D'Cunha Nathan Martin, Isbel Stephen, McKune Andrew J, Kellett Jane, Naumovski Nenad
School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia.
Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, Australian Capital Territory, Australia.
BMJ Open. 2020 Oct 6;10(10):e040753. doi: 10.1136/bmjopen-2020-040753.
To summarise the evidence from interventions investigating the effects of out of care setting activities on people with dementia living in residential aged care.
A systematic review.
A systematic search of electronic databases (PubMed, PsycINFO, Scopus, Web of Science and the Cochrane Library) was performed to identify intervention trials published from journal inception to January 2020. Controlled trials, or quasi-experimental trials, which measured pre-intervention, post-intervention or during-intervention outcomes, where the participants were required to leave the care setting to participate in an intervention, were eligible for inclusion. Quality appraisal of the studies was performed following the Cochrane Collaboration's Risk of Bias or Newcastle-Ottawa Scale tools.
Of the 4155 articles screened, 11 articles met the inclusion criteria from 9 different studies. The number of participants in the studies ranged from 6 to 70 people living with dementia and lasted for 3 weeks up to 5 months. The interventions were aquatic exercise, wheelchair cycling, art gallery discussion groups, an intergenerational mentorship programme, horse riding, walking and outdoor gardening. Overall, the studies indicated preliminary evidence of psychological (n=7), physical (n=4) and physiological (n=1) benefits, and all interventions were feasible to conduct away from the aged care facilities. However, the low number of participants in the included studies (n=177), the absence of a control group in all but three studies, and potential for selection bias, limits the generalisability of the findings.
Activities outside of the residential aged care setting have the potential to be effective at providing a range of benefits for people living with dementia. Higher quality studies are required to encourage care providers to implement these type of activities in dementia care settings.
CRD42020166518.
总结关于院外活动对居住在老年护理机构中的痴呆症患者影响的干预研究证据。
系统评价。
对电子数据库（PubMed、PsycINFO、Scopus、Web of Science和Cochrane图书馆）进行系统检索，以识别从期刊创刊至2020年1月发表的干预试验。纳入标准为对照试验或准实验性试验，测量干预前、干预后或干预期间的结果，参与者需离开护理机构参与干预。采用Cochrane协作网的偏倚风险工具或纽卡斯尔-渥太华量表工具对研究进行质量评估。
在筛选的4155篇文章中，9项不同研究的11篇文章符合纳入标准。研究中的参与者人数为6至70名痴呆症患者，持续时间为3周至5个月。干预措施包括水上运动、轮椅骑行、艺术画廊讨论小组、代际指导计划、骑马、散步和户外园艺。总体而言，研究表明有初步证据显示心理（n = 7）、身体（n = 4）和生理（n = 1）方面的益处，且所有干预措施在老年护理机构外实施都是可行的。然而，纳入研究的参与者数量较少（n = 177），除三项研究外均无对照组，且存在选择偏倚的可能性，限制了研究结果的普遍性。
老年护理机构外的活动有可能为痴呆症患者带来一系列益处。需要更高质量的研究来鼓励护理提供者在痴呆症护理环境中实施这类活动。
PROSPERO注册号：CRD42020166518。
