家庭尊严干预在老年轻度认知障碍患者主要照顾者中的应用
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摘要
目的探讨家庭尊严干预对老年轻度认知障碍患者主要照顾者照顾负担及负性情绪的影响。方法便利选取80对老年轻度认知障碍患者及其主要照顾者,按出院单双日分为实验组和对照组各40对。实验组在实施常规心理护理的基础上增加家庭尊严干预,对照组实施常规心理护理。应用照顾者负担量表、医院焦虑抑郁量表、Herth希望指数量表评价干预效果。结果干预后实验组主要照顾者的照顾负担评分和焦虑抑郁评分明显低于对照组,希望指数评分明显高于对照组,差异有统计学意义(P<0.05)。结论家庭尊严干预能够明显减轻老年轻度认知障碍患者主要照顾者的照顾负担,有效缓解其负性情绪,提高其希望水平。
Objective To explore the effects of family dignity intervention on care burden and negative emotions in primary caregivers of elderly patients with mild cognitive impairment(MCI). Methods We conveniently enrolled80 pairs of MCI patients and their primary caregivers,and divided them into the experimental group(n=40 pairs)and the control group(n=40 pairs) based on the day of discharge. The control group was given conventional psychological care while family dignity intervention was added to the experimental group. Zarit Burden Scale,Hospital Anxiety and Depression Scale,and Herth Hope Index were used to evaluate the effects before and after the intervention. Results After the intervention,the care burden score and anxiety depression score of the main caregivers in the experimental group were significantly lower than those in the control group,and the hope index score was significantly higher than the control group,and the differences were statistically significant(P <0.05). Conclusion Family dignity intervention can significantly relieve the burden of primary caregivers of elderly patients with MCI,effectively alleviate their negative emotions and improve level of hope.
Objective To explore the effects of family dignity intervention on care burden and negative emotions in primary caregivers of elderly patients with mild cognitive impairment(MCI). Methods We conveniently enrolled80 pairs of MCI patients and their primary caregivers,and divided them into the experimental group(n=40 pairs)and the control group(n=40 pairs) based on the day of discharge. The control group was given conventional psychological care while family dignity intervention was added to the experimental group. Zarit Burden Scale,Hospital Anxiety and Depression Scale,and Herth Hope Index were used to evaluate the effects before and after the intervention. Results After the intervention,the care burden score and anxiety depression score of the main caregivers in the experimental group were significantly lower than those in the control group,and the hope index score was significantly higher than the control group,and the differences were statistically significant(P <0.05). Conclusion Family dignity intervention can significantly relieve the burden of primary caregivers of elderly patients with MCI,effectively alleviate their negative emotions and improve level of hope.
引文
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[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.
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[5]Ho AHY,Car J,Ho MR,et a1.A novel Family Dignity Intervention(FDI)for enhancing and informing holistic palliative care in Asia:study protocol for a randomized controlled trial[J].Trials,2017,18(1):587.
[6]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.
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[15]林锦波,张云凤,巫伟忠,等.蒙特利尔认知评估量表筛查老年轻度认知功能障碍的价值[J].广西医学,2015,37(7):967-968.
[16]王烈,杨小湜,侯哲,等.护理者负担量表中文版的应用与评价[J].中国公共卫生,2006,22(8):970-972.
[17]马海萍,卢惠娟,姚剑英,等.脊髓损伤患者照顾者照顾负担与应对方式的调查分析[J].中华护理杂志,2013,48(10):906-909.
[18]张伟,王维利,洪静芳,等.医院焦虑抑郁量表在住院癌症患者焦虑抑郁筛查中临界值的研究[J].护理学报,2012,19(10A):1-4.
[19]Li Q,Lin Y,Hu C,et al.The Chinese version of hospital anxiety and depression scale:psychometric properties in Chinese cancer patients and their family caregivers[J].Eur J Oncol Nurs,2016,25:16-23.
[20]赵海平,王健.血液透析患者的社会支持和希望[J].中华护理杂志,2000,35(5):306-308.
[21]张爱英,孙柳,付猛,等.128例膀胱肿瘤患者希望水平与应对方式的相关性研究[J].护理学报,2015,22(8):64-66.
[22]许丽华,张敏,闻子叶.老年痴呆患者家庭照顾者负担与压力现状及影响因素[J].中国老年学杂志,2016,36(12):3025-3027.
[23]蒋芬,李春艳,王庆妍,等.老年期痴呆患者照顾者照顾负担与社会支持及相关性研究[J].护理学报,2013,20(2B):5-8.
[24]杨桂华,常宗霞,焦琳琳,等.阿尔茨海默病照顾者的心理干预研究进展[J].中华护理教育,2015,12(1):74-78.
[25]张建凤,李志菊,王芳云,等.家庭访视对脑卒中患者照顾者照顾负担及积极体验的影响研究[J].中华护理杂志,2017,52(7):830-834.
[26]赵姜楠,郑蔚,孙萌,等.住院脑卒中患者主要照顾者照顾负担与积极感受的相关性研究[J].中国实用神经疾病杂志,2014,17(23):98-100.
[27]李华,常亭玲,孙谷珍,等.支持性心理干预对住院老年痴呆患者监护人焦虑抑郁的改善作用[J].护理学杂志,2013,28(19),74-75.
[28]Sutter M,Perrin PB,Peralta SV.Beyond strain:personal strengthsand mental health of mexican and argentinean dementia caregivers[J].J Transcult Nurs,2016,27(4):376.
