Laver Kate, Cumming Robert, Dyer Suzanne, Agar Meera, Anstey Kaarin J, Beattie Elizabeth, Brodaty Henry, Broe Tony, Clemson Lindy, Crotty Maria, Dietz Margaret, Draper Brian, Flicker Leon, Friel Meg, Heuzenroeder Louise, Koch Susan, Kurrle Sue, Nay Rhonda, Pond Dimity, Thompson Jane, Santalucia Yvonne, Whitehead Craig, Yates Mark
Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia.
Guideline Adaptation Committee, Clinical Practice Guidelines for Dementia in Australia, Adelaide, South Australia, Australia.
Aust Occup Ther J. 2017 Feb;64(1):3-10. doi: 10.1111/1440-1630.12309. Epub 2016 Oct 3.
BACKGROUND/AIM: The first evidence-based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence-based recommendations for occupational therapists. The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy. Common characteristics of effective occupational therapy programmes for people with dementia are described.
Guideline development involved adaptation of existing high-quality guidelines developed overseas and 17 systematic reviews to ensure that the most recent high-quality evidence was included. One of the systematic reviews involved examining the evidence for interventions to promote independence in people with dementia. Specifically, we looked at the evidence for occupational therapy and its effect on activities of daily living, quality of life and carer impact.
A total of 109 recommendations are included in the Guidelines. Occupational therapy was found to significantly increase independence in activities of daily living and improve quality of life. Effective occupational therapy programmes involve: environmental assessment, problem solving strategies, carer education and interactive carer skills training.
Occupational therapists working with people with dementia in community settings should ensure that their time is spent on those aspects of intervention that are shown to be effective.
背景/目的：澳大利亚发布了首个基于证据的痴呆症患者临床实践指南及护理原则。该指南详细列出了多项针对职业治疗师的重要循证建议。本文旨在（1）概述指南的制定过程，以及（2）描述支持职业治疗建议的证据。文中描述了针对痴呆症患者的有效职业治疗项目的共同特征。
指南制定过程包括改编海外制定的现有高质量指南以及17项系统评价，以确保纳入最新的高质量证据。其中一项系统评价涉及审查促进痴呆症患者独立的干预措施的证据。具体而言，我们研究了职业治疗的证据及其对日常生活活动、生活质量和照顾者影响的作用。
该指南共包含109条建议。研究发现，职业治疗能显著提高日常生活活动的独立性并改善生活质量。有效的职业治疗项目包括：环境评估、问题解决策略、照顾者教育和互动式照顾者技能培训。
在社区环境中为痴呆症患者提供服务的职业治疗师应确保将时间花在已证明有效的干预方面。
