多元化課程對高齡失智長者在延緩認知退化之探討

目的：本論文旨在評估在失智症日間照護中心施行多元課程，是否能延緩高齡失智病人的認知能力退化，並且維持生活自理能力，以及減輕照護者的負擔。方法：本研究為回溯性分析研究，以探討多元文化課程及認知和生活自理能力的關聯性。課程內容包含現實導向、藝術課程、肢體活動、音樂課程、認知課程、感官課程、懷舊課程、職能課程、園藝課程，以及戲劇課程等等。評估內容包簡易智能量表、日常生活活動量表、工具性日常生活活動量表、照顧者負荷量表，以及照護者壓力量表。我們以成對樣本t檢定檢驗課程前後的差距，針對多次追蹤的數據則採One-way repeated measurement ANOVA分析。結果：本研究總共納入25位失智症個案，進行為期30個月的多元化課程。其中以女性較多共19位（76%）。個案年齡平均值與標準差為82.4 ± 5.6歲，其中有16位（64%）超過80歲。在接受透過多元化課程後，失智症個案的認知功能退化呈現明顯的和緩趨勢，以One-way repeated measurement ANOVA分析簡易心智量表（Mini-mental state examination, MMSE）量表測試結果，在第24個月（兩年後），認知功能才出現顯著的下降。失智個案的主要照護者負擔量表在接受課程前平均為6.2 ± 1.6的，下降到5.2 ± 1.7，且均達到統計顯著差異。結論：多元化課程可以有效維持高齡輕度失智症病人的認知功能與自我照護能力，並且減少照護者負擔。

關鍵字

多元化課程；輕度失智；認知功能；照護者負擔

並列摘要

Objective: The current study aimed to assess whether implementing diversity courses in dementia daycare centers can delay the cognitive decline of the elderly with dementia, maintain their self-care ability, and reduce the burden on the caregivers. Methods: This current study adopted a design of retrospective analysis to explore the correlation between multicultural curriculum and cognition and daily life self-care ability. The curriculum included courses in reality orientation, art, physical activities, music, cognitive, sensory, old-day memory, occupational, gardening, drama, etc. The assessments consisted of the mini-mental state examination (MMSE), Activities of Daily Living scale (ADL), Instrumental Activities of Daily Living scale (IADL), caregiver depression status, and Caregiving Burden Scale. We used paired sample t-tests to test the difference before and after the course and one-way repeated measurement ANOVA for diversity follow-up data. Results: A total of 25 dementia cases were included in this study, and the 30-month diversity courses were introduced. Among them, 19 (76%) were female. The average and standard deviation of their age were 82.4 ± 5.6 years, of which 16 (64%) were over 80. After receiving diversity courses, the cognitive function deterioration of the cases was significantly alleviated. The one-way repeated measurement ANOVA of the MMSE showed that their cognitive function declined significantly at 24 months. The main caregiver burden scale dropped from 6.2 ± 1.6 to 5.2 ± 1.7 significantly. Conclusion: Diversity courses can effectively maintain the cognitive function and self-care ability of the elderly with mild dementia and reduce the burden of the caregivers.

並列關鍵字

diversified courses ； mild dementia ； cognitive function ； caregiver burden

主題瀏覽