Wu Helen Zong Ying, Low Lee-Fay, Xiao Shifu, Brodaty Henry
Primary Dementia Collaborative Research Centre, University of New South Wales, Coogee, Australia.
Int Psychogeriatr. 2009 Jun;21(3):476-84. doi: 10.1017/S1041610209008643. Epub 2009 Mar 4.
There are limited cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). The aim of the present study was to increase understanding of the effects of culture on BPSD by comparing the rates of BPSD in nursing home residents across three residential facility types: (1) mainstream nursing homes in Sydney, (2) ethno-specific Chinese nursing homes in Sydney, and (3) a long-term high care facility in Shanghai known as a dementia hospital.
149 residents and their caregivers voluntarily participated in this study. The rates and levels of BPSD were assessed by interviewing staff with the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Clinical interviews using the Mini-mental State Examination (MMSE) and Global Deterioration Scale (GDS) were conducted with residents to assess dementia severity.
The mean NPI-NH total score for the sample was 28.5 (SD = 17.2) with no significant differences across the three facility types. Comparison of NPI-NH subscales showed residents from the ethno-specific Chinese facilities had lower rates of hallucinations than Shanghai residents (p = 0.003), but no differences from those in mainstream facilities. Shanghai residents had lower frequencies of disinhibition and irritability than ethno-specific Chinese residents (p = 0.003, p = 0.004 respectively), but no differences with mainstream residents.
The prevalence of BPSD does not differ among nursing home populations of different cultural backgrounds. Longitudinal community studies among different cultural groups would better elucidate the effects of culture on BPSD at different stages of dementia.
关于痴呆症行为和心理症状（BPSD）的跨文化研究有限。本研究的目的是通过比较三种居住设施类型中养老院居民的BPSD发生率，来增进对文化对BPSD影响的理解：（1）悉尼的主流养老院，（2）悉尼特定民族的华人养老院，以及（3）上海一家被称为痴呆症医院的长期高护理设施。
149名居民及其照料者自愿参与本研究。通过使用神经精神科问卷-养老院版（NPI-NH）对工作人员进行访谈来评估BPSD的发生率和程度。对居民进行简易精神状态检查表（MMSE）和总体衰退量表（GDS）的临床访谈，以评估痴呆症的严重程度。
样本的NPI-NH总分平均为28.5（标准差=17.2），三种设施类型之间无显著差异。NPI-NH分量表比较显示，特定民族的华人设施中的居民幻觉发生率低于上海居民（p=0.003），但与主流设施中的居民无差异。上海居民的脱抑制和易怒频率低于特定民族的华人居民（分别为p=0.003，p=0.004），但与主流居民无差异。
不同文化背景的养老院人群中BPSD的患病率没有差异。不同文化群体之间的纵向社区研究将更好地阐明文化在痴呆症不同阶段对BPSD的影响。
