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多组分干预方案对痴呆患者神经精神症状和照护者心理健康的影响:一项可行性试点研究。

Impacts of a multicomponent intervention programme on neuropsychiatric symptoms in people with dementia and psychological health of caregivers: A feasibility pilot study.

机构信息

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong.

出版信息

Int J Geriatr Psychiatry. 2019 Dec;34(12):1765-1775. doi: 10.1002/gps.5191. Epub 2019 Aug 13.

Abstract

OBJECTIVES

The objectives of this study are to explore the feasibility of a multicomponent intervention programme and to evaluate its impacts on behavioural and psychological symptoms of dementia (BPSD) and psychological health of caregivers.

METHODS

Fifty-six community-dwelling people with dementia (PWD) and knee osteoarthritis (OA) and their caregivers were recruited and randomized into the intervention group (IG) or comparison group (CG). Each participant in both groups received an individual physiotherapy session (personalized home exercises and care education) and underwent 8 weeks of a 1-hour-structured group exercise session weekly at a day care centre. They were instructed to follow the prescribed home exercise. The IG received a multicomponent programme, combining knee OA-specific therapeutic exercise with self-management support, while the CG attended the routine group exercise programme. The attendance rate and reasons for non-attendance were recorded for evaluating the feasibility. The Chinese versions of the Revised Scale for Caregiving Self-Efficacy (RSCSE) and the Neuropsychiatric Inventory Questionnaire (NPI-Q) were measured at the baseline and postintervention.

RESULTS

Fifty-four dyads completed the programme with high attendance rate (94.4%). Compared with the CG, caregivers in the IG significantly improved in three domains of RSCSE scores (P ≤ .005) and caregivers' distress (P = .004) after the intervention. However, no effects were observed in terms of BPSD severity in PWD. No adverse events or falls were reported.

CONCLUSION

This multicomponent programme is feasible and safe for dementia caregivers and older people with mild-to-moderate dementia and knee OA. The programme has beneficial effects on caregiving self-efficacy and distress of dementia caregivers.

摘要

目的

本研究旨在探讨一项多组分干预方案的可行性,并评估其对痴呆患者行为和心理症状(BPSD)以及照料者心理健康的影响。

方法

招募了 56 名患有痴呆症(PWD)和膝关节骨关节炎(OA)的社区居住者及其照料者,并将他们随机分为干预组(IG)或对照组(CG)。两组的每位参与者都接受了个体物理治疗(个性化家庭运动和护理教育),并在日间护理中心每周进行 1 小时结构化的小组运动。他们被指示遵循规定的家庭运动。IG 接受了一种多组分方案,将膝关节 OA 特定的治疗性运动与自我管理支持相结合,而 CG 则参加常规的小组运动方案。记录出勤率和缺勤原因以评估可行性。在基线和干预后测量了修订版照料自我效能感量表(RSCSE)和神经精神问卷(NPI-Q)的中文版。

结果

54 对完成了该方案,出勤率高(94.4%)。与 CG 相比,IG 中的照料者在 RSCSE 评分的三个领域(P ≤.005)和照料者的困扰(P =.004)方面在干预后显著改善。然而,在 PWD 的 BPSD 严重程度方面没有观察到效果。没有报告不良事件或跌倒。

结论

对于轻度至中度痴呆症和膝关节 OA 的痴呆症照料者和老年人来说,该多组分方案是可行且安全的。该方案对痴呆症照料者的照料自我效能感和困扰具有有益的影响。

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