運用Zenbo陪伴型機器人於路易氏體失智症併精神行為症狀病人之護理經驗

Nursing Experience of Applying Companion Robot Zenbo to a Patient with Dementia with Lewy Bodies Combined Behavioral and Psychological Symptoms

10.6540/NTJN.202209_24(2).0015

林逸欣(Yi-Xin Lin)；陳祐蓉(Yu-Jung Chen)

Zenbo陪伴型機器人 ； 路易氏體失智症 ； 精神行為症狀 ； companion robot Zenbo ； dementia with Lewy bodies ； behavioral and psychological symptoms of dementia

新臺北護理期刊

24卷2期（2022 / 09 / 01）

157 - 167

繁體中文

本文探討一位59歲路易氏體失智症病人，因視幻覺、肢體不協調、焦慮症狀加劇，造成家屬不堪負荷，而文獻指出陪伴型機器人能對失智症病人提供療癒效果，故入院後運用Zenbo陪伴型機器人介入之照護經驗。筆者於2020年12月10日至2020年12月22日期間，運用生理、心理、智能、社會及靈性五大層面整體性評估，確立病人有：感覺及知覺紊亂、記憶功能障礙、焦慮、無效性因應能力、低自尊及潛在危險性跌倒之健康問題。照護過程運用Zenbo陪伴型機器人於每天固定時段、每次20到30分鐘給予個別性的非藥物治療：告知定向感資訊、引導參與常規作息，並於症狀干擾時給予陪伴及轉移注意力，伴以監測用藥、調整環境、使用適當溝通原則、採取相關因應技巧及討論合適日常活動，達到改善病人幻覺、焦慮狀況，家屬亦獲得資源及喘息之結果。此護理經驗分享陪伴型機器人實踐於路易氏體失智症伴隨幻覺及焦慮之精神行為症狀成果，期待提供臨床照護者面對相關疾病時有更多科技面的非藥物治療選擇。惟Zenbo在軟、硬體設備及護理應用上仍有限制，建議研發者可精進適用於護理照護的功能，護理人員能擴展科技照護視野，有助於未來提供病人多元的護理照護。

This article discusses a 59-year-old patient with dementia with Lewy bodies who was admitted to the hospital due to visual hallucinations, limbs incoordination, and worsening anxiety symptoms, causing overwhelming burdens to the family members. Much literature has pointed out that companion robots can provide healing effects for patients with dementia. Therefore, the author used the companion robot Zenbo to intervene in the nursing experience after the patient's admission. From December tenth, 2020 to December twenty-second, 2020, the author used a holistic assessment of five dimensions of physiology, psychology, intelligence, society and spirituality to access and record the patient's health problems of sensory and perception disorders, memory dysfunction, anxiety, ineffective coping, low self-esteem, and potential risk for falls. The companion robot Zenbo was used to provide individual non-pharmacological treatments at a fixed time every day, 20 to 30 minutes each time, including informing orientation information, guiding participation in routine activities, and providing companionship and transfer attention when symptoms interfere. These were carried out accompanied by monitoring medication, adjusting the environment, using appropriate communication principles, adopting relevant coping skills, discussing appropriate daily activities with the patient and further improving their hallucinations and anxiety, and giving the family members a time of rest by supporting with additional caregiving resources. This nursing experience shares the results of companion robot practiced in a patient with dementia with Lewy bodies accompanied by behavioral and psychological symptoms of hallucinations and anxiety. It is expected to provide more technological nonpharmacological therapy options for clinical caregivers when facing related diseases. However, there are still limitations of Zenbo in the software, hardware equipment and nursing applications. It is recommended that developers improve the functions applicable to nursing care. If nursing staff can expand the vision of scientific and technological care, it will help offer diverse nursing care for patients in the future.

