Study on the Effects of Individualized Learning Therapy on Cognitive Function and Behavioral and Psychological Symptoms of Dementia in the Institutionalized Older Adults

Hsiao-Mei Chen; Li-Jane Tsai; Shu-Yuan Chao; Mary Jo Clark

doi:10.1097/jnr.0000000000000118

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Study on the Effects of Individualized Learning Therapy on Cognitive Function and Behavioral and Psychological Symptoms of Dementia in the Institutionalized Older Adults

个别式学习疗法对改善机构失智老人认知及行为精神症状之成效探讨

陈晓梅(Hsiao-Mei Chen) ；蔡丽珍(Li-Jane Tsai) ；赵淑员(Shu-Yuan Chao) ； Mary Jo Clark

The Journal of Nursing Research ； 24 卷 4 期 (2016 / 12 / 01) ， P300 - 310

英文 DOI： 10.1097/jnr.0000000000000118

个别式学习疗法；失智长者；认知功能；神经精神症状； individualized learning therapy ； cognitive function ； dementia among the elderly ； neuropsychiatric symptoms

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摘要 │ 参考文献 (29) │ 被引用文献 (1) │ 国际计量

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Background: The increasing number of elderly people affected by dementia in Taiwan hasmade dementia care a crucial issue of concern. This issue is particularly important in terms of the proper management of behavioral symptoms and improvement of the cognitive functions of those affected by this disease. Purpose: This study examined the effects of individualized learning therapy on cognition and neuropsychiatric symptoms among elderly people with dementia. Methods: A quasi-experimental, pretest-posttest research de-sign was adopted. We recruited elderly people with dementia at the only two institutions for elderly patients with dementia in Central Taiwan. These institutions were assigned randomly as the experimental or control group, with totals of 23 and 21 participants, respectively. The participants in the experimental group received individualized learning therapy for 30 minutes twice weekly for 3 months. The comparison group received usual care only. The cognitive function and neuropsychiatric symptoms of all participants were measured using the Mini-Mental Status Examination (MMSE) before the start of and immediately after the 12-week intervention and the Chinese version of the Neuropsychiatric Inventory (CNPI), which was administered once per week during the intervention. Independent t tests (or Mann- Whitney U tests), chi-square tests (or Fisher's exact tests), paired t test, and generalized estimating equations were used for data analysis. Results: Participants in the experimental group had significantly higher MMSE scores (p ＜ .01) and lower CNPI scores (p ＜ .01) than their comparison group peers after the intervention. Furthermore, the neuropsychiatric symptoms in the experimental group such as hallucinations, bizarre behavior, depression, apathetic expression, irritability, and sleep disorder had significantly improved by the seventh week. Conclusions/Implications for Practice: Individualized learning therapy may be an effective approach to improve cognitive function and reduce neuropsychiatric symptoms among older people with dementia. Therefore, future clinical application is warranted.

参考文献 ( 29 ) 〈TOP〉

Taiwan Alzheimer's Disease Association. (2012). World Health Organization(WHO) published a global dementia report in Taiwan. Retrieved from http://www.Tada-2002.org.tw/tada_event_detail.aspx?pk=188 (Original work published in Chinese)
Chen, Y. Z.、Dai, Y. S.、Yang, Q. C.、Wang, C. Q.、Chang, Y. X.(1995)。Assembly of Functional assessment scales for long-term care service。Taipei Ministry of Health and Welfare，33，7-10。
Farina, E.,Mantovani, F.,Fioravanti, R.,Pignatti, R.,Chiavari, L.,Imbornone, E.,Nemni, R.(2006).Evaluating two group programmes of cognitive training in mild-to-moderate AD: Is there any difference between a "global" stimulation and a "cognitive-specific" one?.Aging & Mental Health,10(3),211-218.
Gates, N. J.,Sachdev, P. S.,Fiatarone Singh, M. A.,Valenzuela, M.(2011).Cognitive and memory training in adults at risk of dementia:A systematic review.BMC Geriatrics,11,55.
Guo, N. W.、,Liu, H. C.、Wang, P. F.、Liao, K. K.、Yan, S. H.、Lin, K. P.、Hsu, T. C.(1988)。Chinese version and norms of theMini-Mental State Examination。Journal of Rehabilitation Medicine Association，16，52-59。

被引用文献 ( 1 ) 〈TOP〉

叶启斌,黄三原,曾念生,陈顺益,陈俊延,张勳安,高誉诚,周雨青,李昆明,江玮珊(2017).The Impact of Pharmacological Treatments on Cognitive Function and Severity of Behavioral Symptoms in Geriatric Elder Patients with Dementia.台湾精神医学,31(1),69-79+iii.

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