[29]王燕丽,张小芳.尊严疗法对晚期肺癌病人尊严和负性情绪的影响[J].护理研究,2018,32(24):3946-3948.
[30]肖星明.乳腺癌晚期患者尊严疗法干预对其希望水平及负性情绪的影响分析[J].数理医药学杂志,2016,29(6):919-920.
[31]肖闻宇,郑舒华,何小珍.社区护理干预对老年痴呆患者及照料者生活质量影响的研究[J].中华全科医学,2016,14(1):150-152.
[32]张爱英,王艳玲,付猛,等.泌尿系肿瘤患者希望水平及应对方式的相关性研究[J].护理学杂志,2016,31(6):16-18.
[33]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.
[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]周茜,陈凤娇,罗珊霞,等.抑郁症住院病人家庭照顾者负担现状及影响因素[J].护理研究,2015,29(3):1115-1117.
[4]Garand L,Dew MA,Eazor LR,et al.Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment[J].Int J Geriatr Psychiatry,2005,20(6):512-522.
[5]Ho AHY,Car J,Ho MR,et a1.A novel Family Dignity Intervention(FDI)for enhancing and informing holistic palliative care in Asia:study protocol for a randomized controlled trial[J].Trials,2017,18(1):587.
[6]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.
[7]王丹丹,苗秀欣,董玉珍.老年中重度认知障碍痴呆病人激越行为的质性研究[J].护理研究,2018,32(1):108-109.
[8]田金洲.中国痴呆诊疗指南[M].北京:人民卫生出版社,2012.
[9]杨萍萍.老年痴呆家庭照顾者虐待倾向现状及与照顾负担相关性的研究[D].重庆:重庆医科大学,2013.
[10]杜晓.失智老人家庭照顾者的疲劳及影响因素的研究[D].重庆:重庆医科大学,2014.
[11]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.
[12]Johnston B,Ostlund U,Brown H.Evaluation of the dignity care pathway for community nurses caring for people at the end of life[J].Int J Palliat Nurs,2012,18(10):483-489.
[13]Johnston B,Larkin P,Connolly M,et al.Dignity-conserving care in palliative care settings:an integrative review[J].J Clin Nurs,2015,24(13/14):1743-1772.
[14]Nasreddine ZS,Phillips NA,Bédirian 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.
[15]林锦波,张云凤,巫伟忠,等.蒙特利尔认知评估量表筛查老年轻度认知功能障碍的价值[J].广西医学,2015,37(7):967-968.
[16]王烈,杨小湜,侯哲,等.护理者负担量表中文版的应用与评价[J].中国公共卫生,2006,22(8):970-972.
[17]马海萍,卢惠娟,姚剑英,等.脊髓损伤患者照顾者照顾负担与应对方式的调查分析[J].中华护理杂志,2013,48(10):906-909.
[18]张伟,王维利,洪静芳,等.医院焦虑抑郁量表在住院癌症患者焦虑抑郁筛查中临界值的研究[J].护理学报,2012,19(10A):1-4.
[19]Li Q,Lin Y,Hu C,et al.The Chinese version of hospital anxiety and depression scale:psychometric properties in Chinese cancer patients and their family caregivers[J].Eur J Oncol Nurs,2016,25:16-23.
[20]赵海平,王健.血液透析患者的社会支持和希望[J].中华护理杂志,2000,35(5):306-308.
[21]张爱英,孙柳,付猛,等.128例膀胱肿瘤患者希望水平与应对方式的相关性研究[J].护理学报,2015,22(8):64-66.
[22]许丽华,张敏,闻子叶.老年痴呆患者家庭照顾者负担与压力现状及影响因素[J].中国老年学杂志,2016,36(12):3025-3027.
[23]蒋芬,李春艳,王庆妍,等.老年期痴呆患者照顾者照顾负担与社会支持及相关性研究[J].护理学报,2013,20(2B):5-8.
[24]杨桂华,常宗霞,焦琳琳,等.阿尔茨海默病照顾者的心理干预研究进展[J].中华护理教育,2015,12(1):74-78.
[25]张建凤,李志菊,王芳云,等.家庭访视对脑卒中患者照顾者照顾负担及积极体验的影响研究[J].中华护理杂志,2017,52(7):830-834.
[26]赵姜楠,郑蔚,孙萌,等.住院脑卒中患者主要照顾者照顾负担与积极感受的相关性研究[J].中国实用神经疾病杂志,2014,17(23):98-100.
[27]李华,常亭玲,孙谷珍,等.支持性心理干预对住院老年痴呆患者监护人焦虑抑郁的改善作用[J].护理学杂志,2013,28(19),74-75.
[28]Sutter M,Perrin PB,Peralta SV.Beyond strain:personal strengthsand mental health of mexican and argentinean dementia caregivers[J].J Transcult Nurs,2016,27(4):376.
[29]王燕丽,张小芳.尊严疗法对晚期肺癌病人尊严和负性情绪的影响[J].护理研究,2018,32(24):3946-3948.
[30]肖星明.乳腺癌晚期患者尊严疗法干预对其希望水平及负性情绪的影响分析[J].数理医药学杂志,2016,29(6):919-920.
[31]肖闻宇,郑舒华,何小珍.社区护理干预对老年痴呆患者及照料者生活质量影响的研究[J].中华全科医学,2016,14(1):150-152.
[32]张爱英,王艳玲,付猛,等.泌尿系肿瘤患者希望水平及应对方式的相关性研究[J].护理学杂志,2016,31(6):16-18.
[33]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.