阿尔茨海默病患者居家护理方案的构建与应用  

Construction and application of home nursing scheme for patients with Alzheimer’s disease

作　　者：周娜 ZHOU Na(Zhengzhou Ninth People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第九人民医院,河南郑州450000

出　　处：《中国实用神经疾病杂志》2022年第7期880-885,共6页Chinese Journal of Practical Nervous Diseases

基　　金：中国卒中学会脑血管病全程管理项目启航基金(编号:2020017)。

摘　　要：目的制订阿尔茨海默病(AD)患者出院后的居家护理方案,并探讨其应用效果。方法2019-02—2020-05在郑州市第九人民医院就诊的AD患者,随机分为观察组和对照组。对照组接受常规护理指导,观察组接受居家护理方案。对比分析2组患者出院12个月内的日常生活能力、RTC(拒绝配合)、精神行为症状、照顾者负担、抗精神疾病药物应用状况。结果(1)2组患者在出院6或12个月时,RTC、日均活动时间较出院时有明显改变(P<0.017)。而2组之间,出院12个月时,观察组的RTC分值明显低于对照组(拒绝配合情况向好变化),差异有统计学意义(P<0.05)。出院后的日常生活能力指标无统计学差异(P>0.05)。(2)观察组患者出院后12个月时的照顾者负担和精神行为症状得分明显低于对照组(照顾者负担和精神行为症状向好变化)。(3)2组患者出院时及出院后,抗精神疾病药物应用情况也大致相近,差异均无统计学意义(P>0.05)。但观察组各种药物用药情况(用药率)均低于对照组,尤其在出院12个月时。结论居家护理方案可改善AD患者的抗拒护理行为和精神行为症状,缓解家属的照顾负担,但不能提高患者的日常生活能力。Objective To formulate a home care plan for patients with Alzheimer’s disease(AD)after discharge and explore its application effect.Methods Patients with AD in our hospital from February 2019 to May 2020 were randomly divided into observation group and control group.The control group received routine nursing guidance,while the observation group received home nursing plan.The activities of daily living,RTC(refusal to cooperate),mental and behavioral symptoms,caregiver burden,and the use of antipsychotic drugs were compared and analyzed between the two groups within 12 months after discharge.Results(1)The RTC and average daily activity time of patients in the two groups changed significantly at 6 or 12 months after discharge(P<0.017).However,between the two groups,the RTC score of the observation group was significantly lower than that of the control group at 12 months after discharge(the refusal to cooperate changed for the better),and the difference was significant(P<0.05).There was no significant difference in ADL after discharge(P>0.05).(2)The scores of caregivers’burden and mental and behavioral symptoms in the observation group were significantly lower than those in the control group 12 months after discharge(caregivers’burden and mental and behavioral symptoms changed for the better).(3)The application of antipsychotic drugs in the two groups was similar after discharge,and there was no significant difference(P>0.05).However,the usage rate of various drugs in the observation group was lower than that in the control group,especially at 12 months after discharge.Conclusion Home-based nursing program can improve the resistance to nursing behavior and mental behavior symptoms of AD patients,and relieve the care burden of family members,but it cannot improve the daily living ability of patients.

关 键 词：阿尔茨海默病 居家护理 构建 精神行为症状 

分 类 号：R473.74[医药卫生—护理学]