Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, Pennsylvania.
VA Western NY Healthcare System, Batavia, New York.
J Gerontol B Psychol Sci Soc Sci. 2015 Jan;70(1):35-45. doi: 10.1093/geronb/gbt102. Epub 2013 Dec 4.
This randomized controlled study tested the effectiveness of individualized activities, led by certified nursing assistants (CNAs), to increase positive and reduce negative affect and behavior among nursing home residents with dementia.
Nursing home residents with mild to advanced dementia (N = 180) were randomly assigned to usual care (UC, n = 93) or 1 of 2 experimental conditions. Residents in the attention control group (AC, N = 43) participated in standardized one-to-one activities with their CNAs. Individualized Positive Psychosocial Intervention (IPPI) participants (n = 44) received a CNA-led activity matched to their interests and ability. Outcomes were residents' positive and negative affect and verbal and nonverbal behavior.
The IPPI and AC groups experienced similar benefits-more pleasure, alertness, engagement, positive touch, and positive verbal behavior-compared with UC. The AC group displayed more anger, uncooperativeness, and very negative verbal behavior than UC or IPPI.
This study demonstrates the value of individualized activities for nursing home residents with dementia. In a stringent test, residents were happier and less angry during a customized intervention compared with a standardized intervention. Even brief individualized CNA-led activities bring pleasure to nursing home residents and constitute an effective strategy to enhance positive affect and engagement in persons with dementia.
本随机对照研究测试了由认证护士助理（CNA）主导的个性化活动对增加轻度至重度痴呆养老院居民积极情绪和减少其消极情绪和行为的有效性。
轻度至重度痴呆（N=180）的养老院居民被随机分配至常规护理组（UC，n=93）或 2 个实验组之一。注意力对照组（AC，n=43）的居民与他们的 CNA 参加标准化的一对一活动。个性化积极心理社会干预（IPPI）组（n=44）接受与他们的兴趣和能力相匹配的 CNA 主导的活动。结果是居民的积极和消极情绪以及言语和非言语行为。
与 UC 相比，IPPI 和 AC 组经历了类似的益处——更多的愉悦、机敏、参与、积极的触摸和积极的言语行为。与 UC 或 IPPI 相比，AC 组表现出更多的愤怒、不合作和非常消极的言语行为。
本研究证明了个性化活动对痴呆养老院居民的价值。在一项严格的测试中，与标准化干预相比，居民在定制干预期间更快乐、愤怒情绪更少。即使是简短的个性化 CNA 主导的活动也能给养老院居民带来愉悦感，是增强痴呆患者积极情绪和参与感的有效策略。
