早期家庭护理干预对阿尔茨海默病患者生活质量的影响

Effects of Early Family Nursing Intervention on Quality of Life of Patients with Alzheimer's Disease

目的探讨早期家庭护理干预对提高早、中期阿尔茨海默病(Alzhei mer’s disease,AD)患者生活自理能力和生活质量的效果。方法将52例早、中期AD患者按随机数字法分为观察组和对照组,每组各26例。对照组患者采用常规出院指导,出院后不进行任何护理干预。观察组患者及照顾者进行AD疾病知识和护理技能宣教、心理护理、家居安全、康复训练等遵医行为的家庭护理干预。两组患者干预前后分别采用精神状态量表(mini mental state examination,MMSE)、日常生活能力量表(activities of daily living,ADL)、健康状况调查问卷(SF-36)进行评定。结果干预后观察组患者ADL为(15.86±3.81)分,SF-36综合评分为(578.3±142.4)分,均高于对照组患者,差异有统计学意义(P<0.05)。观察组患者MMSE得分为(16.12±2.84)分,与对照组患者相比差异有统计学意义(P<0.01)。干预后观察组患者在躯体健康、社会功能、躯体角色功能、躯体疼痛、心理健康、情绪角色功能、精力和总体健康8个维度及综合评分上与对照组患者的差异有统计学意义(P<0.05或P<0.01)。结论有效的家庭护理干预可提高AD患者的生活自理能力和生活质量,改善其心理调适能力,延缓了病情进展。

Objective To investigate the effects of early family nursing intervention on the quality of life of patients with Alzheimer＇s disease（AD）at early and middle stage.Methods Fifty-two patients diagnosed with early or mid-term AD were equally randomized into the observational group and the control group.The control group received routine discharged guidance without any post-discharge nursing intervention.Besides routine guidance,the patients and caregivers of the observational group received family nursing intervention,such as education and nursing skills training of treatment compliance on AD,psychological nursing,home safety nursing,rehabilitation training.Before and after the intervention,mini mental state examination（MMSE）,activities of daily living（ADL）and health survey questionnaire（SF-36）were employed to evaluate the quality of life of patients in the two groups.Results After intervention,the ADL score of the observational group and the composite score of SF-36 were 15.86±3.81 and 578.3±142.4 respectively,which were both significantly higher than that of the control group（P0.05）.The MMSE score of the observational group was 16.12±2.84,which was significantly different from that of the control group（P0.01）;Significant differences were observed on the eight domains somatic health,social function,somatic role function,somatic pain,psychological health emotional role function,the general health and energy between the observational group and the control group（P0.05 or P0.01）.Conclusion Family nursing intervention can improve the self-care ability,quality of life and psychological adaptation ability and alleviate their illness advances of the patients with early or mid-term AD.