中重度痴呆患者愉悦性活动参与情况及其影响因素分析

The status quo and influencing factors of pleasant events in people with moderate and severe dementia

目的:调查中重度痴呆患者愉悦性活动参与现状并分析其影响因素。方法:采用一般资料问卷、痴呆老人愉悦性活动问卷(PES-AD)、抑郁自评量表(SDS)、简易应对方式问卷(SCSQ)以及照顾者反应量表(CRA)对157例中重度痴呆患者及其家庭主要照顾者进行问卷调查。结果:中重度痴呆患者愉悦性活动参与情况得分为(18.01±8.80)分,4个维度得分由低到高依次为自主性活动(0.84±0.67)分、家庭性活动(0.92±0.67)分、感官刺激活动(1.09±0.57)分、情感刺激活动(1.15±0.68)分;多因素回归分析显示痴呆类型、痴呆严重程度、家庭主要照顾者抑郁、家庭主要照顾者反应中自尊维度以及经济问题维度是痴呆患者愉悦性活动的影响因素(P<0.01),可解释变异的49.3%。结论:中重度痴呆患者自主性活动参与性最差,家庭性活动次之,情感刺激活动参与性最好。医务人员应根据痴呆患者愉悦性活动参与的影响因素制定相应的干预措施,提高痴呆患者愉悦性活动的参与性。

Objective: To describe and analysis the current status and influencing factors of the pleasant events in patients with moderate and severe dementia. Methods: Totally 157 patients with moderate and severe dementia and their caregivers were investigated using instruments including the Pleasant Events Schedule-AD (PES-AD), Self-rating Depression Scale (SDS), Simplified Coping Style Questionnaire (SCSQ) and Caregiver Reaction Assessment (CRA). Result: The overall score of PES-AD was 18.0±8.80. The dimension score from low to high were autonomy activities 0.84±0.67, family avtivities 0.92±0.67, sensory stimulation activities 1.09±0.57, emotional stimulation activities 1.15±0.68. Multiple linear regression analysis showed that the type and severity of dementia, depression of caregivers, economic problems and self-esteem dimension were main influencing factors (P<0.01), which could explain 49.3% variation of PES-AD. Conclusion: The score of autonomy activities was the lowest, followed by family activities, and the score of emotional stimulation activities was the highest. Medical staff should pay attention to these influencing factors and take relevant measures to further improve the score of PES-AD.