Mental Health Services for Older People, Hertfordshire Partnership NHS Foundation Trust, Hemel Hempstead, Hertfordshire, UK.
Int J Geriatr Psychiatry. 2013 Jun;28(6):589-96. doi: 10.1002/gps.3863. Epub 2012 Jul 30.
To investigate whether recovery-orientated psychiatric assessment and therapeutic intervention enhances the wellbeing of people with dementia and their family carers.
In a preliminary randomised controlled trial, 48 people with early dementia were recruited. Of 34 who completed the trial, 17 were in the recovery and 17 in the treatment as usual group. Recovery participants received a recovery-focused pre-diagnostic wellbeing assessment and counselling, diagnostic consultation with written feedback and post-diagnostic support over a period of 6 months using the WHO Wellbeing Index as the primary measure, and Mini Mental State Examination, Cornell Scale for Depression in Dementia, EUROQOL and Zarit Burden Interview as secondary outcome measures.
People in the recovery group showed a significant improvement in the WHO Wellbeing Index (18.3 for recovery vs 9.46 for treatment as usual; t = -2.28, p = 0.03), with trends of improvement in other outcome measures.
This trial shows that a recovery-focused diagnostic consultation and post-diagnostic support enhance the wellbeing of people with mild cognitive impairment and early dementia.
探讨以康复为导向的精神科评估和治疗干预是否能提高痴呆患者及其家庭照顾者的幸福感。
在一项初步的随机对照试验中，招募了 48 名早期痴呆患者。在完成试验的 34 名患者中，17 名患者在康复组，17 名患者在常规治疗组。康复组患者接受了以康复为重点的预诊断幸福感评估和咨询、诊断咨询并提供书面反馈以及为期 6 个月的后续支持，主要采用世界卫生组织幸福感指数作为测量指标，同时还采用了简易精神状态检查、痴呆患者的康奈尔抑郁量表、欧洲五维健康量表和Zarit 负担量表作为次要结果测量指标。
康复组患者的世界卫生组织幸福感指数显著提高（康复组为 18.3，常规治疗组为 9.46；t=-2.28，p=0.03），其他结果测量指标也有改善趋势。
本试验表明，以康复为导向的诊断咨询和诊断后支持可以提高轻度认知障碍和早期痴呆患者的幸福感。
