Yonsei University College of Nursing, Seoul, South Korea.
Mo-Im Kim Nursing Research Institute, Seoul, South Korea.
Gerontologist. 2022 Apr 20;62(4):e253-e264. doi: 10.1093/geront/gnaa207.
The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness.
A systematic review and meta-analysis were conducted. We searched through 5 databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence checklist. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement.
In total, 36 studies were systematically reviewed. Intervention types were reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function.
Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, health care providers should consider person-centered interventions as a vital element in dementia care.
以患者为中心的护理理念已被应用于各种干预措施，以提高与健康相关的结果，并确保为痴呆患者提供的护理质量。已经有一些关于在痴呆护理背景下使用以患者为中心的干预措施的系统评价，但迄今为止，尚无研究分析按干预类型和目标结果划分的干预效果。本研究旨在综述痴呆护理背景下使用的以患者为中心的干预措施，并评估其效果。
进行了系统评价和荟萃分析。我们在五个数据库中搜索了 1998 年至 2019 年期间在痴呆患者中使用以患者为中心的干预措施的随机对照试验。使用国家卫生与临床优化研究所的清单评估研究质量。荟萃分析的感兴趣结局为痴呆患者的行为和心理症状（BPSD）以及基线测量后即刻的认知功能。
共系统评价了 36 项研究。干预类型包括回忆、音乐和认知疗法以及多感官刺激。30 项研究被纳入荟萃分析。结果表明，整体干预的效果大小为中等，音乐疗法的效果大小较小，回忆疗法对 BPSD 和认知功能的效果大小为中等。
总体而言，以患者为中心的干预措施对降低 BPSD 和改善认知功能具有即时的干预效果，尽管每种结局的效果大小和意义因干预类型而异。因此，医疗保健提供者应将以患者为中心的干预措施视为痴呆护理的重要组成部分。
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