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光与音乐疗法在预防老年住院患者谵妄中的可行性。

Feasibility of Light and Music Therapy in the Elderly for the Prevention of Hospital-Associated Delirium.

机构信息

Department of Emergency Medicine, Beaumont Health System, Royal Oak, MI; Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.

Oakland University William Beaumont School of Medicine, Rochester, MI.

出版信息

R I Med J (2013). 2023 May 1;106(4):35-39.

Abstract

Hospital-associated delirium is common in older adults, especially those with dementia, and is associated with high morbidity and mortality. We performed a feasibility study in the emergency department (ED) to examine the effect of light and/or music on the incidence of hospital- associated delirium. Patients aged ≥ 65 who presented to the ED and tested positive for cognitive impairment were enrolled in the study (n = 133). Patients were randomized to one of four treatment arms: music, light, music and light, and usual care. They received the intervention during their ED stay. In the control group, 7/32 patients developed delirium, while in the music-only group, 2/33 patients developed delirium (RR 0.27, 95% CI 0.06-1.23), and in the light-only group (RR 0.41, 95% CI 0.12-1.46), 3/33 patients developed delirium. In the music + light group, 8/35 patients developed delirium (RR 1.04, 95% CI 0.42--2.55). Providing music therapy and bright light therapy to ED patients was shown to be feasible. Although this small pilot study did not reach statistical significance, there was a trend towards less delirium in the music-only and light-only groups. This study lays the groundwork for future investigation into the efficacy of these interventions.

摘要

医院相关性谵妄在老年人中很常见,尤其是那些患有痴呆症的患者,并且与高发病率和死亡率相关。我们在急诊科进行了一项可行性研究,以研究光线和/或音乐对医院相关性谵妄发生率的影响。年龄≥65 岁且认知障碍检测呈阳性的急诊科患者纳入研究(n=133)。患者被随机分为四组治疗组:音乐组、光照组、音乐和光照联合组以及常规护理组。他们在急诊科住院期间接受干预。在对照组中,32 名患者中有 7 名发生谵妄,而在仅音乐组中,33 名患者中有 2 名发生谵妄(RR 0.27,95%CI 0.06-1.23),在仅光照组中(RR 0.41,95%CI 0.12-1.46),33 名患者中有 3 名发生谵妄。在音乐+光照组中,35 名患者中有 8 名发生谵妄(RR 1.04,95%CI 0.42-2.55)。为急诊科患者提供音乐疗法和明亮光照疗法是可行的。尽管这项小型试点研究没有达到统计学意义,但仅音乐组和仅光照组的谵妄发生率呈下降趋势。这项研究为进一步研究这些干预措施的疗效奠定了基础。

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