新冠疫情对上海某三甲医院老年科认知障碍患者及照料者的影响与远程医疗模式的初步探索  

The Impact of COVID-19 on Elderly Patients with Cognitive Impairment and Caregivers:A Preliminary Exploration of Remote Medical Care Models

作　　者：裴文志 王启辉 岳玲[1] Wenzhi PEI;Qihui WANG;Ling YUE(Shanghai Mental Health Center,Shanghai 201109;Anhui Mental Health Center,Anhui 230022;Hefei Fourth People’s Hospital Anhui,Hefei 230022;Shenzhen Mental Health Center Guangzhou,Shenzhen 518020)

机构地区：[1]上海市精神卫生中心,上海201109 [2]安徽省精神卫生中心,安徽230022 [3]合肥市第四人民医院,安徽合肥230022 [4]深圳市康宁医院,广州深圳518020

出　　处：《阿尔茨海默病及相关病杂志》2023年第3期222-229,共8页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：上海市科学技术委员会(20Y11906800)。

摘　　要：目的:2022年3月,新冠疫情在上海暴发,为了解此次新冠疫情对老年认知障碍患者及照料者的影响,并进一步明确远程医疗(电话访谈形式)在疫情下对认知障碍老人可能的帮助作用,展开此项研究。方法:纳入2021年1月~12月在上海市精神卫生中心老年科住院的69例认知障碍患者,在2022年4月通过自制问卷以电话访谈形式收集患者疫情期间的相关情况,采用NPI问卷明确认知障碍老人精神行为症状情况、Zarit负担量表了解家属负担情况,并给予个体化远程指导和心理支持。一月后再次进行电话随访。结果:最终有49名患者及照料者顺利完成评估,结果提示:认知障碍老人的精神行为症状在疫情期间以情感淡漠(67.3%),幻觉(61.2%),睡眠夜间行为(61.2%),妄想(53.1%)、易激惹(51%)为主要症状。家属负担量表显示:认知障碍的照料者中有一半以上(59.2%)的家属有较重的负担,77.6%的家属认为疫情期间最大的困难就是购买药物,其他困难还包括看病(57.1%)、担心患者被感染隔离(36.7%),以及担心患者病情反复(44.9%)等。电话随访证实85.7%的患者家属认可远程电话医疗方式,有77.6%的患者家属认为这样的方式能很有效的帮助患者,同时也能缓解在疫情期间的焦虑情绪。结论:此次上海新冠疫情对老年认知障碍患者及照料者身体和心理负担造成了一定的影响。而远程电话医疗方式能被多数家属所接受,可能为以后更好地帮助有认知障碍的患者及照料者发挥更大的作用。Objective:In March 2022,the outbreak of COVID-19 in Shanghai presented an opportunity to investigate the impact of this pandemic on elderly patients with cognitive impairment and their caregivers.Additionally,the study aimed to elucidate the potential benefits of remote medical interventions(in the form of telephone interviews)for elderly individuals with cognitive impairments during the pandemic.This research endeavor was undertaken to further our understanding in this area.Methods:The study included 69 elderly patients with cognitive impairment who were hospitalized in the geriatric department of Shanghai Mental Health Center between January and December 2021.In April 2022,relevant data regarding the patients'experiences during the pandemic were collected through a self-designed questionnaire conducted via telephone interviews.The NPI(Neuropsychiatric Inventory)questionnaire was utilized to assess the mental and behavioral symptoms of cognitive impairment in elderly patients,while the Zarit Burden Interview was employed to gauge the burden experienced by caregivers.Individualized remote guidance and psychological support were provided during the interviews.A follow-up telephone interview was conducted one month later.Results:Ultimately,49 patients and their caregivers successfully completed the evaluation.The results indicated that during the pandemic,the main mental and behavioral symptoms among elderly individuals with cognitive impairment were emotional indifference(67.3%),hallucinations(61.2%),nocturnal disturbances(61.2%),delusions(53.1%),and irritability(51%).The Zarit Burden Interview revealed that over half of the caregivers for patients with cognitive impairment(59.2%)experienced significant burdens.Regarding the challenges faced during the pandemic,77.6%of caregivers cited difficulties in purchasing medications,while other challenges included seeking medical care(57.1%),concerns about patient infection and isolation(36.7%),and worries about the recurrence of the patient's condition(44.9%).Follow-up in

关 键 词：COVID-19 老年认知障碍 照料者负担 远程医疗 

分 类 号：C916[经济管理]