Oppikofer Sandra, Geschwindner Heike
University of Zurich, Switzerland.
Dementia (London). 2014 May;13(3):306-17. doi: 10.1177/1471301212461110. Epub 2012 Oct 15.
This study had two objectives: firstly, to assess and compare the frequency and circumstances of agitation and, secondly, to generate decision-making aids for the treatment of agitation patients by applying a nursing intervention in cases of dementia and agitation. For that purpose, 1002 measurements of open nursing interventions in cases of agitation were obtained over a period of 11 weeks in two nursing homes in the city of Zurich and in the nursing home Sonnweid. Before, during and after two intervention periods of four weeks each, data were collected for 60 persons suffering from severe dementia. The results show that two-thirds of the residents were never agitated, one-quarter was moderately agitated and only very few suffered from medium-to-severe agitation. In almost half the cases, agitation occurred while the person was alone (46%), followed by cases of agitation as a constant state (26%). There was rarely any agitation while the residents were engaged in activities. After analysing 433 documented cases, it turned out that the most successful care interventions were avoiding noise, accompanying the person to the toilet, communication/validation, walking about/movement and administering beverages. Being based on newly translated observational methods and a unique longitudinal study design with combined intervention, this study provides important insights into how agitation in dementia can be influenced within the care context, as well as a practical evaluation of interventions specific to different institutions.
其一,评估和比较激越的频率及情况;其二,通过对痴呆伴激越患者实施护理干预,生成用于治疗激越患者的决策辅助工具。为此,在苏黎世市的两家养老院以及松维德养老院,于11周的时间内获取了1002次激越情况下开放式护理干预的测量数据。在两个为期四周的干预期之前、期间和之后,收集了60名重度痴呆患者的数据。结果显示,三分之二的居民从未出现激越,四分之一的居民有中度激越,只有极少数居民患有中度至重度激越。在近一半的案例中,激越发生在患者独处时(46%),其次是激越呈持续状态的案例(26%)。居民参与活动时很少出现激越。在分析了433个有记录的案例后发现,最成功的护理干预措施是避免噪音、陪患者上厕所、沟通/确认、走动/活动以及提供饮品。基于新翻译的观察方法以及独特的纵向联合干预研究设计,本研究为在护理环境中如何影响痴呆患者的激越提供了重要见解,同时也对不同机构特有的干预措施进行了实际评估。