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急性护理医院中针对脆弱老年患者的多模式综合护理对痴呆症行为心理症状的缓解作用:病例系列研究

Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series.

作者信息

Honda Miwako, Ito Mio, Ishikawa Shogo, Takebayashi Yoichi, Tierney Lawrence

机构信息

National Hospital Organization Tokyo Medical Center, Meguro, Tokyo 152-0021, Japan.

Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo 173-0015, Japan.

出版信息

Case Rep Med. 2016;2016:4813196. doi: 10.1155/2016/4813196. Epub 2016 Mar 16.

Abstract

Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care.

摘要

痴呆行为和心理症状(BPSD)的管理是老年痴呆护理中的一项关键挑战。一种多模式综合护理方法——人文关怀,以眼神交流、言语沟通和触摸为要素,被应用于一家急症医院中三位常规护理无效的老年痴呆患者。每个护理过程都通过视频分析进行评估。所有患者均患有晚期痴呆并伴有BPSD。护理失败的表现为患者大喊大叫、尖叫或肢体突然动作。在这个病例系列中,三位患者的常规护理均告失败。护理沟通的每个要素在常规护理中都比在人文关怀护理中短得多,而人文关怀护理为患者所接受。护理过程中各要素的平均占比在常规护理中眼神交流为0.6%、言语沟通为15.7%、触摸为0.1%,在人文关怀护理中分别为12.5%、54.8%和44.5%。每位患者在护理期间攻击行为的持续时间在常规护理中分别为25.0%、25.4%和66.3%,在人文关怀护理中分别为零基础、零基础和0.3%。在我们的病例系列中,常规护理的眼神交流、言语沟通和触摸较少。多模式综合护理方法——人文关怀,减少了BPSD,并因患者对护理的接受而取得成功。

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