Dasgupta Monidipa, Beker Lyndsay, Schlegel Kim, Hillier Loretta M, Joworski Lisa, Crunican Karli, Coulter Corrine
Division of Geriatric Medicine, Shulich School of Medicine, Western University, London, ON.
Lawson Health Research Institute, London, ON.
Can Geriatr J. 2021 Jun 1;24(2):125-137. doi: 10.5770/cgj.24.469. eCollection 2021 Jun.
Non-pharmacological interventions are recommended to manage challenging behaviours among cognitively impaired older adults, however few studies have enrolled patients in acute care. This study aimed to determine the feasibility of implementing non-pharmacological interventions to manage behaviours in hospitalized older adults.
A self-identity approach was used to identify potentially engaging activities for 13 older medically ill adults admitted to acute hospital; these activities were trialed for a two-week period. Data were collected on frequency of intervention administration and assistance required, as well as frequency of behaviours and neuroleptic use in the seven days prior to and following the trial of activities.
Per participant, 5-11 interventions were prescribed. Most frequently interventions were tried two or more times (46%); 9% were not tried at all. Staff or family assistance was not required for 27% of activities. The mean number of documented behaviours across participants was 4.8 ± 2.3 in the pre-intervention period and 2.1 ± 1.9 in the post-intervention period. Overall the interventions were feasible and did not result in increasing neuroleptic use.
Non-pharmacologic interventions may be feasible to implement in acute care. More research in this area is justified.
建议采用非药物干预措施来管理认知受损老年人的挑战性行为，但很少有研究将急性护理中的患者纳入其中。本研究旨在确定实施非药物干预措施来管理住院老年人行为的可行性。
采用自我认同方法为13名入住急性医院的老年内科疾病患者确定可能吸引人的活动；这些活动进行了为期两周的试验。收集了关于干预措施实施频率和所需协助、以及活动试验前后七天内行为频率和抗精神病药物使用频率的数据。
每位参与者接受了5 - 11项干预措施。大多数干预措施被尝试了两次或更多次（46%）；9%的干预措施根本没有被尝试。27%的活动不需要工作人员或家人协助。干预前参与者记录的行为平均数量为4.8±2.3，干预后为2.1±1.9。总体而言，这些干预措施是可行的，且并未导致抗精神病药物使用增加。
非药物干预措施在急性护理中实施可能是可行的。该领域需要更多研究。
