Åse thought the meetings were exciting. She liked getting home tasks and thought it was satisfying to talk about what she had learned when she came to the next meeting. She thought the intervention was meaningful and was motivated to make an active contribution, which is at the core of Antonovsky’s sense of coherence theory (16).
Antonovsky argues that our power of resistance depends on how understandable, manageable and meaningful we consider life to be. This includes a motivational component, which motivates change (16).
Strengths and weaknesses of the study
It is important that validity and credibility are an integral part of the research process, which entails all stages being transparent, open and carried out with conviction (7). A weakness of the study may be the dual role of therapist and researcher, since the study might be characterised by subjective observation. The subjectivity was moderated by the co-authors being involved in the reflections in the analysis process.
The fact that the researcher was also the therapist meant that she could observe the subjects’ body language, which gave an indication of how they experienced the meeting. The observations were subjective and may therefore be inaccurate. If the dialogue in the meetings had been recorded digitally and then transcribed, this may have enhanced the credibility of the study by giving different researchers access to everything that was said.
The study has just two subjects, with different degrees of cognitive impairment. This necessitated different approaches to the intervention and resulted in different levels of efficacy. Qualitative studies do not aim to generalise findings, rather they are intended to go into depth and describe what happened, which can be useful in terms of further developing the experiences from this study.
One strength of the study was that the qualitative method was supplemented with quantitative measuring instruments to evaluate whether the intervention impacted on the subjects’ everyday lives and quality of life. The findings cannot be generalised, but further research can be carried out to examine quality of life and signs of depressive symptoms following a similar intervention with a larger dataset.
In addition, future research can explore how the situation of family members is affected by participating in the intervention, and whether a positive change could help people with dementia to remain living at home for longer.
Findings from this study show that the intervention affected the everyday lives of subjects and their quality of life in different ways and to different degrees. The interaction between the subjects and the therapist varied considerably depending on the subject’s insight into the disease and their motivation to participate.
Knut’s life was not particularly affected by his lack of insight. Åse was motivated to learn and felt that everyday life became more predictable when she used aids. Discovering what had a positive effect on her mood and improving the communication with her husband made her feel less depressed. Both spouses felt that their efforts were appreciated and that they had gained a better understanding of how they could support their family member.
There is reason to believe that a thorough study of people with dementia may make it possible to determine whether this intervention is suitable. Further research should study the person more thoroughly before including them and investigate the significance of the number of meetings on the benefit different people gain from the therapy. The intervention can also be tested in group meetings, or in combination with individual meetings.
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