Department of Occupational Therapy,Kwong Wah Hospital,Kowloon, Hong Kong.
Department of Medicine and Geriatrics,Kwong Wah Hospital,Kowloon,Hong Kong.
Int Psychogeriatr. 2019 Jan;31(1):91-99. doi: 10.1017/S1041610218000546. Epub 2018 May 3.
ABSTRACTBackground:Getting lost is a recognized complication in patients with dementia. Preventive measures are lacking. This study aims to investigate the effectiveness of a home-based missing incident prevention program (HMIPP) in reducing missing incidents, time of searching, and caregivers' stress.
The design was a pre- and post-intervention study. Patients were recruited from a hospital-based Geriatric Memory Clinic. Inclusion criteria were as follows: aged 60 years or above, established dementia, and Modified Functional Ambulation Categories score VI or VII. An occupational therapist performed the interventions at the patients's home. These included dementia education, prescription of assistive devices, on-site skills training, environmental modifications, community service referrals, and redesigning of daily life routine tasks. The number of missing incidents and caregivers' stress at three months and one year were compared with baseline data from one year before and the secondary outcome was time for searching of the last incident.
A total of 54 patients were recruited. The mean age was 78.8 years and 54% were females. Majority of patients had moderate dementia. The mean number of missing incidents per year was significantly reduced at three months and one year (0.70, 0.22, and 0.14 at 0, 3, and 12 months, respectively; p < 0.001). The time for searching of last missing episode was reduced significantly (6.25, 0.13, and 0.35 hours, respectively; p < 0.001). The caregivers' stress also decreased significantly at three months and one year.
The HMIPP was effective in reducing the number of missing incidents, searching time, and caregivers' stress at three months and one year.
摘要
迷路是痴呆患者公认的并发症。但目前缺乏预防措施。本研究旨在调查家庭为基础的走失事件预防方案（HMIPP）对减少走失事件、寻找时间和照顾者压力的有效性。
设计为干预前后研究。从医院老年记忆诊所招募患者。纳入标准为：年龄 60 岁或以上、确诊痴呆症、改良功能性步行能力分类评分 VI 或 VII。职业治疗师在患者家中进行干预。包括痴呆症教育、辅助器具处方、现场技能培训、环境改造、社区服务转介和日常生活任务重新设计。比较三个月和一年时的走失事件数量和照顾者压力，以及一年前的基线数据。次要结局是最后一次走失事件的寻找时间。
共招募 54 例患者。平均年龄为 78.8 岁，54%为女性。大多数患者有中度痴呆。每年平均走失事件数在三个月和一年时显著减少（0、3 和 12 个月时分别为 0.70、0.22 和 0.14；p < 0.001）。最后一次走失事件的寻找时间也显著减少（分别为 6.25、0.13 和 0.35 小时；p < 0.001）。三个月和一年时照顾者的压力也显著降低。
HMIPP 可有效减少三个月和一年时的走失事件数量、寻找时间和照顾者压力。
