Research Institute on Aging of Charles E. Smith Life Communities, Rockville, MD 20852, USA.
Am J Geriatr Psychiatry. 2011 Oct;19(10):859-70. doi: 10.1097/JGP.0b013e318202bf5b.
Engagement refers to the act of being occupied or involved with an external stimulus. In dementia, engagement is the antithesis of apathy.
The Comprehensive Process Model of Engagement was examined, in which environmental, personal, and stimulus characteristics impact the level of engagement.
: Participants were 193 residents of 7 Maryland nursing with a diagnosis of dementia. Stimulus engagement was assessed via the Observational Measure of Engagement, measuring duration, attention, and attitude to the stimulus. Twenty-five stimuli were presented, which were categorized as live human social stimuli, simulated social stimuli, inanimate social stimuli, a reading stimulus, manipulative stimuli, a music stimulus, task and work-related stimuli, and two different self-identity stimuli.
All stimuli elicited significantly greater engagement in comparison to the control stimulus. In the multivariate model, music significantly increased engagement duration, whereas all other stimuli significantly increased duration, attention, and attitude. Significant environmental variables in the multivariate model that increased engagement were: use of the long introduction with modeling (relative to minimal introduction), any level of sound (especially moderate sound), and the presence of between 2 and 24 people in the room. Significant personal attributes included Mini-Mental State Examination scores, activities of daily living performance and clarity of speech, which were positively associated with higher engagement scores.
Results are consistent with the Comprehensive Process Model of Engagement. Personal attributes, environmental factors, and stimulus characteristics all contribute to the level and nature of engagement, with a secondary finding being that exposure to any stimulus elicits engagement in persons with dementia.
参与是指被外部刺激占据或涉及的行为。在痴呆症中，参与是冷漠的对立面。
检验参与的综合过程模型，其中环境、个人和刺激特征影响参与水平。
参与者是马里兰州 7 家养老院的 193 名患有痴呆症的居民。通过观察参与度评估量表评估刺激参与度，该量表衡量对刺激的持续时间、注意力和态度。共呈现了 25 个刺激，分为活体人类社交刺激、模拟社交刺激、无生命社交刺激、阅读刺激、操作刺激、音乐刺激、与任务和工作相关的刺激以及两种不同的自我认同刺激。
与对照刺激相比，所有刺激都显著增加了参与度。在多变量模型中，音乐显著增加了参与度持续时间，而所有其他刺激都显著增加了持续时间、注意力和态度。在多变量模型中，增加参与度的显著环境变量包括：使用带有示范的长介绍（相对于最小介绍）、任何级别的声音（特别是中等声音）以及房间内有 2 到 24 人。显著的个人属性包括简易精神状态检查分数、日常生活活动表现和语言清晰度，这些都与更高的参与度评分呈正相关。
结果与参与的综合过程模型一致。个人属性、环境因素和刺激特征都有助于参与的水平和性质，次要发现是任何刺激的暴露都会引起痴呆症患者的参与。
