认知行为干预对阿尔茨海默病主要照顾者应对方式和情绪状态的影响
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摘要
目的观察认知行为干预对阿尔茨海默病(AD)照顾者应对方式和情绪状态的影响。方法选择2014年1月至2016年1月AD病人的主要照顾者80名作为研究对象,采用随机数字表法分为两组,每组40名,对照组主要照顾者仅提供门诊或电话咨询,每月电话随访1次。观察组主要照顾者给予认知行为干预。入组时、居家6个月后采用Zung焦虑(SAS)、抑郁(SDS)自评量调查主要照顾者情绪状态,采用简易应对方式量表(SCSQ)评价照顾者应对方式。结果观察组干预6个月后SAS、SDS评分为(35.35±2.00)、(37.57±0.70)分,明显低于入组时的(51.24±2.73)、(47.43±1.16)分,且低于对照组6个月后的(51.68±1.98)、(47.12±1.41)分,均差异有统计学意义(P<0.05)。观察组干预6个月积极应对因子得分为(26.36±1.11)分,明显高于入组时的(20.44±0.83)分,且高于对照组6个月后的(20.87±0.89)分,消积应对因子得分(9.48±0.59)分,低于入组时的(15.34±0.73)分,且低于对照组6个月后的(15.67±0.50)分,均差异有统计学意义(P<0.05)。结论认知行为干预可改善AD照顾者情绪状态,促进应对方式向积极的方向发展,使病人在一个良性循环的模式中有质量的生活。
Objective To observe the effect of cognitive behavioral intervention on the coping style and emotional state of Alzheimer′s disease(AD) caregivers.Methods From January 2014 to January 2016,80 main caregivers of patients with AD were selected as the research object,by using digital table and were randomly divided into two groups,with 40 in each group.in the control group,the caregivers only provide outpatient service or telephone consultation,1 time per month for 6 month.The group′s primary caregivers were given cognitive behavioral intervention.Into the group,home after six months using Zung anxiety(SAS) and depression(SDS) from evaluation survey main caregivers emotional state,using simplified coping style questionnaire(SCSQ) evaluation of caregivers coping styles.Results Team for intervention 6 months after the SAS and SDS score(35.35±2.00),(37.57±0.70),significantly lower than in group(51.24±2.73),(47.43±1.16) and lower than the control group after 6 months(51.68±1.98),(47.12±1.41),the difference had statistical significance(P<0.05).Team 6 months intervention to address the factor score for(26.36±1.11),significantly higher than in group(20.44±0.83), and higher than that of the control group after 6 months(20.87±0.89).Negative coping factor score(9.48±0.59) lower than the group(15.34±0.73) and lower than the control group after 6 months(15.67±0.50) points of difference had statistical significance(P<0.05).Conclusion The continuation of nursing intervention can improve the emotional state of AD caregivers and promote the development of coping style in a positive direction,which can promote the quality life in a virtuous cycle.
Objective To observe the effect of cognitive behavioral intervention on the coping style and emotional state of Alzheimer′s disease(AD) caregivers.Methods From January 2014 to January 2016,80 main caregivers of patients with AD were selected as the research object,by using digital table and were randomly divided into two groups,with 40 in each group.in the control group,the caregivers only provide outpatient service or telephone consultation,1 time per month for 6 month.The group′s primary caregivers were given cognitive behavioral intervention.Into the group,home after six months using Zung anxiety(SAS) and depression(SDS) from evaluation survey main caregivers emotional state,using simplified coping style questionnaire(SCSQ) evaluation of caregivers coping styles.Results Team for intervention 6 months after the SAS and SDS score(35.35±2.00),(37.57±0.70),significantly lower than in group(51.24±2.73),(47.43±1.16) and lower than the control group after 6 months(51.68±1.98),(47.12±1.41),the difference had statistical significance(P<0.05).Team 6 months intervention to address the factor score for(26.36±1.11),significantly higher than in group(20.44±0.83), and higher than that of the control group after 6 months(20.87±0.89).Negative coping factor score(9.48±0.59) lower than the group(15.34±0.73) and lower than the control group after 6 months(15.67±0.50) points of difference had statistical significance(P<0.05).Conclusion The continuation of nursing intervention can improve the emotional state of AD caregivers and promote the development of coping style in a positive direction,which can promote the quality life in a virtuous cycle.
