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基于社区的痴呆症患者(COTID-IT 项目)及其照护者职业治疗的初步研究:在意大利具有适用性的证据。

A pilot study of community-based occupational therapy for persons with dementia (COTID-IT Program) and their caregivers: evidence for applicability in Italy.

机构信息

University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.

Geriatric Research Group, Brescia, Italy.

出版信息

Aging Clin Exp Res. 2019 Sep;31(9):1299-1304. doi: 10.1007/s40520-018-1078-7. Epub 2018 Nov 28.

Abstract

OBJECTIVE

To assess the applicability in Italy of a community-based occupational therapy program (COTID) on occupational performance of persons with dementia and their caregivers.

METHODS

Prospective cohort study: twenty-seven older persons with mild-to-moderate dementia living in the community and their primary caregivers were included. Ten sessions of occupational therapy over 5 weeks were delivered. Main outcome measures were the level of performance and satisfaction perceived by people with dementia during the participation in significant activities assessed with the Canadian Occupational Performance Measure (COPM); caregiver burden assessed with the sense of competence questionnaire (SCQ).

RESULTS

The average age of the population was 80.59 ± 8.46 in persons with dementia and 57.78 ± 13.47 in the caregivers. There was a significant improvement in the caregivers' burden in the SCQ (pre treatment 77.19 ± 13.27 vs 82.56 ± 12.57 post treatment; p = .005). Persons with dementia showed a significant improvement in the COPM performance (4.56 ± 1.44 vs 6.68 ± 1.59; p = .000) as well as in the satisfaction (5.08 ± 1.84 vs 7.04 ± 1.71; p = .000). No significant variations were registered in the overall cognitive functions, behavioral and psychological symptoms of dementia, daily functioning, depressive symptoms, perceived quality of life and global health of people with dementia. There was also no difference in the quality of life, global health, depression or burden in the caregivers.

CONCLUSIONS

The study shows that the COTID program is applicable in the Italian context. The findings suggest a positive effect on patients and caregivers providing a preliminary support for the program implementation at a national level.

摘要

目的

评估基于社区的职业治疗方案(COTID)对意大利痴呆患者及其照料者职业表现的适用性。

方法

前瞻性队列研究:纳入 27 名居住在社区的轻中度痴呆老年人及其主要照料者。在 5 周内进行 10 次职业治疗。主要结局指标为使用加拿大职业表现量表(COPM)评估患者在参与重要活动时的表现和满意度;使用能力感问卷(SCQ)评估照料者负担。

结果

患者的平均年龄为 80.59±8.46 岁,照料者的平均年龄为 57.78±13.47 岁。SCQ 中照料者负担显著减轻(治疗前 77.19±13.27 分,治疗后 82.56±12.57 分;p=0.005)。COPM 中患者的表现(4.56±1.44 分 vs 6.68±1.59 分;p=0.000)和满意度(5.08±1.84 分 vs 7.04±1.71 分;p=0.000)均显著提高。患者的整体认知功能、行为和心理症状、日常功能、抑郁症状、感知生活质量和整体健康状况无显著变化。照料者的生活质量、整体健康、抑郁或负担也无差异。

结论

本研究表明 COTID 方案在意大利具有适用性。研究结果提示该方案对患者和照料者有积极影响,为在全国范围内实施该方案提供了初步支持。

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