老年轻度认知障碍患者的尊严疗法干预
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摘要
目的探讨尊严疗法干预在老年轻度认知障碍患者的应用效果。方法采用便利抽样法,选取92例老年轻度认知障碍患者作为研究对象,将其随机分为干预组和对照组各46例,对照组实施常规护理,干预组实施尊严疗法干预。干预前及干预后2周使用患者尊严量表、医院焦虑抑郁量表、蒙特利尔认知评估量评估效果。结果干预组干预后的尊严及认知功能得分显著优于对照组,焦虑、抑郁得分显著低于对照组(P<0.05,P<0.01)。结论尊严疗法干预可降低老年轻度认知障碍患者尊严受损程度,减轻其焦虑抑郁情绪,提高其认知能力。
Objective To explore the effect of dignity therapy on patients with mild cognitive impairment(MCI).Methods By conve-nience sampling method, 92 MCI patients were selected and evenly randomized into 2 groups :the control group received routine care, while the intervention group received dignity therapy.Patients were measured with the Patient Dignity Inventory(PDI), the Hospital Anxiety and Depression Scale(HADS), and the Montreal-Cognitive Assessment(MoCA) scale at baseline, and 2 weeks into the intervention.Results After the intervention, the intervention group had higher dignity and cognitive scores, and lower an-xiety and depression scores, than the controls(P<0.05,P<0.01).Conclusion Dignity therapy could reduce the degree of dignity damage, anxiety and depression levels in MCI patients, and improve their cognitive function.
Objective To explore the effect of dignity therapy on patients with mild cognitive impairment(MCI).Methods By conve-nience sampling method, 92 MCI patients were selected and evenly randomized into 2 groups :the control group received routine care, while the intervention group received dignity therapy.Patients were measured with the Patient Dignity Inventory(PDI), the Hospital Anxiety and Depression Scale(HADS), and the Montreal-Cognitive Assessment(MoCA) scale at baseline, and 2 weeks into the intervention.Results After the intervention, the intervention group had higher dignity and cognitive scores, and lower an-xiety and depression scores, than the controls(P<0.05,P<0.01).Conclusion Dignity therapy could reduce the degree of dignity damage, anxiety and depression levels in MCI patients, and improve their cognitive function.
引文
[1] 林萍.轻度认知障碍临床研究进展[J].世界最新医学信息文摘,2017,17(84):20-21.
[2] 潘惠英,王君俏,周标,等.老年轻度认知障碍患者抑郁水平的调查与分析[J].中华护理杂志,2012,47(1):17-19.
[3] Morris J C,Storandt M,Miller J P,et al.Mild cognitive impairment represents early-stage Alzheimer disease[J].Arch Neurol,2001,58(3):397-405.
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[9] Bentley B,O′Connor M,Kane R,et al.Feasibility,acceptability,and potential effectiveness of dignity therapy for people with motor neurone disease[J].PLoS One,2014,9(5):e96888.
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[12] Guo Q,Chochinov H M,McClement S,et al.Development and evaluation of the Dignity Talk question framework for palliative patients and their families:a mixed-methods study[J].Palliat Med,2018,32(1):195-205.
[13] Chochinov H M,Hassard T,McClement S,et al.The Patient Dignity Inventory:a novel way of measuring dignity-related distress in palliative care[J].J Pain Symptom Manage,2008,36(6):559-571.
[14] 焦延超.中晚期癌症患者自我感受负担现状及影响因素分析[D].泰安:泰山医学院,2012.
[15] 戴晓阳.常用心理评估量表手册[D].北京:人民军医出版社,2015:167-168.
[16] Nasreddine Z S,Phillips N A,Bedirian V,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[17] Berg A I,Wallin A,Nordlund A,et al.Living with stable MCI:experiences among 17 individuals evaluated at a memory clinic[J].Aging Ment Health,2013,17(3):293-299.
[18] Clare L.We′ll fight it as long as we can:coping with the onset of Alzheimer′s disease[J].Aging Ment Health,2002,6(3):139-148.
[19] Robinson R G,Jorge R E.Post-stroke depression:a review[J].Am J Psychiatry,2016,173(3):221-231.
[20] Haneda E,Higuchi M,Maeda J,et al.In vivo mapping of substance P receptors in brains of laboratory animals by high-resolution imaging systems[J].Synapse,2007,61(4):205-215.
