“适应模式”日常行为能力训练在阿尔茨海默病患者中的应用研究  

Study on application of"adaptation model"daily behavior ability training in patients with Alzheimer's disease

作　　者：黄丽娟[1] 张翠玲[1] 黄凤霞[1] 谭燕[1] 方雅秀 HUANG Lijuan;ZHANG Cuiling;HUANG Fengxia;TAN Yan;FANG Yaxiu(Neurology Department,Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong,China)

机构地区：[1]广州医科大学附属脑科医院神经内科,广东广州510370

出　　处：《右江医学》2021年第12期920-924,共5页Chinese Youjiang Medical Journal

基　　金：广州市卫生健康科技项目(20201A011044)。

摘　　要：目的观察阿尔茨海默病(AD)患者应用“适应模式”为指导的日常生活能力训练对日常生活能力、症状变化、心电图指标、认知功能、焦虑情绪的影响。方法选取2019年6月~2020年6月于广州医科大学附属脑科医院确诊的阿尔茨海默病患者54例为研究对象,根据患者所接受的治疗方法的不同将入选患者分为对照组(n=30)和观察组(n=24),对照组患者接受常规药物维持治疗并实施智能康复训练,观察组在对照组药物治疗基础上增加“适应模式”为指导的日常生活能力训练,比较两组患者治疗前及治疗6个月后日常生活能力、症状变化、心电图指标、认知功能、焦虑情绪变化情况,并对两种方法的护理质量进行评价。结果治疗6个月后,观察组患者日常生活能力量表(ADL)评分、老年临床评定量表(SCAG)评分低于治疗前及对照组(P<0.05或0.001),但对照组患者ADL评分、SCAG评分与治疗前比较差异无统计学意义(P>0.05)。治疗6个月后,观察组患者心率(HR)、PR间期值与治疗前及对照组比较差异均无统计学意义(P>0.05),两组患者精神状况检查量表(MMSE)、汉密顿焦虑评分量表(HAMA)评分均有所改善,且观察组患者MMSE、HAMA评分改善程度优于对照组(P<0.001)。与对照组比较,观察组护理时长明显缩短,护理质量评分明显提升(P<0.001)。结论“适应模式”为指导的日常生活能力训练可以有效提高阿尔茨海默病患者的日常生活能力、认知功能,改善临床症状和负性情绪,且患者对训练可耐受,同时可以提升护理质量。Objective To observe the effects of activities of daily living(ADL)training guided by"adaptation model"on ADL,symptom changes,ECG indexes,cognitive functions and anxiety in patients with Alzheimer's disease(AD).Methods 54 patients with AD diagnosed in the Affiliated Hospital of Guangzhou Medical University from June 2019 to June 2020 were selected as research objects.According to different treatment methods,the selected patients were divided into control group(n=30)and experimental group(n=24).The control group received conventional drug maintenance treatment and intelligent rehabilitation training,while the observation group were given ADL training guided by"adaptation model"on the basis of drug treatment in the control group.And then,the ADL,symptom changes,ECG,cognitive functions and anxiety of the two groups were compared before treatment and 6 months after treatment.In addition,the nursing quality of the two methods was evaluated.Results After 6 months of treatment,the ADL score and sandoz clinical assessment geriatric(SCAG)score of the observation group were lower than those before treatment and those of the control group(P<0.05 or 0.001),but the ADL score and SCAG score of the control group were not significantly different from those before treatment(P>0.05).After 6 months of treatment,there were no statistically significant differences in heart rate(HR)and PR interval between the observation group and those before treatment and the control group(P>0.05),the scores of MMSE and HAMA improved in both groups,and those of the observation group improved more significantly than those of the control group(P<0.001).Compared with the control group,the nursing time of the observation group was significantly shorter,and the nursing quality score significantly improved(P<0.001).Conclusion The activities of daily living training guided by"adaptation model"can effectively improve the ability of daily living and cognitive function of patients with AD,improve clinical symptoms and negative emotions,and patients can tolera

关 键 词：适应模式 阿尔茨海默病 日常生活能力训练 心电图 认知功能 焦虑情绪 护理质量 

分 类 号：R749.1[医药卫生—神经病学与精神病学]