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手部按摩对医院环境中痴呆症患者的压力和激越的影响:一项初步研究。

The Effects of Hand Massage on Stress and Agitation Among People with Dementia in a Hospital Setting: A Pilot Study.

机构信息

School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont 21, 1011, Lausanne, Switzerland.

Department of Psychiatry, Lausanne University Hospital (SUPAA, CHUV, FBM), Route du Mont, 1008, Prilly, Switzerland.

出版信息

Appl Psychophysiol Biofeedback. 2018 Dec;43(4):319-332. doi: 10.1007/s10484-018-9416-2.

Abstract

Agitation in people with dementia is a growing concern as it causes distress for both patients and their nurses and may contribute to relational disorders. Previous studies involving patients with dementia living in long-term care facilities have reported decreased agitation following massage. The objective of this pilot study was to investigate the effect of hand massage on agitation and biological markers of stress in patients with dementia hospitalized in an acute geriatric psychiatry service. In this randomized controlled trial we included 40 agitated patients with dementia with an intervention group and a control group. The study is designed to test the effect of seven hand massages over three continuous weeks on agitation and levels of salivary cortisol (sC) and alpha-amylase (sAA). Compared to the control group, the intervention group exhibited larger increases in sC and sAA at week 1 from before to after the massage, but larger decreases at week 2 and 3, with a significant group effect for sAA at week 2. Agitation scores were not significantly different between the groups but tended to decrease more in the intervention group than the control group. This study provides first encouraging results suggesting that hand massage might have beneficial effects on stress and agitation in hospitalized patients with dementia. It also highlights the challenges associated with conducting such studies with this complex patient population. Further studies are needed to confirm these findings and the benefits of hand massage as part of routine care for patients with dementia.

摘要

痴呆患者的激越问题日益受到关注,因为它会给患者及其护士带来痛苦,并可能导致人际关系障碍。先前涉及长期护理机构中痴呆患者的研究报告称,按摩后激越症状有所减轻。本项初步研究的目的在于调查手部按摩对急性老年精神病学服务机构中住院痴呆患者激越和应激生物标志物的影响。在这项随机对照试验中,我们纳入了 40 例激越性痴呆患者,分为干预组和对照组。该研究旨在测试在连续 3 周内进行 7 次手部按摩对激越和唾液皮质醇(sC)和唾液淀粉酶(sAA)水平的影响。与对照组相比,按摩后第 1 周,干预组 sC 和 sAA 的水平升高幅度更大,但在第 2 周和第 3 周下降幅度更大,第 2 周时 sAA 存在显著的组间效应。两组间激越评分无显著差异,但干预组激越评分的下降趋势较对照组更明显。本研究初步结果提示,手部按摩可能对住院痴呆患者的应激和激越有有益影响,但同时也凸显了对这类复杂患者人群开展此类研究的挑战。还需要进一步的研究来证实这些发现以及手部按摩作为痴呆患者常规护理的一部分的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/718d/6223738/ca23c2ad02a9/10484_2018_9416_Fig1_HTML.jpg

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