The effect of reminiscence therapy on quality of life,attitudes to ageing,and depressive symptoms in institutionalized elderly adults with cognitive impairment: A quasi‐experimental study

The aim of this study was to analyse the effect of group narrative reminiscence therapy on cognition, quality of life, attitudes towards ageing, and depressive symptoms in a group of older adults with cognitive impairment in institutional care. A quasi‐experimental pretest/post‐test control group design was employed. Interventions involving reminiscence therapy with a narrative approach were included in the care plan and implemented in groups of between five and ten respondents once a week for 8 weeks (total 59 participants). The members of the control group (n = 57) received standard care. A study questionnaire was designed to measure demographic characteristics, quality of life (WOHQOL‐BREF, WHOQOL‐OLD), depressive symptoms (GDS), cognition (MMSE), and attitudes towards ageing (AAQ). Reminiscence therapy positively affected older adults’ quality of life (mostly the areas of mental health and social participation), and also their attitudes to ageing and old age. It reduced symptoms of depression, but had no discernible effect on cognitive function. Reminiscence therapy can positively affect selected aspects of quality of life, attitudes towards old age, and symptoms of depression in the elderly in long‐term healthcare facilities. Group reminiscence therapy can be used as a nursing intervention.     

怀旧治疗对老年轻度认知障碍患者认知功能的影响

目的探讨怀旧治疗对老年轻度认知障碍（MCI）患者认知功能的影响。方法选取40例老年MCI患者随机分为实验组20例和对照组20例,对照组给予常规护理,实验组在此基础上进行为期4个月的怀旧治疗干预,用简易智能状态检查量表（MMSE）、蒙特利尔认知评估量表（MOCA）、日常生活能力评分量表（ADL）评价干预效果。结果4个月后,实验组和对照组MMSE、MOCA、ADL评分比较差异均有统计学意义（P〈0．05）;对照组3项评分与干预前比较,差异无统计学意义（P〉0．05）;实验组MOCA、ADL评分均优于干预前,差异有统计学意义（P〈0．05）,MMSE评分与干预前比较,差异无统计学意义（P〉0．05）。结论怀旧治疗能改善老年MCI患者的认知功能。     

舒适性新生儿沐浴干预方案对黄疸患儿的作用

目的 分析舒适性新生儿沐浴干预方案对黄疸患儿的运用效果.方法 选取咸宁市中医医院2017年1月至2018年12月病理性黄疸患儿100例,将其分成对照组与干预组,各50例,对照组予以常规沐浴方案护理,干预组予以舒适性新生儿沐浴干预方案护理.比较两组患儿住院时间、每日排便次数、首次胎粪转黄及完全退黄时间、血清胆红素水平、皮...     

Effectiveness of a program to facilitate recovery for people with long‐term mental illness in Japan

Recovery is defined as the process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. This study aimed to develop a program to facilitate recovery and examine its effectiveness in a randomized controlled trial. The program was developed with three components that enhance benefit finding, personal meaning, and a sense of happiness. Sixty‐three participants with long‐term mental illness were randomly allocated to the intervention group (n = 32) or the control group (n = 31). The intervention group attended eight 2‐h group sessions, with one held every week. Recovery was assessed at baseline, post‐intervention, and at a three‐month follow‐up. In the per‐protocol analysis, after excluding those who dropped out, the intervention group showed significant improvement in recovery compared with the control group (P < 0.05). In the intention‐to‐treat analysis, a repeated measures analysis of variance did not show any significant intervention effect (time × group) (P > 0.05). The program had the potential to facilitate recovery.     

认知层面的情境化预演习方案在精神分裂症患者中的应用

目的:探讨认知层面的情境化预演习方案在精神分裂症(SCH)患者中的应用效果。方法:选取2018年1月1日~2019年12月31日收治的SCH患者70例为研究对象,采用随机信封法分为常规组和干预组各35例。常规组给予常规护理干预,干预组在常规护理干预基础上实施基于认知层面的情境化预演习。均干预6个月,比较两组干预前后认知功能[采用精神分裂症认知功能评估量表(SCoRS)]、临床症状[采用阳性和阴性症状量表(PANSS)]、自尊水平[采用自尊量表(SES)]、心理情绪[采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)]、社会功能[采用个人和社会功能量表(PSP)]及生活质量[采用精神分裂症患者生活质量量表(SQLS)]。结果:干预3、6个月,干预组SCoRs评分低于常规组(P<0.05,P<0.01);干预后,干预组PANSS中阴性症状、精神病理症状评分低于常规组(P<0.05,P<0.01);干预后,干预组SES评分高于常规组(P<0.01),HAMA、HAMD评分低于常规组(P<0.05,P<0.01);干预后,干预组PSP中有益活动、社会关系、自我照料维度得分高于常规组(P<0.01,P<0.05),SQLS中心理社会、精力/动力维度得分低于常规组(P<0.01,P<0.05)。结论:针对SCH患者实施认知层面的情境化预演习方案,可有效提高其认知功能和社会功能,改善阴性症状和负性情绪,提高生活质量。     

