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帕金森病患者认知策略训练干预的可行性。

Feasibility of a cognitive strategy training intervention for people with Parkinson's disease.

机构信息

a Program in Occupational Therapy , Washington University in School of Medicine , St. Louis , MO , USA.

b Department of Neurology , Washington University in School of Medicine , St. Louis , MO , USA.

出版信息

Disabil Rehabil. 2018 May;40(10):1127-1134. doi: 10.1080/09638288.2017.1288275. Epub 2017 Feb 23.

Abstract

PURPOSE

To investigate the feasibility of a novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD).

MATERIALS AND METHODS

This was a case series of seven people with PD without dementia but with subjective cognitive decline. The intervention involved ≥5 treatment sessions at the participant's home. Participant acceptance and engagement were assessed by the Credibility/Expectancy Questionnaire (CEQ), Client Satisfaction Questionnaire (CSQ), enjoyment and effort ratings, and homework completion. Logistical information was tracked, and the Canadian Occupational Performance Measure (COPM) was an exploratory outcome measure. Data analysis was descriptive.

RESULTS

CEQ scores were positive and increased over time. CSQ scores were high (M = 30.8, SD = 0.75), with all participants rating all items positively. Almost all (95%) effort and enjoyment ratings were ≥3 (Much), and homework completion rates averaged 84% (SD = 18). Intervention duration was 6-15 weeks (M = 9.2, SD = 2.8), with treatment sessions averaging 1.7 h (SD = 0.5). Group and most individual COPM ratings improved ≥2 points.

CONCLUSIONS

These findings support the feasibility of the intervention for people with PD. It was acceptable, engaging, and promising in terms of its effect on self-identified functional cognitive problems. Implications for Rehabilitation People with Parkinson's disease (PD) without dementia can experience cognitive decline that negatively impacts function and quality of life. Strategy-based interventions that explicitly train for transfer may mitigate the negative functional consequences of cognitive decline in this population. We developed a client-centered cognitive strategy training intervention for people with PD. This small case series supports its feasibility, indicating that it is acceptable and engaging for people with PD and promising in terms of its effect on self-identified functional cognitive problems.

摘要

目的

研究一种新的以患者为中心的认知策略训练干预措施在帕金森病(PD)患者中的可行性。

材料与方法

本研究为 7 例无痴呆但有主观认知下降的 PD 患者的病例系列研究。该干预措施在患者家中进行了≥5 次治疗。通过可信度/期望问卷(CEQ)、患者满意度问卷(CSQ)、享受度和努力度评分以及家庭作业完成情况来评估患者的接受度和参与度。记录了所有逻辑信息,并采用加拿大职业表现测量(COPM)进行探索性结果测量。数据分析采用描述性方法。

结果

CEQ 评分呈阳性且随时间推移而增加。CSQ 评分较高(M=30.8,SD=0.75),所有参与者均对所有项目给予了积极评价。几乎所有(95%)的努力和享受评分均≥3(很多),家庭作业完成率平均为 84%(SD=18)。干预持续时间为 6-15 周(M=9.2,SD=2.8),治疗次数平均为 1.7 小时(SD=0.5)。组内和大多数个体 COPM 评分均提高了≥2 分。

结论

这些发现支持该干预措施在 PD 患者中的可行性。该干预措施具有可接受性、参与性,并且对自我认定的认知功能问题有改善作用,前景可期。

对康复的意义

无痴呆但有认知下降的帕金森病患者可能会经历认知功能下降,从而对其功能和生活质量产生负面影响。针对该人群,基于策略的干预措施可明确针对转移进行训练,从而减轻认知下降对功能的负面影响。我们为帕金森病患者开发了一种以患者为中心的认知策略训练干预措施。本小型病例系列研究支持其可行性,表明该干预措施对帕金森病患者具有可接受性和参与性,并且对自我认定的认知功能问题有改善作用,前景可期。

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