of digital-based self-management programs on patient outcomes in people with OA. Seven online databases and three grey literature databases were searched for randomized controlled trials (RCT) assessing digital-based structured self-management programs (D-SMP) on self-reported outcomes including pain, function, disability, and health-related quality of life in people with OA. Two reviewers independently screened the search results and reference list of identified papers and related reviews. Data about the intervention components and delivery, and behavioral change techniques were extracted. Meta-analysis, risk of bias sensitivity analysis and subgroup analysis were performed where appropriate. The GRADE approach was used to assess the quality of evidence. Eight studies were eligible including 2687 people with OA. Self-management programs were delivered via telephone plus audio/video, internet or mobile app. D-SMP compared to Treatment As Usual control group resulted in a significant, homogeneous, moderate reduction in pain (SMD -0.28, 95% CI -0.38 to -0.18) and improvement in physical function (-0.26 95% CI -0.35 to -0.16) at post-treatment. The D-SMP effect reduced slightly at 12 months follow-up but remained significant and moderate. Using the GRADE approach, the quality of evidence was rated as ‘moderate’. D-SMPs may result in a moderate improvement in pain symptoms and function in people with OA delivered. Further research is required to confirm the findings of the review and assess the effects of D-SMPs on other health-related outcomes. Clinical Trial: PROSPERO: CRD42018089322
    • Group singing improves quality of life for people with Parkinson’s: an international study

      Irons, J. Yoon; Hancox, Grenville; Vella-Burrows, Trish; Han, E-Y; Chong, H-J; Sheffield, David; Stewart, Donald E; University of Derby; Sing to Beat Parkinson's, Cantata Canterbury Trust; Canterbury Christ Church University, Kent; et al. (Taylor & Francis, 2020-02-05)
      Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson’s (PwPs) in Australia, UK and South Korea. The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson’s health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p < .05. ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson’s. The findings are encouraging and warrant further research using more robust designs.
    • A group singing program improves quality of life: An international study

      Irons, J. Yoon; Hancox, Grenville; Vella-Burrows, Trish; Han, E-Y; Chong, H-J; Sheffield, David; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (University of Derby, 2019-06-05)
      People with Parkinson’s (PwPs) may experience stigma, isolation, stress and anxiety due to the chronic nature of Parkinson’s. Complementary therapies, including singing, have been reported to impact positively on quality of life (QoL) in PwPs. This paper reports on an international trial of Sing to Beat Parkinson’s®, a community group singing program, involving PwPs from Australia, the UK, and South Korea on QoL and mental well-being. PwPs (N=95; mean age=70.26; male 45%) participated in a standardized 6-month weekly group singing program, which included breathing exercises, vocal warm-ups and preferred song singing. PDQ39 and modified DASS21 were administered at baseline and follow-up to assess QoL and mental well-being, respectively. MANOVA and ANOVAs were performed with significance set as p<.05. MANOVA showed statistically significant multivariate effects of Time, Country, Time by Country and Time by Gender interactions on QoL. Follow-up univariate ANOVAs revealed main effects of Time on Stigma and Social Support domains of QoL; both improved. Further, MANOVA revealed a multivariate effect of Time on mental well-being; anxiety and stress significantly decreased from pre-test to post-test. This first international singing study with PwPs demonstrated that group singing enhanced some aspects of quality of life and mental well-being. Participating in a weekly group singing program for a 6-month period impacted positively on social support, and feeling stigmatized, as well as reductions in anxiety and stress. The findings are encouraging and warrant further research using more robust designs that include comparator groups.
    • "I don’t want to hold your hand": Can Covid-19 public health messages delivered through songs?

      Sheffield, David; Irons, J Yoon; University of Derby (The British Psychological Society, 2020-10-28)
      In response to the outbreak of Covid-19, governments around the world have published their guidelines including rigorous hand washing, respiratory etiquette, social distancing and restrictions in movements and gatherings (European Centre for Disease Prevention and Control, 2020). Songs have been used to share key advice since the start of the outbreak in many countries (Hui, 2020). In the UK, the first advice proffered concerned rigorous hand washing.
    • An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions.

      Irons, J Yoon; Garip, Gulcan; Cross, Ainslea J; Sheffield, David; Bird, Jamie; University of Derby (PloS, 2020-12-07)
      We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.
    • Songs for health education and promotion: a systematic review with recommendations

      Sheffield, David; Irons, J. Yoon; University of Derby (Elsevier, 2021-09-06)
      We aimed to assess evidence of the effectiveness of song-based public health programmes and to examine the analyses of song lyrics to learn what their key qualities for public health promotion are. A systematic search was employed to identify empirical studies that examined song interventions for public health education and promotion. We searched the following databases: MEDLINE, PubMed, CINAHL, PsycINFO and AMED. We also backwards searched references of all relevant studies. Of the 137 studies identified, ten studies were included: four were quantitative and six were qualitative. The qualities of the included studies were assessed to be fair or good. The studies were from developing/low-income countries, South Africa and the United States, involving children and adults. Through a narrative data synthesis, three themes were identified; song-based programmes increased public health knowledge and changed behaviours. Additionally, developing songs for public health promotion involved consultations with local people utilising culturally and socially relevant genres or songs. Although the current evidence is limited by the small number of available studies and their heterogeneity, there is evidence that songs may be an effective method to deliver public health messages that result in improved education and changes in behaviour. Several advantages of using songs as public health strategies were identified that included their social and cultural relevance, ubiquity, low cost and enjoyment. Given these advantages, further research with the robust methodology is required to assess the benefits of songs using quantifiable outcomes along with evaluation of processes. We recommend that public health professionals, stakeholders and communities utilise songs as public health strategies.
    • A systematic review on the effects of group singing on persistent pain in people with long‐term health conditions

      Irons, J. Yoon; Sheffield, David; Ballington, Freddie; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (Wiley, 2019-09-23)
      Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions. We searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments. Included studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits. Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.