社区内老年痴呆三级多模式综合管理的研究  

Study on three-level multi-mode comprehensive management of Alzheimer's Disease in community

作　　者：谢静[1] 许力[1] 刘晓林[1] 刘东亮 王春[1] 刘明洁 Xie Jing;Xu Li;Liu Xiaolin;Liu Dongliang;Wang Chun;Liu Mingjie(Department of neurology,the first affiliated hospital of Bengbu Medical College,Bengbu,233000,China;Clinical school of Bengbu Medical College,Bengbu,233000,China)

机构地区：[1]蚌埠医学院第一附属医院神经内科,安徽蚌埠233000 [2]蚌埠医学院临床医学院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2021年第17期1551-1556,共6页Journal of Qiqihar Medical University

基　　金：安徽高校人文社科研究项目资助,教育厅重点课题(SK2019A0192)。

摘　　要：目的调研蚌埠市各个社区管辖内,三级甲等医院神经精神科医生指导下,社区医生和照护者协同参与的老年痴呆多种方式协调下共同管理的效果,为防治老年痴呆及其并发症发生的策略制定提供切实可靠的理论参考。方法对蚌埠市主要社区管理的老年痴呆患者200例进行相关基本情况调查,随机分为实验组(进行三级多模式综合管理组)和对照组(未进行三级多模式综合管理组干预)两组,每组各100例。制定治疗方案,实验组由三甲医院神经精神科专科医生全程参与和指导,在社区开展有关老年痴呆病人的护理常识宣讲时相互合作,在患者及家属中开展相关的老年痴呆的知识技能宣教工作,激发社区监督管理患者及照护者的积极性,开展各项指导性工作,分析比较加强多模式综合管理与未加强多模式综合管理组患者发生老年痴呆并发症的概率。观察和比较两组患者干预前后的服药依从性、老年痴呆生活质量评分(QOL-AD)、并发症发生率、神经精神科量表(NPI)评估患者的精神状态,Barthel指数和康奈尔痴呆抑郁量表(CSDD)实施效果评价,中国家庭看护者自我效能感调查表(SEQCFC)比较三级多模式管理前后照护者自我效能感差异。结果两组患者接受干预前的各项指标无显著性差异(P>0.05)。与干预前比较,两组患者干预后的服药依从性、并发症发生率QOL-AD、NPI、Barthel指数、CSDD、SEQCFC一致存在不同程度的改善,同时实验组患者上述指标明显胜过对照组,差异具有统计学意义(P<0.05)。加强三级综合管理的实验组患者发生并发症的概率远小于未加强组(P<0.05),且实验组的患者服药依从性远高于对照组(P<0.05)。结论社区综合干预可对老年阿尔茨海默症患者的康复进程施加积极影响,能提高该患者群体在社区的生存质量,具有较高的推广价值。加强三级甲等医院神经精神科医生指导的综合�Objective To investigate the effect of co-management of Alzheimer's Disease under the jurisdiction of various communities in Bengbu city,under the guidance of neuropsychiatrists in Grade 3A hospital and with the participation of community doctors and caregivers,so as to provide practical and reliable theoretical reference for the formulation of strategies for the prevention and treatment of Alzheimer's Disease and its complications.Methods A survey of 200 cases of Alzheimer's patients managed by the main communities of Bengbu City was carried out.They were randomly divided into two groups:the experimental group(three-level multi-mode comprehensive management group,n=100)and the control group(no three-level multi-mode comprehensive management group,n=100).The treatment plan was worked out,and the experimental group,with the participation and guidance of neuropsychiatrists in Grade 3A hospital,cooperated with each other in promoting nursing knowledge about Alzheimer's patients in the community,and carried out related education on Alzheimer's knowledge and skills among patients and their families,so as to stimulate the enthusiasm of community supervisors and caregivers and carry out all kinds of guiding work.To analyze and compare the probability of complications of Alzheimer's Disease between the strengthened multi-mode comprehensive management group and the non-strengthened multi-mode comprehensive management group.The medication compliance,quality of life in Alzheimer's Disease score(QOL-AD),incidence of complications,neuropsychiatric inventory(NPI)used to assess the mental state of patients,Barthel index and the Cornell scale for depression in dementia(CSDD)used to evaluate the implementation effect,and self-efficacy questionnaire for Chinese family caregivers(SEQCFC)used to evaluate the differences of caregivers'self-efficacy were observed and compared between the two groups before and after three-level multi-mode comprehensive management.Results There was no significant difference in all indexes between the tw

关 键 词：老年痴呆 三级多模式综合管理 社区医疗 

分 类 号：R741[医药卫生—神经病学与精神病学]