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托弗塔费尔对长期住院护理的痴呆症患者冷漠、社交互动及社交活动的影响:一项非对照自身设计研究的结果

Effects of the Tovertafel on apathy, social interaction and social activity of people with dementia in long-term inpatient care: results of a non-controlled within-subject-design study.

作者信息

Konrad Robert, Güttler Carina, Öhl Natalie, Heidl Christian, Scholz Stefanie, Bauer Christian

机构信息

Institute of Rescue, Emergency and Disaster Management, Technical University of Applied Sciences Würzburg-Schweinfurt, Nuremberg, Germany.

Department of Palliative Medicine, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.

出版信息

Front Neurol. 2024 Nov 28;15:1455185. doi: 10.3389/fneur.2024.1455185. eCollection 2024.

Abstract

INTRODUCTION

Tovertafel is a VR-based serious game for dementia care (SGDC) that aims to stimulate residents affected by dementia in nursing homes, promote social and cognitive skills and reduce apathy. The aim of this study is to investigate the effects of using Tovertafel on apathy, social interaction and social activity of people with dementia (PWD) in long-term inpatient care in Germany.

METHODS

In this monocentric intervention study, 25 residents of an inpatient long-term care facility with moderate or severe dementia had two weekly applications of Tovertafel over a period of 8 weeks. Effects on the residents' social interaction and activity were recorded before (T1), during (T2) and 1 h after (T3) each intervention using the Engagement of a Person with Dementia Scale (EPWDS). The degree of apathy was assessed using the Apathy Evaluation Scale (AES). Effects of Tovertafel were examined using a simple repeated measures analysis of variance (ANOVA).

RESULTS

Thirteen residents with moderate (52%) and 12 residents with severe dementia (48%) were included. Results showed that residents' apathy changed over the course of the trial and was partially reduced. ANOVA revealed significant changes in the positive expression of social participation in the overall group between individual observation times ( < 0.001; T1: MW = 2.67, SD = 1.352; T2: MW = 3.66, SD = 1.365; T3: MW = 3.10, SD = 1.300) and a significantly lower negative expression of social participation at T2 (MW = 1.09, SD = 0.358) than at T1 (MW = 1.19, SD = 0.579; = 0.028). There was a significantly higher positive expression of behavioral involvement in the overall group at T3 (MW = 1.17, SD = 0.552) than at T1 ( = 0.003) or T2 ( = 0.045). Analyses did not find any significant interaction between observation times and degree of dementia.

DISCUSSION

Results of the study show that the use of Tovertafel over a period of 2 months had significant effects on apathy, social activity and social interaction in people with moderate or severe dementia. Symptoms of apathy could be reduced and social interaction and activity increased. However, due to limitations of the study design and special circumstances of the COVID-19 pandemic situation, findings might be overestimated and must be interpreted with care. Further research is necessary.

摘要

引言

Tovertafel是一款基于虚拟现实的痴呆症护理严肃游戏(SGDC),旨在刺激养老院中受痴呆症影响的居民,提升社交和认知技能,并减少冷漠情绪。本研究的目的是调查在德国长期住院护理中使用Tovertafel对痴呆症患者(PWD)的冷漠、社交互动和社交活动的影响。

方法

在这项单中心干预研究中,25名患有中度或重度痴呆症的住院长期护理机构居民在8周内每周使用两次Tovertafel。在每次干预前(T1)、干预期间(T2)和干预后1小时(T3),使用痴呆症患者参与量表(EPWDS)记录对居民社交互动和活动的影响。使用冷漠评估量表(AES)评估冷漠程度。使用简单重复测量方差分析(ANOVA)检查Tovertafel的效果。

结果

纳入了13名中度痴呆患者(52%)和12名重度痴呆患者(48%)。结果显示,居民的冷漠在试验过程中发生了变化,部分有所减轻。方差分析显示,在各个观察时间之间,总体组中社交参与的积极表达有显著变化(<0.001;T1:中位数(MW)=2.67,标准差(SD)=1.352;T2:MW=3.66,SD=1.365;T3:MW=3.10,SD=1.300),并且T2时社交参与的消极表达显著低于T1时(MW=1.09,SD=0.358)(MW=1.19,SD=0.579;P=0.028)。T3时总体组中行为参与的积极表达显著高于T1时(P=0.003)或T2时(P=0.045)。分析未发现观察时间与痴呆程度之间有任何显著交互作用。

讨论

研究结果表明持续2个月使用Tovertafel对中度或重度痴呆症患者的冷漠、社交活动和社交互动有显著影响。冷漠症状可以减轻,社交互动和活动可以增加。然而,由于研究设计的局限性以及COVID-19大流行情况的特殊情况,研究结果可能被高估,必须谨慎解读。有必要进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35a0/11638534/d06bae412cb1/fneur-15-1455185-g001.jpg

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