Schroeder Ryan W, Martin Phillip K, Marsh Connie, Carr Susan, Richardson Tara, Kaur Jasmine, Rusk Jennifer, Jiwanlal Shiloh
University of Kansas School of Medicine-Wichita, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Gerontol Geriatr Med. 2018 Jun 21;4:2333721418783121. doi: 10.1177/2333721418783121. eCollection 2018 Jan-Dec.
Neuropsychiatric symptoms are common features of dementia, and these occur in three fourths of patients on psychogeriatric inpatient units. These symptoms have traditionally been treated with pharmacological agents, but many medications are as likely to harm patients with dementia as to help them. As a result, nonpharmacological interventions are increasingly being investigated as ways to reduce these symptoms. The current study evaluated the impact of an individualized music-based intervention on agitation, negative mood, positive mood, compliance with care, need for one-on-one nursing staff intervention, and need for PRN medication. Participants in this study were older adults who were admitted to a geriatric behavioral inpatient unit for acute agitation or behavioral disturbance. Twenty patients were in a treatment as usual group and 21 were in the individualized music group. Agitation, negative mood, and positive mood all benefited from the music-based intervention, with resulting large effect sizes. Resisting care level also significantly benefited from the intervention, with a resulting medium effect size. These findings indicate that an easily implemented and reproducible music-based intervention, which is well tolerated and without adverse side effects, can be an effective way to reduce neuropsychiatric symptoms associated with dementia on a hospital unit.
神经精神症状是痴呆症的常见特征，在老年精神科住院病房中，四分之三的患者会出现这些症状。传统上，这些症状是通过药物治疗的，但许多药物对痴呆症患者造成伤害的可能性与帮助他们的可能性一样大。因此，非药物干预作为减轻这些症状的方法正越来越多地受到研究。本研究评估了个性化音乐干预对激越、消极情绪、积极情绪、护理依从性、一对一护理人员干预需求以及按需用药需求的影响。本研究的参与者是因急性激越或行为障碍而入住老年行为住院病房的老年人。20名患者被分配到常规治疗组，21名患者被分配到个性化音乐组。激越、消极情绪和积极情绪均从基于音乐的干预中受益，效果显著。抗拒护理程度也从干预中显著受益，效果中等。这些发现表明，一种易于实施且可重复的基于音乐的干预，耐受性良好且无不良副作用，可以作为减少医院病房中与痴呆症相关的神经精神症状的有效方法。
