按摩对痴呆患者激越行为效果的Meta分析
|
摘要
目的系统评价按摩对痴呆患者激越行为影响。方法计算机检索PubMed、EMbase、Web of Science、Cochrane Library、JBI、知网(CNKI)、维普(VIP)、中国生物医学文献(CBM)、万方等数据库中关于按摩对痴呆患者激越行为的随机对照试验或准实验研究。由2名研究者独立筛选文献、提取资料与评价文献质量后,采用RevMan 5.3软件行Meta分析。结果最终纳入6项随机对照试验和1项准实验研究,总样本422例。经Meta分析,按摩可有效改善痴呆患者的激越行为[SMD=-1.04,95%CI(-1.79,-0.30),P=0.006]。进一步亚组分析显示,按摩可以改善患者的躯体攻击行为、躯体非攻击行为、语言攻击行为及语言非攻击行为,且手部按摩、足部按摩、头面部按摩均对痴呆患者的激越行为有改善作用,但穴位按摩对痴呆患者激越行为的改善差异无统计学意义(P>0.05)。结论按摩可有效改善痴呆患者的激越行为,但穴位按摩对痴呆患者激越行为的改善效果还有待进一步探索。
Objective To evaluate the effect of massage on the agitation of patients with dementia.Method A computerized search was performed through PubMed, EMbase, Web of science, The Cochrane Library, JBI, CNKI, VIP, CBM and Wanfang Database for randomized controlled trials(RCTs)or quasi-experimental research which studied the effects of massage. After two researchers independently screened the literature, extracted the data and evaluated the literature quality, RevMan 5.3 software was used for Meta analysis. Results An total of 422 cases were included in 6 randomized controlled trials and 1 quasi-experimental study. By Meta analysis, massage can effectively improve the agitation of patients with dementia [SMD=-1.04,95%CI(-1.79,-0.30), P=0.006]. Further subgroup analysis showed that massage can improve physical aggressive behavior, physical non-aggressive behavior, verbal aggressive behavior and verbal non-aggressive behavior of people with dementia, and that hand massage, foot massage, head and face massage can also improve the agitation of patients with dementia, but there were no statistically significant effects of acupressure on agitation in patients with dementia(P>0.05). Conclusion Massage can effectively improve the agitation of patients with dementia, but the effect of acupressure on the agitation of patients with dementia remains to be further explored.
Objective To evaluate the effect of massage on the agitation of patients with dementia.Method A computerized search was performed through PubMed, EMbase, Web of science, The Cochrane Library, JBI, CNKI, VIP, CBM and Wanfang Database for randomized controlled trials(RCTs)or quasi-experimental research which studied the effects of massage. After two researchers independently screened the literature, extracted the data and evaluated the literature quality, RevMan 5.3 software was used for Meta analysis. Results An total of 422 cases were included in 6 randomized controlled trials and 1 quasi-experimental study. By Meta analysis, massage can effectively improve the agitation of patients with dementia [SMD=-1.04,95%CI(-1.79,-0.30), P=0.006]. Further subgroup analysis showed that massage can improve physical aggressive behavior, physical non-aggressive behavior, verbal aggressive behavior and verbal non-aggressive behavior of people with dementia, and that hand massage, foot massage, head and face massage can also improve the agitation of patients with dementia, but there were no statistically significant effects of acupressure on agitation in patients with dementia(P>0.05). Conclusion Massage can effectively improve the agitation of patients with dementia, but the effect of acupressure on the agitation of patients with dementia remains to be further explored.
引文
[1] Moyle W,Murfield J E,Dwyer S,et al.The effect of massage on agitated behaviours in older people with dementia:3 literature review[J].J Clin Nurs,2013,22(5-6):601-610.
[2] Cohen-Mansfield J,Marx M S,Rosenthal A S.A description of agitation in a nursing home[J].J gerontol,1989,44(3):77-84.
[3] Seitz D,Purandare N,Conn D.Prevalence of psychiatric disorder among older adults in long-term care homes:A systematic review[J].Int Psychogeriatr,2010,22(7):1025-1039.
[4] Ray W A,Chung C P,Murray K,et al.Atypical antipsychotic drugs and the risk of sudden cardiac death [J].New England J Medicine,2009,360:225-235.
[5] Hansen N V,J?rgensen T,?rtenblad L.Massage and touch for dementia[J].Cochrane Database of Systematic Reviews,2006,4(4):CD004989.
[6] Wu J,Wang Y,Wang Z.The effectiveness of massage and touch on behavioral and psychological symptoms of dementia:A quantitative systematic review and Meta-analysis[J].J Adv Nurs,2017,73(10):2283-2295.
[7] Moyle W,Cooke M L,Beattie E,et al.Foot massage versus quiet presence on agitation and mood in people with dementia:A randomised controlled trial[J].Int J Nurs Stud,2014,51(6):856-864.
[8] Higgins J P T,Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[M].London:Wiley,2011.
[9] Yang M H,Lin C L,Wu C S,et al.Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation[J].BMC Complement Altern Med,2015,15(1):93.
[10] Mariko A,Matsuda H,Takahashi M,et al.Touch on the acupoint of Shinchuu of Alzheimer's disease patients[J].Geriatr Gerontol Int,2015,15(3):385.
