Roberts Hannah J, Noble James M
From the College of Physicians & Surgeons, Columbia University, New York, NY.
Neurology. 2015 Aug 25;85(8):739-41. doi: 10.1212/WNL.0000000000001867. Epub 2015 Jul 29.
Medical students' comfort level working with dementia is poorly understood, and may impact subsequent experiences with patients and caregivers. Early experiences that take place in a nonmedical setting may allow students to gain a more comprehensive understanding of quality of life and disease management in everyday life.
We studied Columbia University preclinical medical students' perceptions of dementia relative to attending a nonclinical art-centered, museum-based experience designed for people with dementia and their caregivers. Participants individually attended a single 90-minute museum-based art-centered program designed to engage patients with dementia and caregivers; programs are attended by 6-10 patient-caregiver dyads and led by trained museum educators at existing New York City sites including The Metropolitan Museum of Art, The Cloisters, The Studio Museum in Harlem, and The New-York Historical Society.
The Dementia Attitudes Scale (DAS) was administered before and after the intervention (least favorable = 20, neutral = 80, most favorable = 140). A total of 19 students completed baseline and postintervention DAS. At baseline, DAS mean = 97.4 (SD = 11.2). To limit bias of taking the test, 9 students completed a second preintervention DAS (≥1 week apart); among these, DAS increased from 95.7 (SD = 7.7) to 98.7 (SD = 7.4) (p = 0.09). Following the intervention, DAS favorably and significantly increased to 105.8 (SD = 11.0) (p ≤ 0.01 for all comparisons, paired-samples t test); greater differences were identified in comfort than knowledge of dementia.
Although further study is warranted to confirm findings, given the increasing availability of such programs, it is reasonable to consider inclusion of these alongside other nonclinical programs that are already part of medical school curricula.
医学生与痴呆症患者打交道时的舒适程度鲜为人知，且可能会影响他们随后与患者及护理人员的接触体验。在非医疗环境中获得的早期体验可能会让学生对日常生活中的生活质量和疾病管理有更全面的理解。
我们研究了哥伦比亚大学临床前医学生对痴呆症的看法，这与他们参加一个以艺术为中心、基于博物馆的非临床体验有关，该体验是为痴呆症患者及其护理人员设计的。参与者各自参加了一个为期90分钟、以博物馆为基础、以艺术为中心的项目，该项目旨在让痴呆症患者和护理人员参与其中；这些项目由6至10对患者-护理人员组成，由纽约市现有场所（包括大都会艺术博物馆、修道院博物馆、哈莱姆工作室博物馆和纽约历史学会）的训练有素的博物馆教育工作者主持。
在干预前后进行了痴呆症态度量表（DAS）测试（最不利=20，中性=80，最有利=140）。共有19名学生完成了基线和干预后的DAS测试。基线时，DAS平均值=97.4（标准差=11.2）。为了限制测试偏差，9名学生完成了第二次干预前的DAS测试（间隔≥1周）；在这些学生中，DAS从95.7（标准差=7.7）增加到98.7（标准差=7.4）（p=0.09）。干预后，DAS显著升高至105.8（标准差=11.0）（所有比较的p≤0.01，配对样本t检验）；在舒适度方面的差异比在痴呆症知识方面的差异更大。
尽管需要进一步研究以证实研究结果，但鉴于此类项目越来越多，考虑将其纳入医学院课程中已有的其他非临床项目是合理的。
