Psychosocial & Community Health, University of Washington School of Nursing, Seattle.
Washington Department of Social and Health Services, Aging and Long-Term Support Administration, Olympia.
Gerontologist. 2016 Apr;56(2):318-25. doi: 10.1093/geront/gnu012. Epub 2014 Mar 10.
This investigation evaluated participant and caregiver outcomes of a program of specialized dementia adult day services (ADS; Memory Care and Wellness Services: MCWS).
One hundred eighty-seven participant-caregiver dyads were enrolled in a quasiexperimental research investigation; 162 attended MCWS and 25 were comparison dyads that met eligibility criteria but did not have access to ADS within their communities. The objectives of this investigation were to evaluate whether MCWS improved quality of life, mood, behavior, or functional status for participants with dementia and whether caregivers experienced decreased stress, burden, or depression, compared with comparison dyads.
No significant differences were seen between MCWS and comparison dyads at 3 months. However, after 6 months, MCWS participants exhibited significantly fewer depressive behaviors (p < .05) and a trend toward fewer total behavior problems (p < .10) than comparison participants, and MCWS caregivers exhibited significantly less distress over behavior problems (total behavior problems, memory problems, depressive problems, all p < .05) than comparison caregivers.
Although modest, outcomes represent a reversal of the typical direction of change in both behavior problems and caregiver distress, despite the progression of cognitive and functional impairment. Caregivers were highly satisfied with the services. The MCWS program provides a model of a community-based dementia ADS and results provide support for further development of the program.
本研究评估了专门的痴呆成人日托服务（ADS；记忆护理和健康服务：MCWS）计划对参与者和护理人员的影响。
187 名参与者-护理人员二人组参与了一项准实验研究调查；162 人参加了 MCWS，25 人是符合条件但在其社区内无法获得 ADS 的对照组。本研究的目的是评估 MCWS 是否改善了痴呆患者的生活质量、情绪、行为或功能状态，以及与对照组相比，护理人员的压力、负担或抑郁是否减轻。
在 3 个月时，MCWS 组和对照组之间没有显著差异。然而，6 个月后，MCWS 组的参与者表现出明显较少的抑郁行为（p<.05）和行为问题总数的趋势（p<.10）少于对照组，而 MCWS 护理人员表现出明显较少的行为问题（行为问题总数、记忆问题、抑郁问题，均 p<.05）的困扰比对照组护理人员。
尽管幅度不大，但这些结果代表了行为问题和护理人员困扰的典型变化方向的逆转，尽管认知和功能障碍在进展。护理人员对服务非常满意。MCWS 计划提供了一种基于社区的痴呆症 ADS 模式，并为进一步开发该计划提供了支持。
