認知刺激對失智症患者認知、憂鬱情緒、生活品質及焦躁行為之成效探討

Effects of Cognitive Stimulation Therapy on Cognitive Function, Depressive Mood, Quality of Life, and Agitation in People with Dementia

趙慧珍(Hui-Chen Chao) ； 楊雅萍(Ya-Ping Yang) ； 王靜枝(Jing-Jy Wang)

《自然療法暨健康促進期刊》 1卷1期 (2022/11) Pp. 16-29

https://doi.org/10.30192/JNTHP.202211_1(1).0002

摘要

目的：本研究目的為探討認知刺激方案對失智症者的認知、憂鬱情緒、生活品質、焦躁行為之成效。方法：採雙組重複量數混合設計，遴選南臺灣8家長期照護機構之失智症長者，以多單位進行機構隨機配對分派法，分為認知刺激組及另一性質相近的機構則為與對照組。認知刺激組進行為期10週，每週一次、每次45－50分鐘之認知次刺激治療，而對照組則維持原有之日常生活活動。兩組皆以簡短心智量表、中文版康乃爾失智憂鬱量表、中文版焦躁量表及阿茲海默氏症生活品質量表作為評估工具，分別於研究介入前一週及介入結束後第一週與第三個月進行檢測。結果：經過認知刺激方案訓練後，認知刺激組參與者的認知狀態及生活品質有短期效益（p<0.05），至於長期效益部分僅憂鬱情緒及生活品質是達統計上顯著差異（p<0.05）；而焦躁行為於後測與追蹤後測僅持續降低但未達顯著差異（p>0.05）。對照組方面則於認知狀態及生活品質則有持續下降傾向且達統計上顯著差異（p<0.01）。結論：參與認知刺激治療之失智老人之認知與生活品質是有明顯改善，未來本研究結果可做為第一線照護人員在失智症非藥物照護措施之指引。

關鍵字

認知狀態 ； 憂鬱狀態 ； 焦躁行為 ； 生活品質 ； 認知刺激治療

並列摘要

Purpose: The purpose of this research was to examine the effects of Cognitive Stimulation therapy on Cognitive Function, depressive mood, Quality of Life and alleviating agitation in people with dementia (PwD). Methods: A randomized comparisonled trial and repeated measures design was conducted. A two-group, the CST group and the comparison group and repeated measures design was conducted. A random assignment method was used to select subjects residing in long-term care including nursing home and assisted living facilities. The Cognitive stimulation group received a 45-50-minute session per week for continuous 10 weeks program. Measurement instruments include the Mini-Mental State Examination (MMSE), Cornell Scale for Depression in Dementia Chinese version (CSDD), Cohen-Mansfield Agitation Inventory (CMAI) and Quality of life-Alzheimer’s disease scale (AD_QoL). Repeated Measures was assessed at baseline, one week and 3 months following the CST intervention. Results: The findings indicated that MMSE and AD-QoL improved significantly on the post-test (p <0 .05). CSDD and AD-QoL improved significantly on the follow-up test (p <0 .05). However, CMAI decresed but not significantly on the post-test and follow-up test (p > 0.05). On the other hand, MMSE and AD-QoL decreaseds ignificantly in the comparison group (p< 0.01). Conclusion: This study showed that the Cognitive Stimulation Therapy improves cognition status, depression and quality of life in patient with dementia. Findings of this study may serve as references for healthcare providers when planning for non-pharmacological care.

並列關鍵字

cognition status ； depression status ； agitation behavior ； quality of life ； cognitive stimulation therapy