社区护理干预对老年痴呆患者及照料者生活质量影响的研究

The effect of community nursing intervention on quality of life of alzheimer patients and caregivers

目的了解社区老年痴呆(AD)患者护理现状及照顾者的生活状况,探讨社区护理干预对老年痴呆患者及其照顾者生活质量的影响。方法选取社区老年痴呆患者60例,随机分为观察组与对照组,对照组实施常规指导和健康宣教,观察组除实施常规指导和健康宣教外,同时进行新社区护理干预,包过调配饮食、生活起居,心理干预、定期家访等。观查2组患者干预前及干预后2年智能状态和日常生活能力方面的变化及2组照料者干预前及干预后2年生活质量的改善情况。结果观察组患者智能状态在干预后2年较对照组和干预前有明显提高(t=2.59,P<0.05;t=2.36,P<0.05),而且日常生活能力在干预后2年较对照组和干预前也有明显提高(t=2.97,P<0.01;t=2.13,P<0.05);对照组患者在智能状态和日常生活能力方面在干预2年后无明显改变(P>0.05)。采用新的护理干预方法后观察组照料者生活质量较对照组和干预前有明显改善(t=3.86,P<0.01;t=5.90,P<0.01),而对照组则无变化(P>0.05)。结论采取合理和可行的社区护理干预,可以提高AD患者的生活质量,减轻照顾者的心理压力,减轻家庭负担,延缓疾病进程。

Objective To investigate the nursing status for Alzheimer patients and living conditions of caregivers; to ex- plore the effect of community nursing intervention on quality of life of patients and caregivers. Methods Sixty cases in community with Alzheimer disease were randomly divided into observation group and control group. The control group re- ceived the general health guidance and health education, and in addition to the implementation of general health guidance and health education, the observation group received new community nursing intervention, including dietary adjustments, activities of daily living, psychological nursing, regular home visits. Mental state and ability of daily life of Alzheimer pa- tients and life quality evaluation of caregivers were tested before and after 2 years intervention. Results The scores from MMSE in observation group were significantly higher than the control group and before intervention （t = 2.59, P 〈 0.05 ; t = 2.36, P 〈 0.05 ） , but the scores from ADL in intervention group were significantly lower than the control group and be- fore intervention （ t = 2.97, P 〈 0.01 ; t = 2.13, P 〈 0.05 ） ; the scores from MMSE and ADL in the control group had no change （ P 〉 0.05 ） after 2 years intervention. The scores from WHOQOL-BREF for caregivers in observation group were significantly higher than the control group and before intervention （ t = 3.86, P 〈 0.01 ; t = 5.90, P 〈 0.01 ）, The scores from WHOQOL-BREF for caregivers in the control group had no change （ P 〉 0. 05 ） after 2 years intervention. Conclusion Taking reasonable and practicable community nursing intervention could improve the quality of life for Alzheimer patients and slow the course of Alzheimer disease which also reduce the mental stress of caregiver and the bur-den of families.