Suzuki Yukiko, Kazui Hiroaki, Yoshiyama Kenji, Azuma Shingo, Kanemoto Hideki, Sato Shunsuke, Suehiro Takashi, Ikeda Manabu
Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan.
Psychogeriatrics. 2018 Jul;18(4):252-258. doi: 10.1111/psyg.12317. Epub 2018 Feb 7.
It is assumed that care services effectively reduce behavioural and psychological symptoms of dementia (BPSD). However, it is unclear which care services are effective for reducing specific BPSD. The aim of this study was to clarify which care services were recognized by care specialists as being effective for reducing each of 11 BPSD.
We sent unsigned questionnaires to care specialists in Japan. The questionnaires asked specialists to choose from 12 kinds of care services the most, second-most, and third-most effective service for reducing each of 11 BPSD. The most effective service was scored as 3 points, the second-most was 2 points, and the third-most was 1 point. Specialists were also asked to describe why they chose each service. The 12 kinds of care services were categorized into four categories: (i) home-visit; (ii) outpatient; (iii) short-stay; and (iv) facility. Total scores for each category were analyzed using a two-way anova. The reasons care specialists chose each service were analyzed using morphological analysis, and representative reasons were extracted.
A total of 103 questionnaires were returned. Of the four service categories, outpatient services yielded the highest score for reducing apathy (P < 0.001) due to the effectiveness of participating in recreation and receiving stimulation. Facility services yielded the highest score for reducing aberrant motor behaviour (P < 0.001). Short-stay services yielded the lowest score for reducing depression (P < 0.001). For eight other kinds of BPSD, there were no significant differences between home-visit and facility services or between outpatient and facility services.
Care specialists reported that effective care services for reducing BPSD differed among types of BPSD. In-home care services might be effective at reducing many BPSD except for aberrant motor behaviour, suggesting that greater use of in-home care services might enable people with BPSD to live in their homes for longer.
人们认为护理服务能有效减轻痴呆症的行为和心理症状（BPSD）。然而，尚不清楚哪种护理服务对减轻特定的BPSD有效。本研究的目的是明确护理专家认为对减轻11种BPSD中的每一种有效的护理服务。
我们向日本的护理专家发送了无署名问卷。问卷要求专家从12种护理服务中选出对减轻11种BPSD中的每一种最有效、第二有效和第三有效的服务。最有效的服务得3分，第二有效的得2分，第三有效的得1分。专家们还被要求说明选择每种服务的原因。这12种护理服务分为四类：（i）家访；（ii）门诊；（iii）短期住院；（iv）机构护理。使用双向方差分析对每个类别的总分进行分析。使用形态分析对护理专家选择每种服务的原因进行分析，并提取代表性原因。
共收回103份问卷。在这四类服务中，门诊服务在减轻冷漠方面得分最高（P < 0.001），这是因为参与娱乐活动和接受刺激具有有效性。机构护理服务在减轻异常运动行为方面得分最高（P < 0.001）。短期住院服务在减轻抑郁方面得分最低（P < 0.001）。对于其他8种BPSD，家访服务和机构护理服务之间或门诊服务和机构护理服务之间没有显著差异。
护理专家报告称，减轻BPSD的有效护理服务因BPSD的类型而异。居家护理服务可能对减轻除异常运动行为外的许多BPSD有效，这表明更多地使用居家护理服务可能使患有BPSD的人在家中居住更长时间。
