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穴位按压改善长期护理环境中认知障碍老年人的认知和生活质量:一项聚类随机对照试验。

Acupressure Improves Cognition and Quality of Life Among Older Adults with Cognitive Disorders in Long-Term Care Settings: A Clustered Randomized Controlled Trial.

机构信息

Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan.

College of Chinese Medicine, School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Acupuncture, China Medical University Hospital, Taichung, Taiwan.

出版信息

J Am Med Dir Assoc. 2023 Apr;24(4):548-554. doi: 10.1016/j.jamda.2023.02.011. Epub 2023 Mar 15.

Abstract

OBJECTIVE

To examine the effectiveness of acupressure on cognition and quality of life (QoL) among older adults with cognitive disorders residing in long-term care (LTC) settings.

DESIGN

A clustered, randomized, assessor-blinded, controlled trial with a repeated measures design.

SETTING AND PARTICIPANTS

Participants were recruited from residential care facilities in Taiwan from August 2020 to February 2021. Ninety-two older residents in 18 facilities were randomized to either the intervention arm (9 facilities, n = 46) or the control arm (9 facilities, n = 46).

METHODS

Acupressure was performed at Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), Fengchi (GB20), Shuigou (GV26), Neiguan (PC6), Shenmen (HT7), and Zusanli (ST36). The duration for pressing each acupoint was 3 minutes. The acupressure force was maintained at 3 kg. Acupressure was performed once a day 5 times a week for 12 weeks. The primary outcome measure was the Cognitive Abilities Screening Instrument (CASI). Secondary outcomes included the digit span backward test, the Wisconsin Card Sorting Test (perseverative responses, perseverative errors, and categories completed), semantic fluency tests of categories of animals, fruits, and vegetables, and the Quality of Life-Alzheimer's Disease (QoL-AD). Data were collected at preintervention and postintervention. Three-level mixed effects models were performed. This study complied with the CONSORT checklist.

RESULTS

After adjusting for covariates, there was a significant increase in CASI scores, the digit span backward test, perseverative responses, perseverative errors, categories completed, semantic fluency tests of categories, and QoL-AD scores in the intervention versus control arm at 3 months.

CONCLUSIONS AND IMPLICATIONS

This study provides support for the use of acupressure to improve cognition and QoL during care among older residents with cognitive disorders in LTC settings. Acupressure can be integrated into aged care practice to improve cognition and QoL of older residents with cognitive disorders in LTC settings.

摘要

目的

考察穴位按压对长期护理(LTC)环境中认知障碍老年患者认知功能和生活质量(QoL)的影响。

设计

采用聚类随机、评估者盲法、对照临床试验,重复测量设计。

地点和参与者

2020 年 8 月至 2021 年 2 月,参与者从台湾的养老院招募。18 个机构的 92 名老年居民被随机分为干预组(9 个机构,n=46)或对照组(9 个机构,n=46)。

方法

按压百会穴(GV20)、四神聪穴(EX-HN1)、神庭穴(GV24)、风池穴(GB20)、水沟穴(GV26)、内关穴(PC6)、神门穴(HT7)和足三里穴(ST36)。每个穴位按压 3 分钟。穴位按压力保持在 3 公斤。每天一次,每周 5 次,共 12 周。主要结局测量工具是认知能力筛查工具(CASI)。次要结局包括数字跨度倒背测试、威斯康星卡片分类测试(持续反应、持续错误和完成类别)、动物、水果和蔬菜类别语义流畅性测试,以及生活质量-阿尔茨海默病(QoL-AD)。数据在干预前和干预后收集。采用三级混合效应模型。本研究符合 CONSORT 清单。

结果

调整协变量后,干预组与对照组相比,CASI 评分、数字跨度倒背测试、持续反应、持续错误、完成类别、语义流畅性测试、QoL-AD 评分在 3 个月时有显著提高。

结论和意义

本研究为穴位按压在长期护理环境中改善认知障碍老年患者的认知和生活质量提供了支持。穴位按压可以整合到老年护理实践中,以提高长期护理环境中认知障碍老年居民的认知和生活质量。

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