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. 2021 Jun 18;5:230. Originally published 2020 Oct 5. [Version 3] doi: 10.12688/wellcomeopenres.16189.3

Table 1. Initial examples of categories and behavioural expressions of engagement.

Category Definition Behaviour expression of
engagement
Examples of the feedback (s) No. of
participants
commenting
on the
categories
1 Facial
expression
Noticeable
changes on
the PWD’s face
during the
intervention
Mouth and lip movement “mouth moving, mumbling the song” 2
Eyebrows movement (e.g. closed their
eyes or raise their eyebrow)
“The person’s eyebrows were raising
when the music was playing”
1
Facial changes (e.g. neutral look, smile) “I can see that the person (PWD) face
looked different … like she was smiling)

“The person face looked very neutral
without much facial expression, but
you can feel that she was enjoying the
music, as if she was thinking about it.”
6
2 Bodily
movement
and verbal
articulations
Large or
small bodily
movements and
response during
the intervention
Large and subtitle bodily movement
(e.g. hands and feet taping, nodding,
clapping, moving with music)
“Hand clapping and feet tapping”

“There was one person who tapped his
hands on his lap”
6
Verbally responding (e.g. singing,
talking, mouth mumbling)
“One of the elderly was moving her
mouth.”
2
Interacting with instruments (touching
the instrument, playing with the
instruments, making music)
“Hitting the African drum and the hand
drum”

“Playing with the drum stick”
3
3 Attention
and
awareness
of activity
Being focus
and attend to a
stimulate that is
in context with
the intervention
Attention to stimulus (musician, other
participants) undistracted eye contact
“there’s a lot of duplication. Because
when they would said to you, “okay,
this man has been accepted, could you
please do a referral”, and we are all
using information on the same system.
So we end up doing the same thing
again”

“We’re having these discussions with
psychology in the pod meeting they’re
quite often quite like in-depth, which is
great, but then if they’re accepted there
and then in the meeting for psychology,
the clinician, like the care coordinator
then has to go away and type out the
conversation. But we’ve already had the
conversation with psychology, so could
the referral not just be accepted there
and then, without the paper part being
done?”
4
Playing an instrument “Playing and focusing on the
instruments in front of her”
Moving along with music “Her feet was tapping (along with the
music)”
4 Emotional
response
Participant’s
“positive” and
“negative”
emotions in
relations to the
intervention
Pleasure and enjoyment “I don’t really know what’s going on
down here”
4
At ease look (looks as if s/he was
relaxed)
“She closed her eyes, but it looks like
she was enjoying the music.”

“Looking up but thinking about things
but she seemed relaxed”
2
Sad or anxious look (appear agitated,
e.g., eyes down casted like in moment
of unhappiness; tapping his/her fingers
as in people who are anxious)
“I can see that the elderly was sad…but
it does not mean she was not enjoying
the music right? Maybe it made her
remember something”

“But I suppose negative emotions like
looked anxious and sad can mean that
the person is (PWD) is engaging with
the therapy (intervention) right ?)”
2

PWD, person with dementia.