园艺治疗对认知功能障碍老年住院患者社会功能的影响

Effects of horticultural therapy on social function for elderly inpatients with cognitive dysfunction

目的:探讨园艺治疗对认知功能障碍老年住院患者社会功能的疗效。方法:选取符合ICD-10诊断标准的认知功能障碍住院患者90名,用随机数字表法随机分为研究组和对照组,各45名。最终完成研究者共82人,研究组和对照组各41人。两组均根据临床症状进行药物治疗,研究组在药物治疗的同时给予园艺治疗,每周3次,每次90 min,共12周。在基线、治疗4周末、治疗8周末、治疗12周末评估两组患者的住院精神病人社会功能评定量表(scale of social function in psychosis inpatients,SSPI)得分。使用SPSS 25.0软件对两组的人口统计学数据进行卡方检验、独立样本t检验,SSPI量表得分进行重复测量方差分析。结果:将两组患者SSPI量表的各个因子分和总分进行重复测量方差分析,结果显示两组患者在日常生活能力(因子Ⅰ)、动性和交往情况(因子Ⅱ)、社会性活动技能得分(因子Ⅲ)和总分组别主效应(F=7.226、F=13.428、F=24.817、F=19.793)和时间与组别交互效应(F=29.644、F=42.937、F=53.246、F=67.215),均差异有统计学意义(均P<0.01),进一步简单效应分析显示,两组各项因子分和总分在基线时差异无统计学意义,在第8周末时研究组各个因子分和总分[(9.95±2.41)分、(10.39±3.38)分、(6.56±3.24)分、(26.90±7.88)分]和对照组[(8.10±2.45)分、(6.88±3.48)分、(2.81±2.50)分、(17.78±6.96)分]比较均差异有统计学意义(均P<0.05),第12周末时研究组各个因子分和总分[(10.27±2.16)分、(11.61±3.07)分、(7.88±3.08)分、(29.76±7.40)分]和对照组[(7.56±2.41)分、(5.78±3.21)分、(2.34±2.02)分、(15.68±6.24)分]比较差异均有统计学意义(均P<0.05)。研究组在第12周末时,因子Ⅱ、因子Ⅲ和总分[(11.61±3.07)分、(7.88±3.08)分、(29.76±7.40)分]与基线[(8.59±3.93)分、(4.56±3.32)分、(22.02±8.35)分]、第4周末[(9.07±4.14)分、(5.12±3.35)分、(23.59±8.51)分]、第8周末[(10.39±3.38)分、(6.56±3.24)分、(26.90±7.88)分]相比,均差异有统计学意义(均P<0.05),因子Ⅰ[(10.27±2.16)分]与基线[(8.88±2.65)分]和第4周末[(9.39±2.63)分]相比,均差异有统计学意义(均P<0.05),并且得分呈上升趋势。结论:园艺治疗能改善认知障碍老年住院患者的社会功能。

Objective To investigate the effect of horticultural therapy on social function of elderly inpatients with cognitive dysfunction.Methods Ninety inpatients with cognitive dysfunction who met the diagnostic criteria of ICD-10 were randomly divided into horticultural research group and control group,with 45 patients in each group.Finally,totally 82 completed the test with 41 in each group.Patients in the two groups were both given drug therapy according to clinical symptoms.At the same time,patients in the research group were given horticultural therapy 3 times a week,90 minutes each section,for 12 weeks.Scale of social function in psychosis inpatients(SSPI)was used to assess the social function of the patients in the two groups were at baseline,4,8 and 12 weekends of the treatment.SPSS 25.0 software was used to conduct chi-square test and independent sample t-test for demographic data of the two groups,and repeated measures ANOVA was performed for SSPI score.Results The results of repeated measure analysis of variance showed that the group main effect(F=7.226,F=13.428,F=24.817,F=19.793)and interaction effect between time and group were all statistically significant(F=29.644,F=42.937,F=53.246,F=67.215)(all P<0.01)in daily living ability(factorⅠ),mobility and interaction(factorⅡ),social activity skills score(factorⅢ)and total score.Simple effect analysis showed there were no statistically significant differences in each factor score and total score between the two groups at the baseline(P>0.05),and there were statistically significant differences in each factor scores and total score at the end of the 8th weekend((9.95±2.41),(10.39±3.38),(6.56±3.24),(26.90±7.88)vs(8.10±2.45),(6.88±3.48),(2.81±2.50),(17.78±6.96))and 12th weekend((10.27±2.16),(11.61±3.07),(7.88±3.08),(29.76±7.40)vs(7.56±2.41),(5.78±3.21),(2.34±2.02),(15.68±6.24))(all P<0.01).The pair-to-pair comparison within the group showed that the differences in factorⅡ,factorⅢand total score of the research group at the end of the 12th weekend((11.61±3.07),(7.88±3.08),(29.76±7.40))were higher than those at the baseline((8.59±3.93),(4.56±3.32),(22.02±8.35)),4th weekend((9.07±4.14),(5.12±3.35),(23.59±8.51)),and 8th weekend((10.39±3.38),(6.56±3.24),(26.90±7.88))(all P<0.05).FactorⅠ(10.27±2.16)showed a statistically significant difference compared with the baseline(8.88±2.65)and 4th weekend(9.39±2.63)(both P<0.05).All the scores showed an upward trend.Conclusion Horticultural therapy can improve the social function of elderly inpatients with cognitive impairment.