阿尔茨海默病患者挑战性行为评估工具研究进展

doi:10.3761/j.issn.0254-1769.2023.08.017

摘要/Abstract

摘要：

挑战性行为是阿尔茨海默病患者最常见的异常行为症状，也是患者健康状况不佳的一种表现，给患者自身及其照顾者带来了极大的负担。该文介绍了阿尔茨海默病患者挑战性行为常见评估工具的主要内容、信效度、特点、应用现状及适用性，以期为国内阿尔茨海默病患者挑战性行为评估工具的开发提供参考，为医护人员科学选用评估工具提供借鉴。

关键词: 阿尔茨海默病, 痴呆症, 挑战性行为, 躁动, 攻击, 护理评估, 综述

Abstract:

Challenging behavior is the most common abnormal behavioral symptom in patients with Alzheimer’s disease. It is also a manifestation of poor health of patients，which brings great burden to patients and their caregivers. This article introduces the main content，reliability and validity，characteristics，application status and applicability of common assessment tools for challenging behavior in patients with Alzheimer’s disease，in order to provide references for the development of challenging behavior assessment tools for patients with Alzheimer’s disease in China and provide references for medical staff to scientifically select appropriate assessment tools.

Key words: Alzheimer’s Disease, Dementia, Challenging Behavior, Agitation, Aggression, Nursing Assessment, Review

田丹丹, 刘梦琪, 刘雅婷, 文晓慧, 崔旭, 张英群, 何平平. 阿尔茨海默病患者挑战性行为评估工具研究进展[J]. 中华护理杂志, 2023, 58(8): 1005-1011.

TIAN Dandan, LIU Mengqi, LIU Yating, WEN Xiaohui, CUI Xu, ZHANG Yingqun, HE Pingping. Research progress of challenging behavior assessment tools for Alzheimer’s disease patients[J]. Chinese Journal of Nursing, 2023, 58(8): 1005-1011.