团体怀旧疗法对老年痴呆患者影响的Meta分析

目的评价团体怀旧疗法对老年痴呆患者的干预效果。方法计算机检索万方、中国知网、PubMed、Medline、WOS合集、Cochrane library数据库,检索时限均为建库至2016年9月,并追溯纳入研究的参考文献,收集国内外应用团体怀旧疗法治疗老年痴呆患者的随机对照试验研究,并采用RevMan 5.3软件进行Meta分析。结果纳入文献13篇。Meta分析结果显示,团体怀旧疗法可改善老年痴呆患者的认知能力和抑郁情绪(P0.001),减轻其照顾者负担(P=0.002),提高生活质量(P=0.003)和一般心理健康状况(P=0.007)。结论团体怀旧疗法可用于改善老年痴呆患者的认知功能和抑郁情绪,减轻照顾者负担,进一步提高患者的生活质量和一般健康状况。     

Effects of a feeding skills training programme on nursing assistants and dementia patients

Aims and objectives. The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Background. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. Design methods. A quasi‐experimental study was conducted. Two convenience‐chosen dementia‐specialized long‐term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty‐seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in‐service classes and one hour of hands‐on training, whereas the control group did not receive any training. Results. The treatment group had significantly more knowledge (F = 47·7, P < 0·001), more positive attitude (F = 15·75, P = 0·001) and better behaviours (t = 6·0, P < 0·001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2·7, P < 0·05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2·1, P < 0·05) than the control group. There was no significant difference on food intake between the two groups (t = 0·8, P = 0·49). Conclusion. This feeding skills training programme has been found to change nursing assistants’ knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. Relevance to clinical practice. This study raises attention regarding on‐the‐job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.     

Cognitive Dysfunction and Depression May Decrease Activities in Daily Life More Strongly Than Pain in Community-Dwelling Elderly Adults Living With Persistent Pain

Background and Objectives: Chronic pain, dementia, and depression may reduce activities of daily life in elderly people. We evaluated the correlation between pain intensity and daily activities, cognitive state, and depression, as well as their interrelationships in home‐dwelling elderly people with chronic pain. Methods: Forty‐one elderly home‐dwelling people who suffered from long‐lasting pain, and who participated in a rehabilitation program, were enrolled. Severity of pain at rest and after pain‐provoked motion was assessed on a visual analog scale (VAS, 0 to 100) and a 5‐point verbal rating scale (VRS). Cognitive status was assessed with the mini‐mental state examination (MMSE, 0 to 30), depression on the geriatric depression scale (GDS, 0 to 15), and functional ability in daily life was assessed with the Barthel Index (0 to 100). Results: VAS and VRS scores correlated positively with each other. Rating pain at rest on the VRS (mean 1.0, median 1) correlated with severity of depression (GDS mean 5.4) (r = 0.3997, P < 0.01), while scores on the VAS did not. Pain ratings at rest did not correlate with the Barthel Index (mean 87.7), but the latter correlated positively with motion‐evoked VRS pain scores (mean 2.8, median 3) (r = 0.42829, P < 0.01). The MMSE (mean 25.3) did not correlate with any pain parameter, but it correlated positively with the Barthel Index (r = 0.3660, P < 0.05). The Barthel Index correlated negatively with the GDS (r = ?0.39969, P < 0.01). Conclusion: In home‐dwelling elderly people, chronic pain states do not seem to reduce daily activities as much as cognitive dysfunction and depression. The seemingly controversial finding of a positive correlation between daily activities and pain in motion, and lack of correlation with pain at rest, may be explained by a relatively low intensity of pain in our study people.     

