Centre de recherche FRSQ du CHA universitaire de Québec, Canada.
Aging Ment Health. 2011 Sep;15(7):855-65. doi: 10.1080/13607863.2011.569480. Epub 2011 May 23.
Positive results have been reported with psychosocial interventions used to reduce verbal agitation (VA) in people with dementia, but there is no clear information regarding the proportion of persons who demonstrate significant behavioural improvement with such treatments. The main objectives of this pilot study are (a) to identify the proportion of persons with dementia who demonstrate significant behavioural improvement with a need-based intervention to reduce VA and (b) to further evaluate the effectiveness of this type of intervention.
A single-group repeated measures design was used (N = 26). An individualized multicomponent intervention addressing needs for comfort, social interaction and sensory stimulation was applied by a therapist during 30 min sessions during the time of day when VA was most severe. The frequency and duration of VA were measured through computer-assisted direct observation several times before, during and after the intervention.
A statistically significant reduction of the duration of VA during the intervention phase relative to other phases of the protocol was found. This effect was limited to the period during which the treatment is being applied. Half of the participants (54%) demonstrated considerable behavioural improvement during the intervention (50% reduction of symptoms) and those whose functioning is best preserved showed the best response to the intervention.
This need-based intervention appears promising for improving the behaviour of a considerable proportion of patients.
心理社会干预措施已被证实可减少痴呆患者的言语激越,但目前尚不清楚此类治疗方法能使多少患者的行为有显著改善。本研究旨在:(a) 确定基于需求的干预措施减少言语激越后,有多少痴呆患者的行为有显著改善;(b) 进一步评估这种干预的有效性。
采用单组重复测量设计(N=26)。在一天中言语激越最严重的时段,治疗师通过 30 分钟的治疗方案,为患者提供个体化的多组分干预,满足患者对舒适、社交互动和感官刺激的需求。在干预之前、期间和之后,通过计算机辅助直接观察,多次测量言语激越的频率和持续时间。
与方案的其他阶段相比,干预阶段言语激越的持续时间有统计学显著减少。这种效果仅限于治疗应用期间。半数参与者(54%)在干预期间表现出明显的行为改善(症状减少 50%),且功能保存最好的患者对干预的反应最好。
这种基于需求的干预措施似乎有希望改善相当一部分患者的行为。