家庭作业治疗对阿尔茨海默病患者认知功能的影响研究

doi:10.3761/j.issn.0254-1769.2023.06.001

摘要/Abstract

摘要：

目的构建基于作业治疗的家庭干预方案，探讨其对改善阿尔茨海默病患者的认知功能和生活质量的效果。方法通过文献分析和专家会议法形成作业治疗方案。2021年4月—10月，选取某三级专科医院首次入院的68例老年精神科的阿尔茨海默病患者，按患者所在社区分组，梁溪区设为试验组，惠山区设为对照组，每组各34例。试验组在常规护理的基础上实施家庭作业治疗，包括线上沟通，线下家庭访视、护理门诊和社区集体活动等；对照组进行精神科常规护理。在干预前、干预后3、6个月，比较两组简易智能精神状态量表、改良Barthel指数量表、痴呆生活质量量表得分。结果干预后3、6个月，试验组简易智能精神状态量表得分、改良Barthel指数量表得分、老年痴呆患者生活质量量表得分均高于干预前和对照组，差异有统计学意义（P<0.05），试验组干预后3个月的依从性为64.52%，干预后6个月的依从性为90.32%。结论实施家庭作业治疗能改善阿尔茨海默病患者的认知功能，提高其日常生活活动能力和生活质量。

关键词: 阿尔茨海默病, 回归家庭, 作业治疗, 认知, 生活质量, 社区护理

Abstract:

Objective To construct the intervention effect of occupational therapy-based return to family intervention program on improving cognitive function and quality of life in patients with Alzheimer’s disease. Methods Through literature analysis and expert meeting，the return to family intervention program was formed. 68 patients with Alzheimer’s disease in the department of geriatric psychiatry who were admitted for the first time from April 2021 to October 2021 in a tertiary specialized hospital were selected. According to the community where the patients lived，Liangxi district was the study group and Huishan District was the control group，with 34 cases in each group. The study group carried out return to family intervention on the basis of routine nursing，including online communication，offline family visit，nursing clinic and community group activities，for 6 months. The control group received routine psychiatric nursing. The scores of Mini-Mental State Examination，modified Barthel Index Scale and Quality of Life Scale for Alzheimer’s patients were compared before the intervention，3 months and 6 months after the intervention. Results At 3 months and 6 months after the intervention，the scores of Mini-Mental State Examination，modified Barthel Index Scale，and the total score of Quality of Life Scale for patients with Alzheimer’s disease in the study group were higher than those before the intervention and the control group，and the differences were statistically significant（P<0.05）. The compliances of the study group were 64.52% and 90.32% at 3 months and 6 months after intervention，respectively. Conclusion Return to family intervention based on occupational therapy can improve cognitive function，daily living ability and quality of life in patients with Alzheimer’s disease.

Key words: Alzheimer’s Disease, Return to Family, Occupational Therapy, Cognition, Quality of Life, Community Nursing

张瑞芬, 胡佳琪, 顾玲敏, 朱建中, 陆江波. 家庭作业治疗对阿尔茨海默病患者认知功能的影响研究[J]. 中华护理杂志, 2023, 58(6): 645-653.

ZHANG Ruifen, HU Jiaqi, GU Lingmin, ZHU Jianzhong, LU Jiangbo. Effects of occupational therapy on cognitive function in patients with Alzheimer’s disease[J]. Chinese Journal of Nursing, 2023, 58(6): 645-653.

图/表 5

表1 阿尔茨海默病患者家庭作业治疗内容

Table 1 Return to family intervention program for patients with Alzheimer’s disease

表2 两组一般资料比较

Table 2 General baseline data of the 2 groups of patients

表3 两组简易智能精神状态量表评分比较（分，

\bar{x}

±s）

Table 3 Comparison of MMSE scores between the 2 groups before and after intervention（scores，

\bar{x}

±s）

表3 两组简易智能精神状态量表评分比较（分， $\bar{x}$ ±s）

Table 3 Comparison of MMSE scores between the 2 groups before and after intervention（scores， $\bar{x}$ ±s）

表4 两组改良Barthel指数量表评分比较（分，

\bar{x}

±s）

Table 4 Comparison of MBI scores between the 2 groups before and after intervention（scores，

\bar{x}

±s）

表4 两组改良Barthel指数量表评分比较（分， $\bar{x}$ ±s）

Table 4 Comparison of MBI scores between the 2 groups before and after intervention（scores， $\bar{x}$ ±s）

表5 两组痴呆生活质量量表评分比较（分，

\bar{x}

±s）

Table 5 Comparison of DQOL scores between the 2 groups before and after intervention（scores，

\bar{x}

±s）

表5 两组痴呆生活质量量表评分比较（分， $\bar{x}$ ±s）

Table 5 Comparison of DQOL scores between the 2 groups before and after intervention（scores， $\bar{x}$ ±s）

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