虚拟现实训练对认知障碍的脑卒中偏瘫患者的影响

目的:探讨虚拟现实训练对存在认知障碍的脑卒中偏瘫患者认知功能、下肢功能和ADL的影响。方法:将40例存在认知障碍的脑卒中偏瘫患者随机分成观察组和对照组,每组20例,2组患者均进行常规的肢体功能康复治疗,观察组在常规治疗的基础上增加虚拟现实训练。治疗前后分别对2组患者采用简易精神状况检查量表(MMSE)、"起立-行走"计时测试和Barthel指数进行评定。结果:治疗4周后,2组MMSE评分及Barthel指数均较治疗前明显提高(P0.05),观察组上述评分高于对照组(P0.05)。2组起立-步行时间均较治疗前明显降低(P0.05),观察组低于对照组(P0.05)。结论:虚拟现实技术的应用对存在认知障碍的脑卒中偏瘫患者步行能力的提高、认知功能的恢复和ADL的改善有很大的帮助,是一种很有效的康复手段。     

Effect of health contract intervention on renal dialysis patients in Korea

This study is a randomized, controlled trial to examine the effect of the health contract intervention, based on the goal attainment theory, on the self‐care behavior and physiological indices of renal dialysis patients in Korea. The experimental group (n = 21) underwent health contract intervention for 4 weeks, while the control group (n = 22) received routine care. The data were collected using questionnaires and measurement of physiological indices and analyzed using the SPSS WIN 12.0 program. A P value < 0.05 was considered statistically significant. Total score of self‐care behavior (P = 0.011) and individual scores for behaviors, such as diet (P = 0.017), exercise and rest (P = 0.001), and blood pressure and body weight (P = 0.006) were higher in the experimental group. Serum potassium concentration and mean weight gain between dialysis sessions were significantly low in the experimental group (P = 0.002, P = 0.017). Therefore, the health contract intervention based on the goal attainment theory proved effective in improving self‐care behavior and physiological indices (K, P, mean weight gain) in renal dialysis patients in Korea.     

The Effects of Self-Care Intervention Programs for Elderly with Mild Cognitive Impairment

This study examined the effects of a self-care intervention program on self-efficacy, dementia-preventive behavior, cognitive function, depression, and quality of life in elderly with mild cognitive impairment. The study employed a quasi-experimental study design using a nonequivalent control group pre-post. Data were analyzed using the chi-square test, independent t-test, and repeated-measures ANOVA. The results of the study showed that the program reduced dementia risk and strengthened self-care ability in older adults with MCI.     

“I remember when … ”: The impact of reminiscence therapy on discourse production in older adults with cognitive impairment

Abstract

Purpose: Positive outcomes following reminiscence therapy have been reported for older adults with mild cognitive impairment and dementia in cognition and quality of life and, in a small number of studies, communication. Despite the close relationship between cognition and language, the impact on communication has received limited attention. This study aimed to investigate whether the spoken discourse of older adults with mild cognitive impairment or dementia could be improved within the genre of nostalgic recounts following group reminiscence therapy, and whether change generalised to everyday discourse.

Method: Four females (mean: 87 years, SD: 7.3) who lived in a residential aged care facility and were diagnosed with mild (n?=?2) or major (n?=?2) neurocognitive impairment were recruited to attend a group reminiscence programme delivered in eight one-hour treatment sessions over four weeks. Multiple baseline samples of discourse were obtained in the week prior to intervention to monitor stability. Macrostructure, rate, informativeness and efficiency of discourse production were measured to identify change within nostalgic recounts and monitor evidence of generalised change in everyday discourse genres. Cognitive performance and quality of life were also monitored.

Result: While variability was evident, significant increases in macrostructure and richness of nostalgic recounts were found for two participants, with significant generalisation to everyday discourse. Both participants had diagnoses of mild cognitive impairment. No significant improvements were seen in cognition or quality of life with all participants.

Conclusion: This study provides promising evidence for the spoken recall of memories having the potential to improve the communication of people with neurocognitive disorders, with some indication that people with milder impairment may be more amenable to this form of intervention. Nostalgic recounts may provide an explicit context in which speech-language pathologists can facilitate the planning of spoken production in people with cognitive impairment, and influence speaking in everyday contexts.     

