老年性痴呆患者医院-社区-家庭全程护理模式评价  

Hospital-community-family whole-course nursing modes for patients with Alzheimer disease

作　　者：卢少萍[1] 张月华[1] 徐永能[1] 黄巧[1] 符霞[1] 谢银均[1] 

机构地区：[1]广东省人民医院老年医学研究所,广东省广州市510080

出　　处：《中国临床康复》2005年第28期70-73,共4页Chinese Journal of Clinical Rehabilitation

基　　金：广东省医学科学基金项目(A2003004);广东省人民医院科研基金资助项目(Y02019)~~

摘　　要：目的:建立老年性痴呆患者的医院-社区-家庭全程护理模式,并评价其护理效果。方法:选择1998-05/2003-05在广东省人民医院老年医学研究所住院和门诊120例早、中、晚期老年性痴呆患者,随机分为全程组和常规组,每组60例。全程组实施医院-社区-家庭全程护理干预,护理干预内容包括综合能力训练(包括生活自理能力训练、智能训练和体能训练)、心理护理、家居安全护理、预防并发症护理;常规组按常规护理。实施前和实施后1年采用简明精神状态量表、日常生活能力量表、健康状况调查问卷、汉密顿焦虑量表、汉密顿抑郁量表分别进行总评分,分析干预后患者改善情况。结果:进入结果分析的患者为119例。实施干预1年后①全程组(早期、中期患者)简明精神状态量表总评分明显高于常规组(早期、中期患者)(20.12±3.88,17.50±3.10),(t=5.11,P<0.01)。②全程组(早期、中期患者)日常生活能力量表总评分显著低于常规组(早期、中期患者)(15.05±5.02,18.07±6.33),(t=2.35,P<0.05)。③全程组(早期、中期患者)汉密顿焦虑量表总评分显著低于常规组(早期、中期患者)(8.41±4.81,16.94±2.01),(t=2.83,P<0.01)。④全程组(早期、中期患者)汉密顿抑郁量表总评分显著低于常规组(早期、中期患者)(7.63±4.84,16.88±2.13),(t=3.79,P<0.05)。⑤全程组(晚期患者)的肺部感染、泌尿系统感染、褥疮、意外的并发症的发生率明显低于常规组(晚期患者)(25.0,60.0)%,(10.0,40.0)%(15.0,45.0)%,(5.0,50)%。结论:实施全程护理可提高患者的遵医行为,改善精神状态,提高患者的生活能力和生存质量,减轻家庭照顾者的心理压力。AIM： To establish and evaluate the effects of a mode of hospital-community-family nursing for Alzheimer disease（AD） patients.METHODS： Totally 120 AD outpatients and inpatients at early, middle and terminal stages hospitalized in Institute of Geriatric Medicine in People＇s Hospital of Guangdong Province from May 1998 to May 2003 were divided into whole-course nursing group and conventional nursing group randomly, 60 in each group. The whole-course nursing interventions were practiced for the whole-course nursing group,including comprehensive ability training, psychological nursing, home-secure care and complication prophylaxis. The conventional nursing group was nursed routinely. Minimental state examination（MMSE）, activities of daily living（ADL）, SF-36,Hamilton anxiety scale（HAMA）, Hamilton depression scale（HAMD） were adopted to assess the improvement in patients after intervention.RESULTS： Totally 119 patients were analyzed in the result 1 year after intervention. ①The total score of MMSE was significantly higher in the whole-course nursing group （early and middle stage patients） than in the conventional nursing group （early and middle stage patients）（20.12±3.88 vs 17.50±3.10, t=5.11, P 〈 0.01）. ②The total score of ADL was significantly lower in the whole-course nursing group （early and middle stage patients）than in the conventional nursing group （early and middle stage patients）（15.05±5.02 vs 18.07±6.33, t=2.35, P 〈 0.05）. ③The total score of HAMA was significantly lower in the whole-course nursing group（early and middle stage patients） than in the conventional nursing group （early and middle stage patients）（8.41±4.81 vs 16.94±2.01, t=2.83, P 〈 0.01）.④The total score of HAMD was significantly lower in the whole-course nursing group （early and middle stage patients） than in the conventional nursing group （early and middle stage patients）（7.63±4.84 vs 16.88±9.13, t=3.79,P〈 0.05）.⑤The incidences of pulmonary infec

关 键 词：痴呆 训练 护理评价研究 康复护理 

分 类 号：R592[医药卫生—老年医学]