[11] 周晶,倪平,王朝希,等.手部按摩对养老院轻中度痴呆症老人激越行为的影响[J].护理学杂志,2015,30(17):1-4.
[12] Remington R.Calming music and hand massage with agitated elderly[J].Nursing Research.2002,51(5):317-323.
[13] Yang H M,Wu S C,Lin J G,et al.The efficacy of acupressure for decreasing agitated behavior in dementia:A pilot study[J].J Clin Nurs.2007,16(2):308-315.
[14] Keshavarz S,Mirzaei T,Ravari A.Effect of head and face massage on agitation in elderly Alzheimer's disease patients[J].Evidence Based Care Journal,2018,7(4):46-54.
[15] 万晓珊.老年性痴呆的病理特征与防治对策[J].医学与社会,2006,19(12):13-14.
[16] 江芳辉.应用整体护理干预老年痴呆患者认知功能的效果分析[J].护士进修杂志,2014,29(8):721-723.
[17] Hollidaywelsh D M,Gessert C E,Renier C M.Massage in the management of agitation in nursing home residents with cognitive impairment[J].Geriatric Nursing,2009,30(2):108-117.
[18] Bush E.The use of human touch to improve the well-being of older adults:a holistic nursing intervention[J].J Holist Nurs,2001,19(3):256-270.
[19] Harris M,Richards K C.The physiological and psychological effects of slow-stroke back massage and hand massage on relaxation in older people[J].Journal of Clinical Nursing,2010,19(7-8):917-926.
[20] Chen M L,Lin,L C.The Effectiveness of acupressure in improving the quality of sleep of institutionalized residents[J].J Gerontol A Biol Sci Med Sci,1999,54(8):389.
[21] Tsay S L,Rong J R,Lin P F.Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease.[J].Journal of Advanced Nursing,2010,42(2):134-142.
[2] Cohen-Mansfield J,Marx M S,Rosenthal A S.A description of agitation in a nursing home[J].J gerontol,1989,44(3):77-84.
[3] Seitz D,Purandare N,Conn D.Prevalence of psychiatric disorder among older adults in long-term care homes:A systematic review[J].Int Psychogeriatr,2010,22(7):1025-1039.
[4] Ray W A,Chung C P,Murray K,et al.Atypical antipsychotic drugs and the risk of sudden cardiac death [J].New England J Medicine,2009,360:225-235.
[5] Hansen N V,J?rgensen T,?rtenblad L.Massage and touch for dementia[J].Cochrane Database of Systematic Reviews,2006,4(4):CD004989.
[6] Wu J,Wang Y,Wang Z.The effectiveness of massage and touch on behavioral and psychological symptoms of dementia:A quantitative systematic review and Meta-analysis[J].J Adv Nurs,2017,73(10):2283-2295.
[7] Moyle W,Cooke M L,Beattie E,et al.Foot massage versus quiet presence on agitation and mood in people with dementia:A randomised controlled trial[J].Int J Nurs Stud,2014,51(6):856-864.
[8] Higgins J P T,Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0[M].London:Wiley,2011.
[9] Yang M H,Lin C L,Wu C S,et al.Comparison of the efficacy of aroma-acupressure and aromatherapy for the treatment of dementia-associated agitation[J].BMC Complement Altern Med,2015,15(1):93.
[10] Mariko A,Matsuda H,Takahashi M,et al.Touch on the acupoint of Shinchuu of Alzheimer's disease patients[J].Geriatr Gerontol Int,2015,15(3):385.
[11] 周晶,倪平,王朝希,等.手部按摩对养老院轻中度痴呆症老人激越行为的影响[J].护理学杂志,2015,30(17):1-4.
[12] Remington R.Calming music and hand massage with agitated elderly[J].Nursing Research.2002,51(5):317-323.
[13] Yang H M,Wu S C,Lin J G,et al.The efficacy of acupressure for decreasing agitated behavior in dementia:A pilot study[J].J Clin Nurs.2007,16(2):308-315.
[14] Keshavarz S,Mirzaei T,Ravari A.Effect of head and face massage on agitation in elderly Alzheimer's disease patients[J].Evidence Based Care Journal,2018,7(4):46-54.
[15] 万晓珊.老年性痴呆的病理特征与防治对策[J].医学与社会,2006,19(12):13-14.
[16] 江芳辉.应用整体护理干预老年痴呆患者认知功能的效果分析[J].护士进修杂志,2014,29(8):721-723.
[17] Hollidaywelsh D M,Gessert C E,Renier C M.Massage in the management of agitation in nursing home residents with cognitive impairment[J].Geriatric Nursing,2009,30(2):108-117.
[18] Bush E.The use of human touch to improve the well-being of older adults:a holistic nursing intervention[J].J Holist Nurs,2001,19(3):256-270.
[19] Harris M,Richards K C.The physiological and psychological effects of slow-stroke back massage and hand massage on relaxation in older people[J].Journal of Clinical Nursing,2010,19(7-8):917-926.
[20] Chen M L,Lin,L C.The Effectiveness of acupressure in improving the quality of sleep of institutionalized residents[J].J Gerontol A Biol Sci Med Sci,1999,54(8):389.
[21] Tsay S L,Rong J R,Lin P F.Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease.[J].Journal of Advanced Nursing,2010,42(2):134-142.