職能治療計畫介入對日間照顧中心失智症患者日常與社交功能以及照顧者負荷之成效探討

Occupational Therapy Intervention for People with Dementia in Day-Care Centers: The Effectiveness of Activities of Daily Living, Social Function, and Caregiver Burden

柯宏勳(Hung-Hsuin Ko) ； 黃妍華(Yan-Hua Huang) ； 李美慧(Mei-Hui Li) ； 吳菁宜(Ching-Yi Wu) ； 李冠逸(Kuan-Yi Li) ； 謝妤葳(Yu-Wei Hsieh)

《臺灣職能治療研究與實務雜誌》 9卷2期 (2013/12) Pp. 113-125

https://doi.org/10.6534/jtotrp.2013.9(2).113

摘要

The prevalence of dementia is increased in Taiwan in recent years due to rising life expectancy and increasing rate of population aging. More than 80% of dementia patients live in the community, not in institutions. It is urgent to develop feasible strategies and services to reduce the burden of caregivers and enhance physical and mental health of the patient beyond medication. The effect of occupational therapy on activities of daily living and social function in people with dementia and their caregivers were investigated. The study used a randomized pre-test and post-test control group design. Eligible participants were randomly assigned to the experimental group (OT group) or the control group. The intervention lasted ten weeks.Twenty three participants in the experimental group (6 males, 17 females, mean age = 79.22 years) and 19 participants in the control group (9 males, 10 females, mean age = 81.58 years) completed the entire intervention. No significant difference in the demographic data was found between these two groups except the duration of received day-care services. Analyses of covariance (ANCOVAs) were used to assess the effectiveness of the occupational therapy. The experimental group showed significantly higher score in Disability Assessment for Dementia (DAD) than the control group (p ＜ .001). In the Quality of Life in Alzheimer s Disease (QOL-AD), the average rating of the experimental group was higher than that of the control group after intervention, but not statistically significant (p = .09); average rating from the caregiver of the experimental group was significantly higher than that of the control group (p = .03). In the Chinese version of the Zarit Burden Interview (CZBI), the experimental group showed significantly lower score than the control group (p = .03). In the Assessment of Communication and Interaction Skills (ACIS), the score of the experimental group was significantly higher than that of the control group (p ＜ .01).The results showed that occupational therapy could improve daily function and quality of live (based on caregiver s perspective) of dementia patients. Caregiver burden was reduced, and social interaction and communication skills were enhanced compared to the control group.This study shows that occupational therapy intervention can improve activities of daily living, social function, and quality of life in people with dementia in day-care centers. In addition, caregiver burden could also be reduced. Hopefully, this study could provide better understanding of the role of caregivers in day-care centers, and assist therapists to manage activities matching patients' needs. Occupational therapists can improve physical and mental health of dementia patients by their professional knowledge and develop better strategies for community care.

關鍵字

失智症 ； 職能治療 ； 日間照顧中心 ； 隨機對照研究

並列摘要

The prevalence of dementia is increased in Taiwan in recent years due to rising life expectancy and increasing rate of population aging. More than 80% of dementia patients live in the community, not in institutions. It is urgent to develop feasible strategies and services to reduce the burden of caregivers and enhance physical and mental health of the patient beyond medication. The effect of occupational therapy on activities of daily living and social function in people with dementia and their caregivers were investigated. The study used a randomized pre-test and post-test control group design. Eligible participants were randomly assigned to the experimental group (OT group) or the control group. The intervention lasted ten weeks.Twenty three participants in the experimental group (6 males, 17 females, mean age = 79.22 years) and 19 participants in the control group (9 males, 10 females, mean age = 81.58 years) completed the entire intervention. No significant difference in the demographic data was found between these two groups except the duration of received day-care services. Analyses of covariance (ANCOVAs) were used to assess the effectiveness of the occupational therapy. The experimental group showed significantly higher score in Disability Assessment for Dementia (DAD) than the control group (p ＜ .001). In the Quality of Life in Alzheimer s Disease (QOL-AD), the average rating of the experimental group was higher than that of the control group after intervention, but not statistically significant (p = .09); average rating from the caregiver of the experimental group was significantly higher than that of the control group (p = .03). In the Chinese version of the Zarit Burden Interview (CZBI), the experimental group showed significantly lower score than the control group (p = .03). In the Assessment of Communication and Interaction Skills (ACIS), the score of the experimental group was significantly higher than that of the control group (p ＜ .01).The results showed that occupational therapy could improve daily function and quality of live (based on caregiver s perspective) of dementia patients. Caregiver burden was reduced, and social interaction and communication skills were enhanced compared to the control group.This study shows that occupational therapy intervention can improve activities of daily living, social function, and quality of life in people with dementia in day-care centers. In addition, caregiver burden could also be reduced. Hopefully, this study could provide better understanding of the role of caregivers in day-care centers, and assist therapists to manage activities matching patients' needs. Occupational therapists can improve physical and mental health of dementia patients by their professional knowledge and develop better strategies for community care.

並列關鍵字

Dementia ； Occupational therapy ； Day care ； Randomized control trial