[21] Fernandez-Ballesteros R,Botella J,Zamarron M D,et al.Cognitive plasticity in normal and pathological aging[J].Clin Interv Aging,2012,7:15-25.
[22] 吴黎明,陈长香,李建民,等.记忆训练对社区记忆障碍老年人的干预效果[J].中国老年学杂志,2011,31(2):308-10.
[23] 张建,魏秀红,田敏,等.联想记忆训练对轻度认知功能障碍老人认知功能的影响[J].中国老年学杂志,2012,12(32):5109-5111.
[2] 潘惠英,王君俏,周标,等.老年轻度认知障碍患者抑郁水平的调查与分析[J].中华护理杂志,2012,47(1):17-19.
[3] Morris J C,Storandt M,Miller J P,et al.Mild cognitive impairment represents early-stage Alzheimer disease[J].Arch Neurol,2001,58(3):397-405.
[4] Forstmeier S,Maercker A.Motivational processes in mild cognitive impairment and Alzheimer′s disease:results from the Motivational Reserve in Alzheimer′s (MoReA) study[J].BMC Psychiatry,2015,11(15):293-310.
[5] Orgeta V,Qazi A,Spector A,et al.Psychological treatments for depression and anxiety in dementia and mild cognitive impairment:systematic review and meta analysis[J].Br J Psychiatry,2015,207(4):293-298.
[6] 魏亚红,刘巍.尊严疗法在晚期癌症患者中的研究进展[J].中国肿瘤临床,2016,43(19):873-875.
[7] 李莹,周建国.尊严疗法对肺癌晚期患者希望水平和心理状况的影响[J].护理学杂志,2015,30(8):82-83.
[8] Chochinov H M,Kristjanson L J,Breitbart W,et al.Effect of dignity therapy on distress and end-of-life experience in terminally ill patients:a randomised controlled trial[J].Lancet Oncol,2011,12(8):753-762.
[9] Bentley B,O′Connor M,Kane R,et al.Feasibility,acceptability,and potential effectiveness of dignity therapy for people with motor neurone disease[J].PLoS One,2014,9(5):e96888.
[10] Johnston B,Lawton S,McCaw C,et al.Living well with dementia:enhancing dignity and quality of life,using a novel intervention,Dignity Therapy[J].Int J Older People Nurs,2016,11(2):107-120.
[11] 田金洲.中国痴呆诊疗指南(2017版)[M].北京:人民卫生出版社,2018:92-105.
[12] Guo Q,Chochinov H M,McClement S,et al.Development and evaluation of the Dignity Talk question framework for palliative patients and their families:a mixed-methods study[J].Palliat Med,2018,32(1):195-205.
[13] Chochinov H M,Hassard T,McClement S,et al.The Patient Dignity Inventory:a novel way of measuring dignity-related distress in palliative care[J].J Pain Symptom Manage,2008,36(6):559-571.
[14] 焦延超.中晚期癌症患者自我感受负担现状及影响因素分析[D].泰安:泰山医学院,2012.
[15] 戴晓阳.常用心理评估量表手册[D].北京:人民军医出版社,2015:167-168.
[16] Nasreddine Z S,Phillips N A,Bedirian V,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[17] Berg A I,Wallin A,Nordlund A,et al.Living with stable MCI:experiences among 17 individuals evaluated at a memory clinic[J].Aging Ment Health,2013,17(3):293-299.
[18] Clare L.We′ll fight it as long as we can:coping with the onset of Alzheimer′s disease[J].Aging Ment Health,2002,6(3):139-148.
[19] Robinson R G,Jorge R E.Post-stroke depression:a review[J].Am J Psychiatry,2016,173(3):221-231.
[20] Haneda E,Higuchi M,Maeda J,et al.In vivo mapping of substance P receptors in brains of laboratory animals by high-resolution imaging systems[J].Synapse,2007,61(4):205-215.
[21] Fernandez-Ballesteros R,Botella J,Zamarron M D,et al.Cognitive plasticity in normal and pathological aging[J].Clin Interv Aging,2012,7:15-25.
[22] 吴黎明,陈长香,李建民,等.记忆训练对社区记忆障碍老年人的干预效果[J].中国老年学杂志,2011,31(2):308-10.
[23] 张建,魏秀红,田敏,等.联想记忆训练对轻度认知功能障碍老人认知功能的影响[J].中国老年学杂志,2012,12(32):5109-5111.