小组心理护理对酒依赖患者戒断症状和心理渴求的影响

目的:探讨小组心理护理对酒依赖患者戒断症状和心理渴求的影响。方法:将48例酒依赖患者随机分为研究组和对照组各24例,均给予戒酒科常规治疗和护理,研究组同时给予小组心理护理。分别于入院时、入院后4周进行酒精戒断状态评定量表(AWS)和饮酒迫切性量表(AUQ)的测试。结果:重复测量的方差分析发现,时间因素对精神症状、植物神经症状和心理渴求分数均存在主效应(P<0.01);干预因素对精神症状和心理渴求分数存在主效应(P<0.05,P<0.01),对植物神经症状分数无明显主效应(P>0.05);干预因素和时间因素对精神症状和心理渴求分数存在交互作用(P<0.05,P<0.01)。逐步回归分析发现,酒精戒断后精神症状减少值受干预前精神症状和心理护理干预的影响(P<0.01),植物神经症状减少值受干预前植物神经症状和饮酒时间的影响(P<0.05,P<0.01),心理渴求减少值受干预前心理渴求、心理护理干预和饮酒时间的影响(P<0.01)。结论:小组心理护理能明显减轻酒依赖患者的戒断性精神症状和心理渴求症状,且干预前症状和饮酒时间可影响戒断症状和心理渴求的改善程度。     

手指操训练对改善轻度老年痴呆患者认知功能的研究

目的 观察系统的全套手指操对改善轻度老年痴呆患者认知行为的有效性,从而为轻度老年痴呆患者实施系统的康复训练提供理论依据。方法 对入住第六人民医院老年科的老年痴呆患者,选择60例轻度老年痴呆患者,分为对照组(30例)和实验组(30例)。在6个月时间里实验组由专业医务人员指导、培训患者熟练掌握手指操运动,在示范1 个月后领操,每周的三天里定时做手指操,持续6个月,并记录考勤。对照组每周的三天里给患者提供手指功能活动的用具,让患者根据自己的兴趣进行手指的自由活动。在干预前和干预后的第6个月采用蒙特利尔认知评估(MoCA)、简易智能状态检查量表(MMSE)、日常生活能力评分量表(ADL) 这三个量表评价干预效果。结果：将干预效果数据收集,用统计学软件SPSS13.0作统计学处理,发现手指操干预第6个月后,实验组的MMSE 评分显著高于对照组干预后评分(P<0.05) 。实验组干预后的MoCA 评分显著高于对照组干预后评分(P<0.05) 。实验组ADL 评分显著低于对照组干预后(P<0.05) 。结论：对轻度老年痴呆患者定期进行全套系统的手指操训练,可提高或保持日常生活能力,对记忆的改善有一定的提高,能保持其认知水平,从而延缓认知受损的进程。     

实际定向疗法改善血管性痴呆患者认知功能的效果

目的探讨实际定向疗法对改善血管性痴呆患者认知功能的效果。方法将70例轻、中度血管性痴呆患者随机分为实验组和对照组,每组35例。对照组根据病情,按常规进行治疗及护理。实验组在接受常规治疗护理的基础上,实施连续3个月的实际定向疗法的康复训练。两组患者在治疗前及治疗后采用简易智力状态量表（MMSE）及Barthel指数评定量表（MBI）进行评定。结果经治疗后,2组患者的MMSE和MBI均明显提高,但以实验组患者的改善幅度更为显著,与对照组比较,差异有统计学意义（P〈0．05）。结论实际定向疗法能提高轻、中度血管性痴呆患者残存的认知功能和日常生活活动能力。     

Cognitive training on stroke patients via virtual reality-based serious games

Purpose: Use of virtual reality environments in cognitive rehabilitation offers cost benefits and other advantages. In order to test the effectiveness of a virtual reality application for neuropsychological rehabilitation, a cognitive training program using virtual reality was applied to stroke patients. Methods: A virtual reality-based serious games application for cognitive training was developed, with attention and memory tasks consisting of daily life activities. Twenty stroke patients were randomly assigned to two conditions: exposure to the intervention, and waiting list control. Results: The results showed significant improvements in attention and memory functions in the intervention group, but not in the controls. Conclusions: Overall findings provide further support for the use of VR cognitive training applications in neuropsychological rehabilitation.

• Implications for Rehabilitation

• Improvements in memory and attention functions following a virtual reality-based serious games intervention.

• Training of daily-life activities using a virtual reality application.

• Accessibility to training contents.

     

Effects of a community‐based intervention on cardio‐metabolic risk and self‐care behaviour in older adults with metabolic syndrome

This pilot study was performed to investigate the effects of a community‐based intervention (CBI) on cardio‐metabolic risk and self‐care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi‐experimental design was used. The older adults in the intervention group participated in an 8‐week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by ?1.35 cm (P < 0.001) and improved self‐care behaviour (+ 5.17 score, P < 0.05) and self‐efficacy (+ 4.84 score, P < 0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome.     

