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虚拟现实体验干预可能减少痴呆养老院居民的反应性行为:病例系列。

Virtual Reality Experience Intervention May Reduce Responsive Behaviors in Nursing Home Residents with Dementia: A Case Series.

机构信息

Health and Rehabilitation Sciences, Western University, London, ON, Canada.

Gait & Brain Lab, Parkwood Institute, London, ON, Canada.

出版信息

J Alzheimers Dis. 2021;84(2):883-893. doi: 10.3233/JAD-210010.

Abstract

BACKGROUND

People with advanced dementia often exhibit responsive behaviors such as apathy, depression, agitation, aggression, and psychosis. Non-pharmacological approaches (e.g., listening to music, watching television, doing arts and crafts) are now considered as a first-line strategy to manage responsive behaviors in clinical practice due to the potential risks associated with the antipsychotic medications. To date, no evaluations of immersive non-head mounted virtual reality (VR) experience as a non-pharmacologic approach for people with advanced dementia living in nursing homes have been reported.

OBJECTIVE

To evaluate the feasibility (acceptance and safety) of VR experience.

METHODS

A single site case series (nonrandomized and unblinded) with a convenience sample (N = 24; age = 85.8±8.6 years; Cognitive Performance Scale score = 3.4±0.6) measuring depression and agitation before and after the intervention. The intervention was a 30-min long research coordinator- facilitated VR experience for two weeks (10 sessions).

RESULTS

The intervention was feasible (attrition rate = 0% ; adverse events = 0). A reduction in depression and in agitation was observed after the intervention. However, we suggest extreme caution in interpreting this result considering the study design and small sample size.

CONCLUSION

This study provides the basis for conducting a randomized controlled trial to evaluate the effect of VR experience on responsive behaviors in nursing homes. Since our intervention uses a smart remote-controlled projector without a headset, infectious exposure can be avoided following the COVID-19 pandemic-induced physical distancing policy in care homes.

摘要

背景

患有晚期痴呆症的人经常表现出反应性行为,如冷漠、抑郁、躁动、攻击和精神病。由于与抗精神病药物相关的潜在风险,非药物治疗方法(例如听音乐、看电视、做手工艺)现在被认为是临床实践中管理反应性行为的一线策略。迄今为止,尚未有报道评估沉浸式非头戴式虚拟现实(VR)体验作为养老院中患有晚期痴呆症的人的非药物治疗方法。

目的

评估 VR 体验的可行性(接受度和安全性)。

方法

一项单站点病例系列研究(非随机和非盲),采用方便样本(N=24;年龄=85.8±8.6 岁;认知表现量表评分=3.4±0.6),在干预前后测量抑郁和躁动。干预措施是为期两周(10 次)的 30 分钟长的研究协调员协助的 VR 体验。

结果

干预是可行的(失访率=0%;不良事件=0)。干预后观察到抑郁和躁动减少。然而,考虑到研究设计和样本量小,我们建议对这一结果的解释持极端谨慎态度。

结论

本研究为在养老院中进行评估 VR 体验对反应性行为影响的随机对照试验提供了依据。由于我们的干预使用了带有智能遥控器的无耳机投影仪,因此可以避免在养老院中遵循 COVID-19 大流行期间的物理隔离政策后出现传染性暴露。

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