A Flexible Fit. Developing a Suitable Manual Framework for Person Attuned Musical Interaction in Dementia Care Through a Realist Approach
PhD Thesis by Jens Anderson-Ingstrup
Following a realist approach, Jens Anderson-Ingstrup investigates and discusses mechanisms that underlie manuals about complex interventions and explores the concept person attuned musical interaction.
The methods include literature reviews (e.g., state-of-the-art and scoping reviews), video analysis, conversation analysis, analogue and software-supported methods (e.g., Melodyne and ELAN) of extracting information regarding musical parameters, and phenomenological approaches. The data includes video material and publications.
The thesis is compiled by three separate articles and this linking text.
- Article 1 is a state-of-the-art literature review where I question the understanding of mirror neurons through a review of the evidence regarding their presence in the human brain and possible connection to phenomena such as empathy and imitation. While one study has located neurons showing “mirroring properties” in the human brain, the evidence concerning their involvement in phenomena such as empathy and imitation is lacking or contradicting. Based on the findings of this review it is not recommended to apply the concept of mirror neurons as a fact-laden frame to explain these phenomena, which could be of relevance when describing person attuned musical interactions.
- Article 2 is a scoping review where I explore the design of manuals about complex interventions in the field of dementia. Specifically, the analysis concerns the dissemination elements in the manuals, the level of flexibility of the manuals, and the possibility of tailoring the intervention disclosed by the manuals. The results show that the main dissemination elements include written text and a variety of different graphical organisers. None of the manuals contain audio/visual elements, animate or in-animate. All manuals allow tailoring of the intervention and the majority show a medium degree of flexibility. Based on the results it is recommended that developers of future manuals consider the inclusion of audio/visual material, allow tailoring of the intervention, and maintain a certain degree of flexibility in the manual.
- Article 3 is an analysis of video material of a music therapy session with a music therapist and a person with dementia. Inspired by conversation analysis, I analyse and examine the use of music in the interaction between the participants and the development of the quality of their interaction. The method included a phenomenological transcription of the content of the video, extraction of data concerning musical parameters using analogue and software-based methods, and a detailed sequential analysis of the interaction between the participants. The results included an overview of how different musical parameters changed in accordance with the state of the interaction, specifically regarding different types of tempo variations. The results further indicated the presence of two sections in the interaction; a person attuned musical arousal regulation process and a person attuned musical interaction process, where the quality of the interaction shifted from being one-sided to being reciprocal with more equality regarding initiations in the interaction.
The linking text introduces the context for the thesis, presents expanded reflections regarding the methodology of the project, and provides answers for the research questions of the thesis. This includes presenting an ontology for the concept “a manual” and a discussion based on a realist perspective of relevant mechanisms that constitutes an applicable manual. Based on this discussion I propose a framework that can be used to guide the development of manuals. Finally, I provide suggestions regarding the application of the findings, as well as strategies to limit the limitations of the project.
The thesis is part of the PAMI project located at Aalborg University and is funded by the Velux Foundation.