游戏治疗提升阿尔茨海默病患者认知能力及自我效能感的干预研究

The intervention study of play therapy to improve cognitive function and self-efficacy of elderly patients with dementia

目的:探讨医务社工开展游戏治疗对延缓老年认知障碍患者认知衰退的进程及提升其自我效能感的效果。方法:将80例阿尔茨海默病患者随机分为观察组41例及对照组39例。对照组给予常规治疗及护理管理,观察组在此基础上由医务社工为患者开展10节次的桌面游戏治疗小组服务。对2组患者使用简易精神状态量表(MMSE)及画钟试验(CDT)评估认知水平;使用费城老年中心信心量表(PGCMS)及简易版老年抑郁量表(GDS-15)评估负性情绪及自我效能感。结果:干预前,2组患者MMSE、CDT、PGC及GDS-15评分比较差异无统计学意义。干预3周后,2组患者MMSE、CDT、PGC评分均增加(均P<0.05),GDS-15评分减少(P<0.05);且观察组MMSE、CDT、PGC评分均高于对照组(均P<0.05),GDS-15评分低于对照组(P<0.05)。结论:医务社工桌面游戏治疗小组服务的开展对老年认知障碍患者认知功能的改善有积极作用,并能够有效降低患者负性情绪、提升自我效能感,可为医务社工在医疗机构中开展相关临床服务提供参考和借鉴。

Objective:To explore the effect of play therapy conducted by medical social workers on delaying the cognitive decline and improving the self-efficacy of elderly patients with cognitive impairment.Methods:A total of 80 elderly patients with cognitive impairment who were in the ward of a hospital in Beijing from June 2021 to February 2022 were selected.According to the random number table,they were divided into control group(n=39)and experimental group(n=41).The experimental group was treated with routine nursing and board game program of 10 sessions by social workers,and the control group was treated with routine nursing.Before and after intervention,the mini-mental state examination scale(MMSE),clock drawing task(CDT),Philadelphia Geriatric Centermoral scale(PGCMS)and geriatric depression scale-15(GDS-15)were used to evaluate the cognitive function and self-efficacy of patients.Results:Before the intervention,the scores of MMSE,CDT,PGCMS,and GDS-15 between the two groups were not statistically different.After 3 and a half weeks of intervention,the scores of MMSE,CDT and PGCMS in the experimental group were higher than those before intervention,and the scores of GDS-15 were lower than those before intervention(P<0.05).Compared with the control group,the scores of MMSE,CDT and PGCMS in the experimental group were increased,and the scores of GDS-15 decreased(P<0.05).Conclusion:Board game programs performed by social workers can improve the cognitive function and effectively reduce patients’negative emotions,and improve self-efficacy.