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怀旧疗法是一种可行的护理方案,可改善复发性急性缺血性脑卒中患者的认知功能、焦虑和抑郁:一项随机对照研究。

Reminiscence therapy is a feasible care program for improving cognitive function, anxiety, and depression in recurrent acute ischemic stroke patients: a randomized, controlled study.

机构信息

Department of Pharmacy, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, China.

Medical Equipment Section, Jing'an District Central Hospital of Shanghai, Fudan University, Shanghai, China.

出版信息

Ir J Med Sci. 2023 Jun;192(3):1463-1471. doi: 10.1007/s11845-022-03114-7. Epub 2022 Jul 27.

Abstract

OBJECTIVE

Reminiscence therapy provides benefits among first-episode acute ischemic stroke (AIS) patients and their caregivers. This study intended to further compare the effect of reminiscence therapy plus usual care (RTUC) and usual care (UC) on cognitive function, anxiety, and depression among recurrent AIS patients.

METHODS

Totally, 160 recurrent AIS patients were enrolled and randomized in a 1:1 ratio into the RTUC group (N = 81) and UC group (N = 79), then a 12-month corresponding intervention was conducted in each group. Mini-Mental State Examination (MMSE) score and Hospital Anxiety and Depression Scale (HADS) were evaluated on discharge (M0), at month (M) 3, M6, M9, and M12 after discharge.

RESULTS

MMSE scores at M6 (27.0 ± 1.6 vs. 26.3 ± 2.3, P = 0.031) and M12 (27.0 ± 1.7 vs. 26.1 ± 2.4, P = 0.009) were elevated, while cognitive impairment rate at M12 (29.2% vs. 45.7%, P = 0.042) and cognitive impairment severity at M12 (P = 0.029) were declined in RTUC group compared to UC group. Meanwhile, the HADS-anxiety scores at M9 (5.7 ± 3.1 vs. 6.9 ± 4.0, P = 0.046) and M12 (5.6 ± 2.7 vs. 7.0 ± 4.3, P = 0.024), anxiety rate at M12 (22.2% vs. 38.2%, P = 0.039) and anxiety severity at M12 (P = 0.018) were declined in RTUC group compared to UC group. Besides, the HADS-depression score at M12 (5.7 ± 3.1 vs. 6.8 ± 3.3, P = 0.043) was decreased in RTUC group compared to UC group, but depression rate and severity were not different between the two groups at each visit point (all P > 0.05).

CONCLUSION

RTUC program elevates cognitive functions and alleviates mental problems in recurrent AIS patients.

摘要

目的

回忆疗法为首发急性缺血性脑卒中(AIS)患者及其护理人员带来益处。本研究旨在进一步比较回忆疗法联合常规护理(RTUC)与常规护理(UC)对复发性 AIS 患者认知功能、焦虑和抑郁的影响。

方法

共纳入 160 例复发性 AIS 患者,按 1:1 比例随机分为 RTUC 组(n=81)和 UC 组(n=79),然后对每组进行为期 12 个月的相应干预。在出院时(M0)、第 3 个月(M3)、第 6 个月(M6)、第 9 个月(M9)和第 12 个月(M12)评估简易精神状态检查(MMSE)评分和医院焦虑抑郁量表(HADS)。

结果

M6 时 MMSE 评分(27.0±1.6 比 26.3±2.3,P=0.031)和 M12 时 MMSE 评分(27.0±1.7 比 26.1±2.4,P=0.009)升高,而 M12 时认知障碍率(29.2%比 45.7%,P=0.042)和 M12 时认知障碍严重程度(P=0.029)下降。同时,M9 时 HADS 焦虑评分(5.7±3.1 比 6.9±4.0,P=0.046)和 M12 时 HADS 焦虑评分(5.6±2.7 比 7.0±4.3,P=0.024)、M12 时焦虑发生率(22.2%比 38.2%,P=0.039)和 M12 时焦虑严重程度(P=0.018)降低。此外,与 UC 组相比,RTUC 组 M12 时 HADS 抑郁评分(5.7±3.1 比 6.8±3.3,P=0.043)降低,但两组在各随访点的抑郁发生率和严重程度均无差异(均 P>0.05)。

结论

RTUC 方案可提高复发性 AIS 患者的认知功能,缓解精神问题。

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