Baker Roger, Holloway Jane, Holtkamp Chantal C M, Larsson Anita, Hartman Lindy C, Pearce Rebecca, Scherman Birgitta, Johansson Seija, Thomas Peter W, Wareing Lesley Ann, Owens Matthew
Research and Development Support Unit, Poole Hospital NHS Trust and Dorset HealthCare NHS Trust, Poole, UK.
J Adv Nurs. 2003 Sep;43(5):465-77. doi: 10.1046/j.1365-2648.2003.02744.x.
Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS.
To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.).
A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital.
There were limited short-term improvements for both the MSS and activity groups immediately after sessions, and limited short-term improvements between the groups during sessions. There were no significant differences between the groups when assessing change in behaviour, mood or cognition at home/on the ward or at the day hospital. In the UK, however, behaviour at the day hospital for both groups remained stable during the trial but deteriorated once the sessions had stopped, and active/disturbed behaviour at home improved but likewise deteriorated once sessions had stopped.
Overall, MSS was found to be no more effective than an activity in changing the behaviour, mood or cognition of patients with dementia in the short- or long-term.
近年来,多感官刺激(MSS)已成为一种越来越流行的护理方法,在欧洲各地的多个中心得到应用。这种流行可能是由于工作人员可选择的方法有限,以及人们普遍认为MSS是一种友好且高度人性化的方法。因此,进行一项随机对照试验对于评估MSS的有效性和益处程度至关重要。
评估与进行诸如打牌、看照片、做测验等活动的对照组相比,MSS在改变老年痴呆患者的行为、情绪和认知方面是否更有效。
来自三个国家(英国、荷兰和瑞典)的136名患者被随机分为MSS组或活动组。患者在4周内参加了8次30分钟的疗程。在疗程开始前、进行中及结束后对行为和情绪进行评分,以研究即时效果。在试验前、中期、后期及随访时进行评估,以研究对家庭/病房或日间医院的认知、行为和情绪的任何影响的普遍性。
疗程结束后,MSS组和活动组短期内的改善都有限,疗程期间两组之间的短期改善也有限。在评估家庭/病房或日间医院的行为、情绪或认知变化时,两组之间没有显著差异。然而,在英国,试验期间两组在日间医院的行为保持稳定,但疗程结束后恶化,在家中的活跃/烦躁行为有所改善,但疗程结束后同样恶化。
总体而言,发现在短期或长期内,MSS在改变痴呆患者的行为、情绪或认知方面并不比一项活动更有效。