图/表 1

参考文献 37

[1]	2022 Alzheimer’s disease facts and figures[J]. Alzheimers Dement, 2022, 18(4):700-789. DOI URL
[2]	王英全, 梁景宏, 贾瑞霞, 等. 2020—2050年中国阿尔茨海默病患病情况预测研究[J]. 阿尔茨海默病及相关病, 2019, 2(1):289-298.
	Wang YQ, Liang JH, Jia RX, et al. Alzheimer disease in China(2015-2050) estimated using the 1% population sampling survey in 2015[J]. Chin J Alzheimer’s Dis Relat Disord, 2019, 2(1):289-298.
[3]	Moniz-Cook E, Woods R, Gardiner E, et al. The Challenging Behaviour Scale(CBS):development of a scale for staff caring for older people in residential and nursing homes[J]. Br J Clin Psychol, 2001, 40(3):309-322. PMID
[4]	Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home[J]. J Gerontol, 1989, 44(3):M77-M84. DOI URL
[5]	Veldwijk-Rouwenhorst AE, Zuidema SU, Smalbrugge M, et al. Very frequent physical aggression and vocalizations in nursing home residents with dementia[J]. Aging Ment Health, 2021, 25(8):1442-1451. DOI URL
[6]	康祎陈, 刘文琳, 丁玎, 等. 年轻型痴呆症患者及其照护者疾病体验的质性研究[J]. 中华护理杂志, 2022, 57(13):1591-1598. DOI
	Kang YC, Liu WL, Ding D, et al. Qualitative study on the dyadic experience of patients with young-onset dementia and their caregivers[J]. Chin J Nurs, 2022, 57(13):1591-1598. DOI
[7]	陈蔚臣, 陈瑜, 高源敏, 等. 老年痴呆照顾者虐待倾向风险评估模型的构建与评价[J]. 中华护理杂志, 2019, 54(7):1005-1011. DOI
	Chen WC, Chen Y, Gao YM, et al. Development and validation of risk assessment model of abuse tendency among caregivers of elders with dementia in long-term care facilities[J]. Chin J Nurs, 2019, 54(7):1005-1011. DOI
[8]	孙晶, 郑秀利, 杨支兰, 等. 痴呆患者居家老年照顾者生活质量评估量表的汉化和信效度检验[J]. 中华护理杂志, 2021, 56(12):1901-1906. DOI
	Sun J, Zheng XL, Yang ZL, et al. Sinicization of the Dementia Quality of Life Scale for Older Family Carers of Patients and the test of its reliability and validity[J]. Chin J Nurs, 2021, 56(12):1901-1906. DOI
[9]	Emerson E, Cummings R, Barrett S, et al. Challenging behaviour and community services 2. Who are the people who challenge services?[J]. J Br Inst Ment Handicap APEX, 2009, 16(1):16-19.
[10]	曾丽娟. 中文版阿尔茨海默病患者挑战性行为量表的信效度研究及其应用[D]. 广州: 南方医科大学, 2018.
	Zeng LJ. Reliability,validity of Chinese version of the Chal-lenging Behavior Scale and its application[D]. Guangzhou: Sou-thern Medical University, 2018.
[11]	马冬飞, 孙皎, 赵英男, 等. 痴呆患者精神行为症状相关护理模式的研究进展[J]. 中华护理杂志, 2019, 54(7):1017-1022. DOI
	Ma DF, Sun J, Zhao YN, et al. Nursing care mode of behavioral and psychological symptoms in patients with dementia:a literature review[J]. Chin J Nurs, 2019, 54(7):1017-1022.
[12]	中国痴呆与认知障碍诊治指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(十):痴呆精神行为症状鉴别诊断和治疗[J]. 中华医学杂志, 2020, 100(17):1290-1293.
	Chinese Guide Group on Dementia and Cognitive Impairment,Cognitive Disorders Professional Committee, Neurology Branch,Chinese Medical Doctor Association. 2018 China guidelines for diagnosis and treatment of dementia and cognitive disorders(10):differential diagnosis and treatment of mental and behavioral symptoms of dementia[J]. Natl Med J China, 2020, 100(17):1290-1293.
[13]	Gerritsen DL, Smalbrugge M, Veldwijk-Rouwenhorst AE, et al. The difficulty with studying challenging behavior[J]. J Am Med Dir Assoc, 2019, 20(7):879-881. DOI PMID
[14]	Magee M, McCorkell G, Guille S, et al. Feasibility of the Namaste Care Programme to enhance care for those with advanced dementia[J]. Int J Palliat Nurs, 2017, 23(8):368-376. DOI PMID
[15]	Lam CL, Chan WC, Mok CC, et al. Validation of the Chinese Challenging Behaviour Scale:clinical correlates of challenging behaviours in nursing home residents with dementia[J]. Int J Geriatr Psychiatry, 2006, 21(8):792-799. DOI URL
[16]	曾丽娟, 陈瑜, 许妹仔, 等. 阿尔茨海默病患者挑战性行为量表的汉化及信度效度检验[J]. 中国护理管理, 2018, 18(5):597-602.
	Zeng LJ, Chen Y, Xu MZ, et al. Reliability and validity of Chinese version of the Challenging Behavior Scale[J]. Chin Nurs Manag, 2018, 18(5):597-602.
[17]	Livingston G, Barber J, Marston L, et al. Clinical and cost-effectiveness of the Managing Agitation and Raising Quality of Life(MARQUE) intervention for agitation in people with dementia in care homes:a single-blind,cluster-randomised controlled trial[J]. Lancet Psychiatry, 2019, 6(4):293-304. DOI PMID
