Gillis Katrin, Lahaye Hilde, Dom Stijn, Lips Dirk, Arnouts Heidi, Van Bogaert Peter
Odisee University College, Sint-Niklaas, Belgium.
Curando VZW, Ruiselede, Belgium.
Int J Older People Nurs. 2019 Dec;14(4):e12269. doi: 10.1111/opn.12269. Epub 2019 Aug 30.
The increase in agitated or aggressive behaviour amongst nursing home residents with dementia is a challenging problem. Such behaviour causes stress for both resident and caregiver. Many non-pharmacological interventions have been studied, but these interventions disregard the resident's unfulfilled needs and are executed by a single, designated caregiver. This study tests a non-pharmacological intervention, applied by the entire team and based on the resident's underlying needs.
A pretest and post-test interventional study design was used, in which 65 residents with dementia who expressed agitated or aggressive behaviour. Data were collected from December 2016 until March 2017.
The ABC method and the Senses Framework were used to assign residents to either therapeutic touch, group music sessions or a meaningful individual activity. All staff members applied the interventions. Data were collected by use of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) and the Cohen-Mansfield Agitation Inventory (CMAI).
The frequency of aggression, loss of decorum, depression and the severity of aggression decreased for all three interventions. However, the overall severity of fear also increased. The overall prevalence of agitated of residents decreased for the therapeutic touch, group music sessions and individual activities.
This study shows the possibilities of designing individualised interventions on the Senses Framework and the ABC method for addressing agitated and aggressive behaviour amongst nursing home residents with dementia. The framework presented in this study should be further explored.
A team-based approach is effective to reduce agitated or aggressive behaviour amongst nursing home residents.
痴呆症养老院居民中激越或攻击性行为的增加是一个具有挑战性的问题。此类行为给居民和护理人员都带来压力。许多非药物干预措施已被研究，但这些干预措施忽视了居民未满足的需求，且由单一指定护理人员执行。本研究测试一种由整个团队应用且基于居民潜在需求的非药物干预措施。
采用前后测试干预研究设计，其中65名表现出激越或攻击性行为的痴呆症居民参与。数据收集时间为2016年12月至2017年3月。
使用ABC方法和感官框架将居民分配到治疗性触摸、团体音乐活动或有意义的个人活动中。所有工作人员都实施这些干预措施。通过使用神经精神科问卷-养老院版（NPI-NH）和科恩-曼斯菲尔德激越量表（CMAI）收集数据。
所有三种干预措施中，攻击行为的频率、失态、抑郁以及攻击行为的严重程度均有所下降。然而，恐惧的总体严重程度也有所增加。治疗性触摸、团体音乐活动和个人活动中居民激越的总体患病率下降。
本研究表明了基于感官框架和ABC方法设计个性化干预措施以解决痴呆症养老院居民激越和攻击性行为的可能性。本研究中提出的框架应进一步探索。
基于团队的方法对于减少养老院居民的激越或攻击性行为是有效的。
