摘要
目的以需要引导行为妥协模式（NDB）为理论框架，探讨养老机构老年痴呆症患者精神行为症状的影响因素。方法于2013年7-8月对浙江省4家公立养老机构687名老年人进行调查，最终纳入老年痴呆症患者246例。利用简易智力状态检查量表（MMSE）、临床痴呆评定量表（CDR）、神经精神科问卷知情版量表（NPI-Q）、中文版晚期老年痴呆症疼痛评估量表（c-PAINAD）进行评估。结果246例老年痴呆症患者中有233例在近1个月内至少有1种精神行为症状，占94．7％，其中以睡眠／夜间行为最多见，占59-3％；其次为异常运动行为占46．7％，易激惹／情绪不稳占44．3％，抑郁占43．5％。基于NDB模式的养老机构老年痴呆症患者精神行为症状影响因素的多元线性回归分析显示，背景因素为日常生活能力和CDR（P〈0．05），紧邻因素为有无门禁、家人探视频率、有无配偶（P〈0．05）。结论精神行为症状是老年痴呆症患者某种需求的提示，如给予恰当的回应，可减少症状的发生。照护人员应依据患者紧邻因素和背景因素给与相应的照护，以减少精神行为症状的发生。
Objective To explore the influencing factors of psychological and behavioral symptoms among dementia patients in old-age care institutions in China along with taking the need-driven dementia- compromised behavior （NDB） model as the theoretical framework. Methods From July to August 2013, 687 elderly people from four public old-age care institutions in Zhejiang Province and 246 dementia patients enrolled in. Assessment was carried out with the Mini-Mental State Examination （MMSE）, Clinical Dementia Rating （CDR）, Neuropsychiatric Inventory-Questionnaire （NPI-Q）, Chinese version of Pain Assessment Scale for Patients with Advanced Dementia （C-PAINAD）. Results Among the 246 patients with dementia, 233 had at least one mental behavioral symptom in the past 1 month, accounting for 94.7%, of which sleep/night behavior was the most common, accounting for 59.3%; followed by abnormal motor behavior （46.7%）, irritability/emotional lability （44.3%） and depression （43.5%）. Multiple linear regression on influencing factors of psychological and behavioral symptoms among dementia patients in old-age care institutions based on NDB model showed that the background factors were activity of daily living and CDR （P 〈 0.05）, the proximal factors included having or not having entrance guard, frequency of family visit and having or not having spouse （P 〈 0.05）. Conclusions Psychological and behavioral symptoms are hints of demands among dementia patients. If an appropriate response is given, the symptom will be reduced. Caregivers should provide corresponding care according to proximal factors and background factors so as to decrease the incidence of psychological and behavioral symptoms.
作者
李小雪
李冬梅
许虹
Li Xiaoxue; Li Dongmei; Xu Hong(School of Nursing, Peking Union Medical College, Beijing 100144, China ; Medical College, Hangzhou Normal University, Hangzhou 310036, China)
出处
《中华现代护理杂志》
2018年第27期3263-3267,共5页
Chinese Journal of Modern Nursing
基金
浙江省卫生厅“教育部留学回国人员科研启动基金”项目（2012KYB163）
关键词
痴呆
老年人
精神行为症状
以需要引导行为妥协模式
养老机构
Dementia
Aged
Psychological and behavioral symptoms
Need-driven dementia-compromised behavior model
01d-age care instituions
