I am currently involved in a pilot, which is looking at the outcomes of CST when given to a group of elderly patients.
A limitation with our pilot is that there are only 2 researchers assessing the outcomes of the treatment; thereby making it unfeasible to the assess patients with objective cognitive measures within a restricted time frame.
We are currently thinking of developing an observational method to assess outcomes; but before we do this I thought it would be worthwhile in raising this query to everyone.
Cheers!
I'm not quite sure if I got you right. You're doing a rather neuropsychological treatment in a group of elderly patients (like in a stroke unit or geronto psychiatry?) and want to assess if there is an outcome of your treatment in terms of cognitive speer or power? But you don't have a lot of people to do the testing?
Well, to me - doing this based on observation which two people involved in the study would be performing... that would not be so great, I think. What is the time frame you guys can invest? Any funding for computer based testing? Or programming skills available to make a little tool by yourself?
For assessing cognitive function, any observation in a group is indirect and so will be weak in inferring any improvement. Because the currently known effect of cognitive stimulation therapy is mixed and moderate, any observation of improvement will be open to question. Also consider that functioning within a therapeutic session is different than improvement in global function.
Considering your limitations, I would suggest combining two of the following:
(1) Your own quantitative observations (i.e. number of activities completed, % of an activity completed, or grading of answers to questions asked at the beginning of each session [to assess effectiveness of the past session]).
(2) Patient chart notes as part of a chart audit, if available. For Alzheimers' and dementia patients, there should be some formal assessment(s) available. Keep in mind that you will have to recode this data for the purpose of your study.
(3) Ask the staff to keep track of easily observed measures (examples: number of times the patient asks for assistance, number of times the patients interacts socially with other patients over an hour, etc.). This could be as easy as creating a list of participant names and asking them to put a check beside the name each time they observe the thing you're looking for.
I'm not sure what specific outcomes you are looking for, so you will have to adjust any questions/items you ask staff to help you with appropriately.
Assuming each measure will show the same concurrent trends, combining these measures will lend more credibility to any findings you come up with.
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