整体护理对阿尔茨海默病患者认知障碍和精神症状的积极影响。

Positive Impact of Holistic Nursing on Cognitive Impairment and Psychiatric Symptoms in Patients With Alzheimer's Disease.

作者信息

Yu Jie, Zhu Lin, Song Yanan, Shi Biyan, Zhou Xiaoping

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, 121000 Jinzhou, Liaoning, China.

Department of Nursing, The First Affiliated Hospital of Jinzhou Medical University, 121000 Jinzhou, Liaoning, China.

出版信息

Actas Esp Psiquiatr. 2025 May;53(3):586-597. doi: 10.62641/aep.v53i3.1948.

DOI:10.62641/aep.v53i3.1948

PMID:40355993

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12069923/

Abstract

BACKGROUND

Alzheimer's Disease (AD) affects millions of elderly individuals worldwide and has been clinically recognized as one of the most significant disorders compromising quality of life in late-stage human development. The objective of this study is to systematically evaluate the influence of holistic nursing (HN) on patients with AD, thereby providing evidence-based references for clinical practice.

METHODS

A total of 105 patients with AD hospitalized in our hospital between January 2023 and January 2024 were enrolled for prospective analysis. Among them, 58 received conventional care (control group), and 47 received HN (observation group). Before and following the nursing interventions, both groups underwent assessment using the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Montreal Cognitive Assessment (MoCA), and Self-rating Anxiety/Depression Scales (SAS/SDS). In addition, neurotransmitter levels and neuroinflammatory markers were measured using enzyme-linked immunosorbent assay and fully automated chemiluminescent immunoassay. Treatment compliance, incidence of adverse events, and family satisfaction were also recorded and compared between the two groups.

RESULTS

After nursing interventions, the observation group demonstrated significantly higher MMSE and MoCA scores compared to the control group. Conversely, NPI, ADAS-cog, SAS, and SDS scores were notably lower in the observation group (p < 0.05). Furthermore, neurotransmitter levels were significantly elevated in the observation group, while the concentrations of central nervous system-specific protein β (S100β) and interleukin-1β (IL-1β) were significantly reduced (p < 0.05). Although the incidence of adverse events did not differ significantly between the two groups (p > 0.05), the observation group exhibited higher treatment compliance and greater family satisfaction (p < 0.05).

CONCLUSION

HN effectively improves cognitive function and alleviates psychiatric symptoms in AD patients, supporting its recommendation for clinical application.

CLINICAL TRIAL REGISTRATION

No. NCT06868004.

摘要

背景

阿尔茨海默病（AD）影响着全球数百万老年人，临床上已被确认为是晚期人类发育阶段影响生活质量的最重要疾病之一。本研究的目的是系统评估整体护理（HN）对AD患者的影响，从而为临床实践提供循证参考。

方法

选取2023年1月至2024年1月在我院住院的105例AD患者进行前瞻性分析。其中，58例接受常规护理（对照组），47例接受整体护理（观察组）。在护理干预前后，两组均采用简易精神状态检查表（MMSE）、神经精神科问卷（NPI）、阿尔茨海默病评估量表认知分量表（ADAS-cog）、蒙特利尔认知评估量表（MoCA）以及焦虑/抑郁自评量表（SAS/SDS）进行评估。此外，采用酶联免疫吸附测定法和全自动化学发光免疫测定法检测神经递质水平和神经炎症标志物。记录并比较两组的治疗依从性、不良事件发生率和家庭满意度。

结果

护理干预后，观察组的MMSE和MoCA评分显著高于对照组。相反，观察组的NPI、ADAS-cog、SAS和SDS评分显著更低（p<0.05）。此外，观察组的神经递质水平显著升高，而中枢神经系统特异性蛋白β（S100β）和白细胞介素-1β（IL-1β）的浓度显著降低（p<0.05）。尽管两组不良事件发生率无显著差异（p>0.05），但观察组的治疗依从性更高，家庭满意度更高（p<0.05）。