Finnema E, Dröes R M, Ribbe M, Van Tilburg W
Institute for Research in Extramural Medicine (EMGO Institute), Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Int J Geriatr Psychiatry. 2000 Feb;15(2):141-61. doi: 10.1002/(sici)1099-1166(200002)15:2<141::aid-gps92>3.0.co;2-5.
This article presents an overview of the results of intervention studies in various emotion-oriented approaches in the care for people suffering from dementia. Recommendations are made with regard to clinical practice and future research.
We searched for references (1990-99) in several bibliographical databases, i.e. Medline, PsycLit, Embase, Sociofile and Current Contents. The terms 'dementia' and 'Alzheimer's disease' were linked separately to the search terms: emotion-oriented, validation (therapy), sensory integration/sensory stimulation/snoezelen, simulated presence therapy and reminiscence (therapy)/life-review. Based on references in the articles found, other publications were traced.
We started from the 'emotion-oriented' approaches used in 24-hour care distinguished by the American Psychiatric Association (1997) i.e. validation, sensory stimulation/integration, simulated presence therapy and reminiscence. We selected research articles that describe intervention, design, measuring instruments and results.
The articles were analyzed with regard to research group, setting, design, effect variables, intervention, measuring instruments, statistical analyses and results.
It is shown that mainly positive results (including increased social interaction and decrease of behavior problems) are achieved with these emotion-oriented approaches. Unfortunately many studies have methodological limitations and are done independently, which makes comparison difficult.
Despite the limited cogency of the studies we traced, the results are promising. Emotion-oriented care approaches offer the opportunity to tailor the care to the individual needs of dementing elderly and can be complemented with other psychosocial approaches (e.g. psychomotor therapy and music therapy) when necessary. The challenge for the care sector is to develop guidelines to determine which approach should be applied to whom and when. Scientific research can contribute by examining which emotion-oriented approaches, possibly in combination with each other or with psychosocial therapies, effect an increase in the well-being and improve functioning in which patients.
本文概述了针对痴呆症患者护理中各种以情感为导向的方法的干预研究结果。并就临床实践和未来研究提出了建议。
我们在多个文献数据库中检索参考文献（1990 - 1999年），即医学索引数据库（Medline）、心理学文摘数据库（PsycLit）、荷兰医学文摘数据库（Embase）、社会科学文献数据库（Sociofile）和现刊目次数据库（Current Contents）。“痴呆症”和“阿尔茨海默病”这两个术语分别与以下检索词相关联：以情感为导向、验证（疗法）、感觉统合/感觉刺激/多感官环境疗法、模拟在场疗法以及回忆（疗法）/生活回顾。根据所找到文章中的参考文献，追溯其他出版物。
我们从美国精神病学协会（1997年）所区分的24小时护理中使用的“以情感为导向”的方法入手，即验证、感觉刺激/统合、模拟在场疗法和回忆。我们选择了描述干预、设计、测量工具和结果的研究文章。
对文章进行了研究组、环境、设计、效应变量、干预、测量工具、统计分析和结果等方面的分析。
结果表明，这些以情感为导向的方法主要取得了积极成果（包括社交互动增加和行为问题减少）。不幸的是，许多研究存在方法学上的局限性，且是独立进行的，这使得比较变得困难。
尽管我们追踪的研究说服力有限，但结果很有前景。以情感为导向的护理方法为根据痴呆症老年患者的个体需求定制护理提供了机会，必要时可与其他心理社会方法（如心理运动疗法和音乐疗法）相结合。护理部门面临的挑战是制定指导方针，以确定应将哪种方法应用于何人以及何时应用。科学研究可以通过研究哪些以情感为导向的方法，可能相互结合或与心理社会疗法结合，能提高患者的幸福感并改善其功能来做出贡献。
