Yang Ya-Ping, Lee Feng-Ping, Chao Hui-Chen, Hsu Fang-Yu, Wang Jing-Jy
Institute of Allied Health Science, College of Medicine, National Cheng-Kung University, Tainan, Taiwan, ROC.
School of Nursing, California State University, Los Angeles, CA.
J Am Med Dir Assoc. 2016 Aug 1;17(8):719-24. doi: 10.1016/j.jamda.2016.03.021. Epub 2016 May 7.
Cognitive stimulation therapy (CST), reminiscence therapy (RT), and aroma-massage therapy (AT) are believed to be beneficial for people with dementia (PwD). However, the comparing effects of these interventions have not been reported in previous studies. The purpose of this research was thus to compare the effects of these 3 interventions on alleviating agitation and depressive mood in PwD.
A cohort study with pre- and post-tests was conducted.
A total of 102 PwD from 10 long-term care facilities were allocated to RT (n = 43), CST (n = 29), or AT (n = 29) groups. The participants received the interventions once a week for 8 to 10 consecutive weeks. The participants were evaluated using the Chinese version of the Cohen-Mansfield Agitation Inventory and the Cornell Scale for Depression in Dementia before and shortly after the intervention. One-way ANOVA and ANCOVA were used to analyze the data.
Significant differences in the effects on agitation and depressive symptoms in PwD were found among the 3 interventions (P = .013 and P < .001, respectively). Post hoc analysis showed that AT was more effective than RT and CST in improving agitated behaviors (P = .006 and P < .001, respectively), and was also more effective than CST and RT in alleviating depressive symptoms (both P < .001).
Our findings indicate that among the 3 alternative remedies, AT can be a more effective intervention than CST and RT with regard to alleviating the agitated behavior and depressive symptoms of PwD. Given that agitated behavior and depressive mood are common among institutionalized PwD, and staff working in long-term care facilities often lack knowledge and time to manage such behaviors, the findings of this study can contribute to future clinical practice in long-term care facilities. In addition, aroma-massage has the advantage of being an easy-to-learn intervention for staff working with PwD.
认知刺激疗法(CST)、怀旧疗法(RT)和香薰按摩疗法(AT)被认为对痴呆症患者有益。然而,以往研究尚未报告这些干预措施的比较效果。因此,本研究的目的是比较这三种干预措施对缓解痴呆症患者的激越和抑郁情绪的效果。
进行一项前后测队列研究。
来自10家长期护理机构的102名痴呆症患者被分配到RT组(n = 43)、CST组(n = 29)或AT组(n = 29)。参与者连续8至10周每周接受一次干预。在干预前和干预后不久,使用中文版的科恩-曼斯菲尔德激越量表和康奈尔痴呆抑郁量表对参与者进行评估。采用单因素方差分析和协方差分析对数据进行分析。
在这三种干预措施中,发现对痴呆症患者的激越和抑郁症状的影响存在显著差异(分别为P = 0.013和P < 0.001)。事后分析表明,AT在改善激越行为方面比RT和CST更有效(分别为P = 0.006和P < 0.001),在缓解抑郁症状方面也比CST和RT更有效(均为P < 0.001)。
我们的研究结果表明,在这三种替代疗法中,就缓解痴呆症患者的激越行为和抑郁症状而言,AT可能比CST和RT更有效。鉴于激越行为和抑郁情绪在机构化痴呆症患者中很常见,而长期护理机构的工作人员往往缺乏管理此类行为的知识和时间,本研究结果可为长期护理机构未来的临床实践提供参考。此外,香薰按摩对于照顾痴呆症患者的工作人员来说,具有易于学习的优势。