基于眼动技术的认知康复策略对脑卒中患者执行功能的影响

目的:观察基于眼动技术的认知康复对脑卒中患者执行功能的影响。方法:选择上海市第四康复医院康复科脑卒中认知障碍患者64例,采用Excel RAND函数分为对照组和观察组,每组32例。2组均给予脑血管病常规治疗。对照组接受常规康复训练,包括物理治疗、作业治疗、吞咽与言语功能训练以及认知功能训练,每项训练20 min,共80 min/次,1次/d,6 d/周,连续治疗6周。观察组采用基于眼动技术的认知康复训练替代常规康复训练中的认知功能训练(20 min/次),其余训练同对照组。2组观察时间均为10周,第1~6周为干预阶段,第7~10周为随访阶段。在干预前、干预后、随访结束后分别采用执行缺陷综合征行为学评价测验(BADS)和威斯康星卡片分类测验(WCST)评价执行功能;采用蒙特利尔认知评估量表-北京版(MoCA-B)评价认知功能;采用反应时评价注意力。结果:干预前,2组BADS、WCST、MoCA-B评分和反应时比较,差异均无统计学意义(P>0.05)。(1)执行功能:与干预前比较,2组干预后BADS总分和WSCT各维度评分(除对照组"完成分类数"外)均明显改善(P<0.05);2组随访后WCST评分(除"完成分类数""正确应答数"外)明显改善(P<0.05)。与干预后比较,2组随访后BADS评分中的"规则转化卡片""总分"以及WSCT评分中的"正确应答数""错误应答数""学习到学会"均明显改善(P<0.05)。与对照组比较,观察组干预后BADS、WSCT各维度评分(除"学习到学会")均明显改善(P<0.05);观察组随访后BADS评分中"规则转换卡片""时间判断测验"和WSCT评分中的"正确应答数""错误应答数""持续性错误数"均明显改善(P<0.05)。(2)认知功能:与干预前比较,2组干预后MoCA-B评分均明显提高(P<0.05)。与干预后比较,观察组随访后MoCA-B评分明显降低(P<0.05)。与对照组比较,观察组干预后MoCA-B评分显著提高(P<0.05)。(3)注意力:与干预前比较,2组干预后、随访后反应时均明显缩短(P<0.05);与干预后比较,2组随访后反应时间均明显延长(P<0.05)。与对照组比较,观察组干预后反应时明显更短(P<0.05)。结论:基于眼动技术的认知康复策略可以有效提高脑卒中患者认知功能、注意力和执行功能,值得临床推广应用。     

Effectiveness of home visits by mental health nurses for Japanese women with post‐partum depression

Post‐partum depression affects 10–13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post‐partum depression. Eighteen post‐partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1–2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open‐ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P < 0.05) were observed at times 2 and 3 between groups in terms of increased median scores of physical, environmental, and global subscales, and the total average score of the World Health Organization/quality of life assessment instrument. On the psychological subscale, significant differences (P = 0.042) were observed between groups at time 2. The qualitative analysis of comments about home visitation revealed four categories related to ‘setting their mind at ease’, ‘clarifying thoughts’, ‘improving coping abilities’, and ‘removing feelings of withdrawal from others’. These results suggest that home visits by mental health nurses can contribute to positive mental health and social changes for women with post‐partum depression. A larger trial is warranted to test this approach to care.     

Cognitive therapy as a tool for caring for the elderly confused person

• ? With the increase in the numbers of elderly people, methods to improve the quality of life for this population has never been more relevant. As the primary carers for this group of people, nurses are likely to be faced with this task.
• ? Cognitive therapies such as reality orientation, validation, reminiscence and life review, can help to maintain or improve aspects of cognitive or behavioural functioning for the elderly confused.
• ? If this in turn can increase life satisfaction for those elderly suffering from dementia then cognitive therapies must be addressed as means to improve individual quality of life.
• ? Existing research otters contradictory evidence as to the practical application and usefulness of such therapies. More substantial research must be undertaken in the area, addressing nursing perspectives with regards to the implementation of cognitive therapies.
• ? The author maintains that the cognitive therapies discussed in this paper have great potential for use within care of the elderly and despite controversial research results, can help to maintain or improve the quality of life for the elderly confused.