家庭随访干预对阿尔茨海默病早期患者康复的影响

目的:评价家庭随访干预对阿尔茨海默病(AD)早期患者康复的影响。方法:将确诊的83例社区居家AD早期患者分为试验组42例,对照组41例,对照组入组时开展一次有关AD知识教育与居家康复训练指导,此后由家庭照顾者督促患者按居家护理方案进行康复训练,试验组在此基础上采用家庭访视和电话随访相结合的干预方式。干预期1年。采用简易智力状态量表(MMSE)、日常生活能力量表(ADL)、汉密尔顿焦虑量表(HAMA)进行效果评定。结果:试验组患者干预前后ADL、HAMA得分及居家不安全事件发生率差异有统计学意义(P0.05),MMSE得分虽无统计学差异(P0.05),但干预后分数较干预前提高,且1年后无患者发展为中期痴呆;试验组与对照组干预后MMSE、HAMA得分差异有统计学意义(MMSE:P0.05;HAMA:P0.01),ADL得分虽无统计学差异(P0.05),但试验组分数较对照组降低;对照组患者干预前后MMSE、ADL、HAMA得分差异无统计学意义(P0.05),1年后有2例患者发展为中期痴呆。结论:仅依靠家庭照顾者督促患者开展居家康复训练是不够的,家庭随访干预可有效维持AD早期患者的认知水平,延缓病情进展,提高患者生活质量。

The influence of home follow-up intervention on the rehabilitation of patients with early Alzheimer disease

Objective： To evaluate the effects of family follow-up intervention on the rehabilitation of patients with early Alzheimer disease.Methods： A total of 83 early AD patients in community were divided into experimental group with 42 clients and control group with 41 clients.The patients in control group were given nursing care to carry out a relevant AD knowledge education,rehabilitation training guidance and then family caregivers urged patients to practice according to the home care plan, while the patients in intervention group were given intervention with for home visits and telephone follow-up one year. Then the intervention effect of all patients was evaluated by MMSE,ADL and HAMA.Results： The scores of ADL,HAMA and home incidence of unsafe events had statistically significant difference（P〉0.05）,MMSE score has not statistically significant difference（P〉0.05） in the experimental group before and after the intervention, and no patients developed dementia（AD）at middle stage after 1 year. The differences of two groups in MMSE and HAMA were statistically significant（MMSE：P〈0.05;HAMA：P〈0.01）before the personalized nursing intervention; patients in the control group before and after the intervention the difference in MMSE,ADL,HAMA were not statistically significant（P〉 0.05）,and a year later two patients developed dementia（AD） at middle stage. Conclusion： It is not enough to rely on family caregivers to urge patients to carry out rehabilitation training at home,Family follow-up early intervention can effectively maintain AD patients＇ cognitive level,slow down disease progression,and improve the quality of life.