老年性痴呆患者精神行为症状的影响因素及认知行为疗法干预效果研究  

Randomized,Single Blind,Controlled Study on the Influencing Factors of Mental and Behavioral Symptoms in Patients with Alzheimer's Disease and the Intervention of Cognitive Behavioral Therapy

作　　者：刘太琴 田金昌[1] Liu Taiqin;Tian Jinchang(Shanghai Jing'an District Mental Health Center,Shanghai,200333,China)

机构地区：[1]上海市静安区精神卫生中心,上海200333

出　　处：《中国初级卫生保健》2023年第9期72-76,共5页Chinese Primary Health Care

摘　　要：目的:探讨老年性痴呆患者精神行为症状的影响因素及认知行为疗法干预的效果。方法:选取2020年6月—2022年6月上海市静安区精神卫生中心收治的86例老年性痴呆患者作为研究对象,将患者随机分为认知行为干预组(n=43)及常规干预组(n=43),分别进行认知行为疗法干预和常规干预,对比干预前后两组患者精神行为症状调查表(NPI-Q)、简易智能精神状态量表(MMSE)、Barthel指数(BI)及健康状态调查表(GQOL-74)评分。结果:发生精神行为症状的患者有80例,发病率为93.02%(80/86),不同年龄、病程、睡眠障碍、婚姻状况、生活自理情况患者NPI-Q评分比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,年龄、病程、婚姻状况、睡眠障碍、生活自理情况是精神行为症状的影响因素(P<0.05)。干预后认知行为干预组MMSE评分为(24.61±2.19)分、BI评分为(70.19±4.22)分,明显高于常规干预组的(22.18±2.46)分、(66.28±3.29)分;干预后认知行为干预组NPI-Q评分为(13.51±1.61)分,低于常规干预组的(14.70±1.22)分,差异均有统计学意义(P值均<0.05)。干预后认知行为干预组心理功能评分为(27.51±6.78)分、社会功能评分为(18.86±3.64)分、躯体功能评分为(15.74±1.83)分、物质生活评分为(20.36±2.71)分,均高于常规干预组的(23.53±5.59)分、(15.73±2.26)分、(13.39±1.59)分、(18.57±2.58)分,差异均有统计学意义(P值均<0.05)。结论:老年性痴呆患者精神行为症状的发生率较高,其发生与年龄、病程、婚姻状况、睡眠障碍、生活自理情况等因素有关。认知行为疗法干预能明显改善老年性痴呆患者的精神行为症状和认知功能,改善患者的自理能力及生活质量。OBJECTIVE To explore the influencing factors of mental behavioral symptoms in patients with Alzheimer's disease and the value of cognitive behavioral therapy intervention.METHODS A total of 86 Alzheimer patients from June 2020 to June 2022were selected and their general data were collected.In a single blind randomized controlled clinical trial,all Alzheimer patients were divided into cognitive behavioral therapy group(n=43)and conventional therapy group(n=43).Cognitive behavioral therapy intervention and conventional therapy were performed,respectively.The scores of nPI-Q,Mini Mental State Scale(MMSE),Barthel Index(BI),and Health Status Questionnaire(GQOL-74)before and after the intervention were compared.RESULTS Taking 86 Alzheimer's disease patients as the research object,80 patients with mental behavioral symptoms were found.Comparing nPI-Q scores of different clinical data,it was found that there were statistically significant differences in age,course of disease,marital status,sleep disorders,and self care status(P<0.05).When it was included in the logistic regression model,age,course of disease,marital status,sleep disorders,and self care were the influencing factors for the occurrence of mental behavioral symptoms(P<0.05);after intervention,the scores of MMSE and BI in cognitive behavioral therapy group were significantly higher than those in conventional therapy group and before intervention,while the nPI-Q scores were lower than those in conventional therapy group and before intervention(P<0.05);after intervention,the psychological function,social function,physical function,and material life in the cognitive behavioral treatment group were significantly higher than those before intervention and higher than those in the conventional treatment group after intervention(P<0.05).CONCLUSION The incidence of mental behavioral symptoms in Alzheimer's disease patients is high,and its occurrence is related to factors such as age,course of disease,marital status,sleep disorders,and self care status.After cognitive

关 键 词：老年性痴呆 精神行为症状 认知行为疗法 影响因素 

分 类 号：R749.16[医药卫生—神经病学与精神病学]