Cultural Adaptation of Cognitive Stimulation Therapy in Hong Kong: A Qualitative Study

Abstract

Background: Cognitive stimulation therapy (CST) has been recommended as an effective intervention for improving cognitive symptoms and quality of life in people with mild to moderate dementia. Evidence-based protocols originally developed in Western countries may not be directly applicable in Chinese population due to different cultures and societal factors. Objective: Following the formative method for adapting psychotherapy (FMAP) guidelines, we aim to investigate the feasibility of applying an evidence-based CST protocol developed in the UK for use in Hong Kong Chinese, and to consolidate opinions of stakeholders on necessary modification for local adaptation. Methods: In this ongoing study, we have conducted focus groups and individual interviews in day care centres and nursing homes with 11 CST group facilitatorsm 30 CST group participants, 4 family caregivers and 2 formal caregivers. The focus groups and interviews were transcribed and analyzed by two researchers independently using thematic analysis method. Findings: Stakeholders in general agreed that CST can be applied in Hong Kong. Some key areas for modifications are related to the lack of formal education and reserved personality common in this populations, which require alternating the format and content of some activities (e.g. word games, discussion of personal affairs) in the sessions. Implications: Areas requiring significant modifications of a CST protocol were identified in this study for adaptation in Hong Kong community and residential care settings. This has led to the development of a revised CST-HK protocol for further testing.