1. 吳怡慧,林明憲(2017)。失智照護。臨床醫學，79(1)，19-25。
   連結：
2. 許庭榕,黃仲禹(2020)。失智症非藥物治療照護。臨床醫學，85(2)，81-87。
   連結：
3. 廖偉廷,劉慕恩,楊誠弘(2017)。老年失智症回顧。臨床醫學，79(2)，72-74。
   連結：
4. Ashley, D. F.(2020).The Rise of Dementia With Lewy Bodies: Nursing Interventions and Implications.Journal of Neuroscience Nursing,52(6),311-315.
5. Connors, M. H.,Quinto, L.,McKeith, I.,Brodaty, H.,Allan, L.,Bamford, C.,Thomas, A.,Taylor, J. P.,O'Brien, J. T.(2018).Non-pharmacological interventions for Lewy body dementia: a systematic review.Psychological Medicine,48(11),1749-1758.
6. Dyer, S. M.,Harrison, S. L.,Laver, K.,Whitehead, C.,Crotty, M.(2018).An overview of systematic reviews of pharmacological and non-pharmacological interventions for the treatment of behavioral and psychological symptoms of dementia.International Psychogeriatrics,30(3),295-309.
7. Hershey, L. A.,Coleman-Jackson, R.(2019).Pharmacological management of dementia with Lewy bodies.Drugs & Aging,36,309-319.
8. Petersen, S.,Houston, S.,Qin, H.,Tague, C.,Studley, J.(2017).The Utilization of Robotic Pets in Dementia Care.Journal of Alzheimer's Disease,55(2),569-574.
9. Vatter, S.,Stanmore, E.,Clare, L.,McDonald, K. R.,McCormick, S. A.,Leroi, I.(2020).Care Burden and Mental Ill Health in Spouses of People With Parkinson Disease Dementia and Lewy Body Dementia.Journal of Geriatric Psychiatry and Neurology,33(1),3-14.
10. Wilson, C. B.,Arendt, L.,Nguyen, M.,Scott, T. L.,Neville, C. C.,Pachana, N. A.(2019).Nonpharmacological Interventions for Anxiety and Dementia in Nursing Homes: A Systematic Review.The Gerontologist,59(6),731-742.
11. World Health Organization. (2017, April 3). Draft global action plan on the public health response to dementia (SEVENTIETH WORLD HEALTH ASSEMBLY Provisional agenda item 15.2). https://apps.who.int/gb/ebwha/pdf_files/WHA70/A70_28-en.pdf?ua1
12. Yumoto, A.,Suwa, S.(2019).Difficulties and associated coping methods regarding visual hallucinations caused by dementia with Lewy bodies.Dementia,20(1)
13. 台灣失智症協會（2020年4月）‧認識失智症‧http://www.tada2002.org.tw/About/IsntDementia
14. 白麗,鄭家凱,林恩如,陳思宇,張譯云,徐業良(2018)。陪伴型機器人使用者經驗評估─以智慧居家機器人Zenbo為例。福祉科技與服務管理學刊，6(3)，265-282。
15. 朱祐萱,林清壽(2019)。銀髮族使用Zenbo機器人服務體驗洞察研究。福祉科技與服務管理學刊，7(1)，150-72。
16. 徐業良,白麗(2018)。智慧科技於高齡者生活與照護應用之前瞻發展建議。福祉科技與服務管理學刊，6(3)，325-338。
17. 徐榮隆(2017)。失智症常見種類與檢查。中華民國內膜異位症婦女協會會刊，24(4)，10-13。
18. 徐灩,吳美鳳(2019)。失智症的精神行為症狀，正確治療與照護很重要。彰基院訓，36(3)，18-19。
19. 國家發展委員會（2020，8月）。中華民國人口推估（2020至2070年）。http://pop-proj.ndc.gov.tw/upload/download/中華民國人口推估（2020至2070年）報告.pdf
20. 衛生福利部統計處（2020，9月）。國際失智症日衛生福利統計通報。https://www.mohw.gov.tw/dl-63592-294f3c91-2032-4f35-a1d2-c94de5f58a78.html