PhD, MMT, ARCM, BA
The Development and Evaluation of Music in Dementia Assessment Scales (MiDAS) (2014)
Prof Martin Orrell, University College London & University of Nottingham, UK
Prof Hanne Mete Ridder, Aalborg University, Denmark
The benefits of music therapy for people with dementia are well documented1, but evaluation of music therapy is a complex task. The majority of quantitative music therapy studies in dementia use standardised psychiatric outcome measures to evaluate the impact of music on the reduction of neuropsychiatric symptoms. However, clinically important changes are highly individual and there are concerns that these measures may not portray what matters most to the client. There was a need to develop a clinically relevant and scientifically robust outcome measure incorporating the values and view of people with dementia.
In order to develop a clinically meaningful outcome measure, focus groups and interviews with people with dementia, family carers, care home staff and music therapists were conducted to explore the importance and values of music for people with dementia and the observed effects of music. The accessibility and immediacy of musical experiences for people at all stages of dementia, a close link between personal identity and music and the importance of shared musical experiences were particularly highlighted2. Key comments and recurring themes were transcribed and scrutinised through expert and peer consultations to identify scale items and ensure the content validity of the new outcome measure.
Music in Dementia Assessment Scales (MiDAS) comprises of the five Visual Analogue Scales (VAS) items: levels of Interest, Response, Initiation, Involvement and Enjoyment and a supplementary checklist. MiDAS is an observational measure: MiDAS forms are to be completed by both music therapists and carers3.
A psychometric evaluation of MiDAS was conducted. A total of 629 MiDAS forms were completed during the main study. The statistical analysis revealed MiDAS has a high therapist inter-rater reliability, a low staff inter-rater reliability, an adequate staff test-retest reliability and a fair concurrent validity4. MiDAS was found to be sensitive to change and feedback from the study participants confirmed the clinical relevance of MiDAS.
This is the first study attempted to develop a psychometrically validated outcome measure from the qualitative data exploring the importance of music for people with dementia. Future recommendations include further evaluation of MiDAS in a randomised controlled trial and the development of MiDAS self-rating version.
MiDAS is now used in clinical practice in the UK, the USA, Canada, Italy and Denmark. Danish and Norwegian translations of MiDAS are being conducted by the Aalborg team.
PhD key publications in peer-reviewed journals
1McDermott, O., Crellin, N., Ridder, H.M. & Orrell, M. (2013). Music Therapy in Dementia: A Narrative Synthesis Systematic Review. International Journal of Geriatric Psychiatry.
2McDermott, O., Orrell, M. & Ridder, H.M. (2014). The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists. Aging & Mental Health, 18, 706-716.
3McDermott, O., Orrell, M. & Ridder, H.M. (2014). The Development of Music in Dementia Assessment Scales (MiDAS). Nordic Journal of Music Therapy.
4McDermott, O., Orgeta, V., Ridder, H.M. & Orrell, M (2014). A preliminary psychometric evaluation of Music in Dementia Assessment Scales (MiDAS). International Psychogeriatrics, 26, 1011-1019.
PhD key conference presentations
Ridder, H.M., Coomans, A., Ottesen, AM., McDermott, O & Brynjulf, S. (2013). Interdisciplinary collaboration in music therapy for persons with dementia-in practice and research: Model of learning for practitioners in dementia care with music therapy and interdisciplinary collaboration as the joint focal point. The 9th European Music Therapy Congress, Oslo, Norway. (symposium)
McDermott, O. (2012). The development of Music in Dementia Assessment Scales (MiDAS). 7th Nordic Music Therapy Congress, Jyväskylä, Finland. (paper)
McDermott, O. (2012). Music Therapy in Dementia: a narrative synthesis systematic review. Older People and Healthy Ageing Service Line Annual Research & Development Conference, Central and North West London NHS Foundation Trust, London. (poster)
McDermott, O. (2012). The development of Music in Dementia Assessment Scales (MiDAS). Voices and vision in creative therapies in dementia, University of Worcester, U.K. (paper)
McDermott, O., Crellin, N., Ridder, H.M. & Orrell, M. (2011). Music Therapy in Dementia: A systematic literature review using a Narrative Synthesis. 27th International Conference of Alzheimer's Disease International, London. (poster)