[18]	Choy CN, Lam LC, Chan WC, et al. Agitation in Chinese elderly:validation of the Chinese version of the Cohen-Mansfield Agitation Inventory[J]. Int Psychogeriatr, 2001, 13(3):325-335. DOI PMID
[19]	赖锦玉. 中文版柯恩-曼斯菲尔德激越情绪行为量表的研制[J]. 中华护理杂志, 2010, 45(6):500-504.
	Lai JY. The Cohen-Mansfield Agitation Inventory:development of a Chinese version[J]. Chin J Nurs, 2010, 45(6):500-504.
[20]	Finkel SI, Lyons JS, Anderson RL. A Brief Agitation Rating Scale(BARS) for nursing home elderly[J]. J Am Geriatr Soc, 1993, 41(1):50-52. DOI PMID
[21]	Logsdon RG, Teri L, Weiner MF, et al. Assessment of agitation in Alzheimer’s disease:the Agitated Behavior in Dementia Scale. Alzheimer’s Disease Cooperative Study[J]. J Am Geriatr Soc, 1999, 47(11):1354-1358. PMID
[22]	Arthur PB, Gitlin LN, Kairalla JA, et al. Relationship between the number of behavioral symptoms in dementia and caregiver distress:what is the tipping point?[J]. Int Psychogeriatr, 2018, 30(8):1099-1107. DOI PMID
[23]	Ryden MB. Aggressive behavior in persons with dementia who live in the community[J]. Alzheimer Dis Assoc Disord, 1988, 2(4):342-355. DOI URL
[24]	Oh H, Hur MH, Eom M. Development and analysis of the effects of caregiver training program on aggressive behavior in elders with cognitive impairment[J]. Taehan Kanho Hakhoe Chi, 2005, 35(4):745-753. PMID
[25]	Ryden MB, Bossenmaier M, McLachlan C. Aggressive behavior in cognitively impaired nursing home residents[J]. Res Nurs Health, 1991, 14(2):87-95. PMID
[26]	Perlman CM, Hirdes JP. The Aggressive Behavior Scale:a new scale to measure aggression based on the minimum data set[J]. J Am Geriatr Soc, 2008, 56(12):2298-2303. DOI URL
[27]	McCreedy E, Ogarek JA, Thomas KS, et al. The minimum data set Agitated and Reactive Behavior Scale:measuring behaviors in nursing home residents with dementia[J]. J Am Med Dir Assoc, 2019, 20(12):1548-1552. DOI PMID
[28]	McCreedy EM, Gutman R, Baier R, et al. Measuring the effects of a personalized music intervention on agitated behaviors among nursing home residents with dementia:design features for cluster-randomized adaptive trial[J]. Trials, 2021, 22(1):681. DOI PMID
[29]	Patel V, Hope RA. A Rating Scale for Aggressive Behaviour in the Elderly:the RAGE[J]. Psychol Med, 1992, 22(1):211-221. DOI PMID
[30]	Adama B, Benjamin C, Jean-Pierre C, et al. French version of the Rating Scale for Aggressive Behaviour in the Elderly (F-RAGE):psychometric properties and diagnostic accuracy[J]. Dement Neuropsychol, 2013, 7(3):278-285. DOI URL
[31]	Rosen J, Burgio L, Kollar M, et al. The Pittsburgh Agitation Scale:a user-friendly instrument for rating agitation in de-mentia patients[J]. Am J Geriatr Psychiatry, 1994, 2(1):52-59. DOI URL
[32]	Leach MJ, Sangalli M, Breakspear I, et al. Essential oils for agitation in dementia[rELOAD]:a pragmatic,cluster-randomized,placebo-controlled,pilot feasibility trial[J]. Integr Med Res, 2021, 10(4):100747. DOI URL
[33]	Bogner JA, Corrigan JD, Bode RK, et al. Rating scale analysis of the Agitated Behavior Scale[J]. J Head Trauma Rehabil, 2000, 15(1):656-669. DOI URL
[34]	Tariot PN, Mack JL, Patterson MB, et al. The Behavior Rating Scale for Dementia of the consortium to establish a registry for Alzheimer’s disease. the behavioral pathology committee of the consortium to establish a registry for Alzheimer’s disease[J]. Am J Psychiatry, 1995, 152(9):1349-1357. DOI URL
[35]	Hope T, Fairburn CG. The Present Behavioural Examination(PBE):the development of an interview to measure current behavioural abnormalities[J]. Psychol Med, 1992, 22(1):223-230. PMID
[36]	Jung S, Wollmer MA, Kruger THC. The Hamburg-Hannover Agitation Scale (H2A):development and validation of a self-assessment tool for symptoms of agitation[J]. J Psychiatr Res, 2015, 69:158-165. DOI URL
[37]	Mansbach WE, Mace RA, Tanner MA, et al. The Columbia Be-havior Scale for Dementia(CBS-8):validity and reliability of a rapidly administered new instrument for dementia-related behaviors in long-term care settings[J]. Res Gerontol Nurs, 2021, 14(3):160-168. DOI PMID