Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA.
Nurs Res. 2010 Nov-Dec;59(6):417-25. doi: 10.1097/NNR.0b013e3181faff52.
Effective nonpharmacological interventions are needed to treat neuropsychiatric symptoms and to improve quality of life for the 5.3 million Americans affected by dementia.
The purpose of this study was to test the effect of a storytelling program, TimeSlips, on communication, neuropsychiatric symptoms, and quality of life in long-term care residents with dementia.
A quasi-experimental, two-group, repeated measures design was used to compare persons with dementia who were assigned to the twice-weekly, 6-week TimeSlips intervention group (n = 28) or usual care group (n = 28) at baseline and postintervention at Weeks 7 and 10. Outcome measures included the Cornell Scale for Depression in Dementia, the Neuropsychiatric Inventory-Nursing Home Version, the Functional Assessment of Communication Skills, the Quality of Life-Alzheimer's Disease, and the Observed Emotion Rating Scale (this last measure was collected also at Weeks 3 and 6 during TimeSlips for the treatment group and during mealtime for the control group).
Compared with the control group, the treatment group exhibited significantly higher pleasure at Week 3 (p < .001), Week 6 (p < .001), and Week 7 (p < .05). Small to moderate treatment effects were found for Week 7 social communication (d = .49) and basic needs communication (d = .43). A larger effect was found for pleasure at Week 7 (d = .58).
As expected, given the engaging nature of the TimeSlips creative storytelling intervention, analyses revealed increased positive affect during and at 1 week postintervention. In addition, perhaps associated with the intervention's reliance on positive social interactions and verbal communication, participants evidenced improved communication skills. However, more frequent dosing and booster sessions of TimeSlips may be needed to show significant differences between treatment and control groups on long-term effects and other outcomes.
需要有效的非药物干预措施来治疗神经精神症状,提高 530 万受痴呆影响的美国人的生活质量。
本研究旨在测试讲故事项目 TimeSlips 对长期护理机构中痴呆患者的沟通、神经精神症状和生活质量的影响。
采用准实验、两组、重复测量设计,比较基线时分配到每周两次、6 周 TimeSlips 干预组(n=28)或常规护理组(n=28)的痴呆患者,在第 7 周和第 10 周进行干预后评估。结果测量包括康奈尔大学痴呆抑郁量表、神经精神疾病住院患者护理版本、沟通技能功能评估、生活质量-阿尔茨海默病量表和观察情感评分量表(最后一项措施也在 TimeSlips 治疗组的第 3 周和第 6 周以及对照组的用餐时间进行收集)。
与对照组相比,治疗组在第 3 周(p<0.001)、第 6 周(p<0.001)和第 7 周(p<0.05)时表现出更高的愉悦感。在第 7 周时,社交沟通(d=0.49)和基本需求沟通(d=0.43)的治疗效果较小到中等。在第 7 周时愉悦感的治疗效果较大(d=0.58)。
正如预期的那样,考虑到 TimeSlips 创意故事讲述干预的吸引力,分析结果显示干预期间和干预后 1 周内积极情绪增加。此外,参与者表现出改善的沟通技巧,这可能与干预依赖积极的社会互动和言语交流有关。然而,可能需要更频繁的 TimeSlips 剂量和强化疗程,才能在长期效果和其他结果上显示出治疗组和对照组之间的显著差异。