Dröes Rose-Marie, Meiland Franka, Schmitz Mirjam, van Tilburg Willem
Department of Psychiatry, Alzheimer Centre, Vrije Universiteit medical centre and Regional Mental Health Care Organisation 'GGZ Buitenamstel', Amsterdam, The Netherlands.
Int J Geriatr Psychiatry. 2004 Jul;19(7):673-84. doi: 10.1002/gps.1142.
A previous study in Amsterdam showed that combined family support in the Meeting Centres Support Programme, in which dementia patients and their carers are both supported by one professional staff member, is more effective in influencing behaviour problems and mood of dementia patients living in the community than non-integrated support, such as day care only.
A multi-centre implementation study tests if similar effects are achieved in other regions of The Netherlands.
A pretest-posttest control group design was applied. 112 dementia patients who visited psychogeriatric day care in eight community centres across the country and in three nursing homes, and their carers participated in the study. The patients in the experimental group (n = 89) received support from the Meeting Centres Support Programme together with their carers, while the control group (n = 23) received day care only. Behaviour problems (agressive behaviour, inactivity, non-social behaviour) and mood (dissatisfaction, depressive behaviour) were assessed using standardized observation scales. Quality of life was assessed by interviewing the patients.
After 7 months the Meeting Centres Support Programme, compared to regular day care, showed a moderately positive effect on the degree of total behaviour problems (effect size = 0.52), especially on inactivity (effect size = 0.37) and non-social behaviour (effect size = 0.60), a large effect on depressive behaviour (effect size = 0.92) and a moderate effect on self-esteem (effect size = 0.43).
The Meeting Centres Support Programme proves to be more effective than regular day care in influencing behaviour problems, especially inactivity and non-social behaviour, and depressed mood. Participation in the programme also seems to have a positive effect on self-esteem, an important aspect of quality of life. These findings surpass the results of the Amsterdam study and confirm the surplus value of the combined family support in the Meeting Centres Support Programme as compared to regular day care for people with mild to severe dementia.
阿姆斯特丹此前的一项研究表明，在“会面中心支持计划”中提供的联合家庭支持，即由一名专业工作人员同时为痴呆症患者及其护理人员提供支持，相较于非综合支持（如仅日间护理），在影响社区痴呆症患者的行为问题和情绪方面更有效。
一项多中心实施研究测试在荷兰其他地区是否能取得类似效果。
采用前测-后测对照组设计。112名在全国八个社区中心和三家养老院接受老年精神科日间护理的痴呆症患者及其护理人员参与了该研究。实验组（n = 89）的患者与其护理人员一起接受“会面中心支持计划”的支持，而对照组（n = 23）仅接受日间护理。使用标准化观察量表评估行为问题（攻击行为、不活动、非社交行为）和情绪（不满、抑郁行为）。通过对患者进行访谈评估生活质量。
7个月后，与常规日间护理相比，“会面中心支持计划”对总体行为问题程度显示出中度积极影响（效应量 = 0.52），尤其对不活动（效应量 = 0.37）和非社交行为（效应量 = 0.60），对抑郁行为有较大影响（效应量 = 0.92），对自尊有中度影响（效应量 = 0.43）。
“会面中心支持计划”在影响行为问题，尤其是不活动和非社交行为以及抑郁情绪方面，比常规日间护理更有效。参与该计划似乎对自尊也有积极影响，自尊是生活质量的一个重要方面。这些发现超过了阿姆斯特丹研究的结果，并证实了“会面中心支持计划”中联合家庭支持相较于常规日间护理对轻至重度痴呆症患者的额外价值。
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