引文
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[13] 李明艳.失智症患者非药物疗法的研究进展[J].现代临床护理,2016,15(6):75-78.
[14] 曾燕,何丽娅,张玉芹,等.阿尔茨海默病家庭照料者教育工作研究进展[J].中国老年学杂志,2012,32(11):2447-2450.
[15] WASHIO M,SAITOH S,ARAI Y,et al.Risk factors for heavy burden among sychofamily Zasshi,caregivers in a rural town in Hokkaido[J].Nihon Ronen Igakkai Zasshi ,2005,42 (2):221-228.
[16] STOWELL JR,KIECOLT-GLASER JK,GLASER RP,et al.Erceived stress and cellular immunity:When coping counts[J].Journal of Behavioral Medicine,2001,24(4):323-339.
[17] 危艳萍,李红,陈萍,等.福建省养老机构阿尔茨海默病患者照顾者生活质量现况调查[J].护士进修杂志,2016,31(8):743-745.
[18] SHURGOT GR,KNIGHT BG.Influence of neuroticism,ethnicity,familism,and Social support on perceived burden in dementia caregivers:Pilottest of the Transactional stress and social support model[J].The Journals of Gerontology,2005,60(6):P331-P334.
[2] 管细红,李博,李素珍,等.怀旧疗法对阿尔茨海默症患者认知功能及生活质量的影响[J].护理学报,2016,23(11):66-68.
[3] 岳芸.Orem自理护理模式对阿尔茨海默病患者并发症及生活质量的影响[J].实用临床医药杂志,2016,20(14):151-152.
[4] 王敏,孙慧敏.老年期痴呆照顾者虐待行为及影响因素研究进展[J].中华现代护理杂志,2015,21(22):2719-2722.
[5] 赵博伦,安力彬.老年痴呆症患者不良口腔健康状态相关问题分析[J].解放军护理杂志,2013,30(13):39-41.
[6] 孙婷婷,贾建军,李榕彬,等.综合康复锻炼对阿尔茨海默病患者日常生活能力和认知能力的影响[J].护理学报,2013,(13):43-45.
[7] 荣丛,胡海霞,陈卉,等.医疗社会工作介入干预对老年性痴呆病人日常生活能力和认知能力的影响[J].护理研究,2016,30(21):2653-2655.
[8] 胡春碧.阿尔茨海默病的现状及护理干预进展[J].重庆医学,2013,42(19):2287-2289.
[9] 林春洁,谭晓雪,陈少梅,等.知信行健康教育模式对提高早期阿尔茨海默病患者遵医行为的影响[J].中国老年学杂志,2013,33(23):5973-5975.
[10] 朱艳艳,阮学平.阿尔茨海默患者家庭照顾者的网络信息服务[J].预防医学情报杂志,2014,30(3):228-231.
[11] NOYES BB,HILL RD,HICKEN BL,et al.The role of grief in dementea caregiving[J].Am J Alzheimers Dis Other Demen,2010,25(1):9-17.
[12] 肖爱祥,韦红梅,杨航,等.综合干预对居家阿尔茨海默病患者照顾者积极感受及悲伤情绪的影响[J].广东医学,2013,34(15):2428-2430.
[13] 李明艳.失智症患者非药物疗法的研究进展[J].现代临床护理,2016,15(6):75-78.
[14] 曾燕,何丽娅,张玉芹,等.阿尔茨海默病家庭照料者教育工作研究进展[J].中国老年学杂志,2012,32(11):2447-2450.
[15] WASHIO M,SAITOH S,ARAI Y,et al.Risk factors for heavy burden among sychofamily Zasshi,caregivers in a rural town in Hokkaido[J].Nihon Ronen Igakkai Zasshi ,2005,42 (2):221-228.
[16] STOWELL JR,KIECOLT-GLASER JK,GLASER RP,et al.Erceived stress and cellular immunity:When coping counts[J].Journal of Behavioral Medicine,2001,24(4):323-339.
[17] 危艳萍,李红,陈萍,等.福建省养老机构阿尔茨海默病患者照顾者生活质量现况调查[J].护士进修杂志,2016,31(8):743-745.
[18] SHURGOT GR,KNIGHT BG.Influence of neuroticism,ethnicity,familism,and Social support on perceived burden in dementia caregivers:Pilottest of the Transactional stress and social support model[J].The Journals of Gerontology,2005,60(6):P331-P334.