多途径延续护理联合同理心干预对阿尔茨海默病患者认知功能的影响

Effects of multi-channel continuous nursing combined with empathy intervention on cognitive function of patients with Alzheimer's disease

目的探究多途径延续护理联合同理心干预对阿尔茨海默病(AD)患者认知功能的影响。方法选择2022年12月-2023年8月上海市浦东新区老年医院收治的老年AD患者88例,按随机数字表法分成观察组(n=44)和对照组(n=44)。对照组予以常规康复护理干预,观察组予以多途径延续护理联合同理心干预,时长为12个月。比较2组心理韧性量表(CD-RISC)评分、应对方式量表(MCMQ)评分、血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]水平、认知功能[采用简易精神状态评估量表(MMSE)、画钟测验(CDT)、洛文斯顿认知功能评定量表(LOTCA)评估]评分、日常生活能力评定量表(ADL)评分、老年痴呆症生活质量量表(QOL-AD)评分和护理满意度的差异。结果干预后,2组CD-RISC、MMSE、CDT、LOTCA、ADL、QOL-AD、MCMQ量表积极应对评分均高于同组干预前,且观察组高于对照组(P<0.05);2组MCMQ量表消极应对评分低于同组干预前,且观察组低于对照组(P<0.05);2组TNF-α、IL-1β、IL-6水平均低于同组干预前,且观察组低于对照组(P<0.05);观察组护理满意率高于对照组(93.18%vs 77.27%,P<0.05)。结论多途径延续护理联合同理心干预可改善老年AD患者的认知功能,有效提高患者心理韧性,改变疾病应对方式,降低炎症因子水平,进而改善认知功能,提高自理能力、生活质量和患者满意度,促进康复,护理效果显著,具有一定的临床应用价值。

Objective To explore the effects of multi-channel continuous nursing combined with empathy intervention on cognitive function of patients with Alzheimer's disease(AD).Methods A total of 88 elderly patients with AD admitted to Geriatrics Hospital of Pudong New District from December 2022 to August 2023 were enrolled and divided into observation group(n=44)and control group(n=44)according to random number table method.The control group received routine rehabilitation nursing intervention,while the observation group received multi-channel continuous nursing combined with empathy intervention.The duration of intervention was 12 months.The scores of Connor-Davidson Resilience Scale(CD-RISC)and Medical Coping Modes Questionnaire(MCMQ),levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)],cognitive function[Mini-Mental State Examination(MMSE),Clock Drawing Test(CDT),Loewenstein Occupational Therapy Cognitive Assessment(LOTCA)],scores of activity of daily living(ADL)and quality of life-Alzheimer s disease(QOL-AD),and nursing satisfaction were compared between the two groups.Results After intervention,the scores of CD-RISC,MMSE,CDT,LOTCA,ADL,QOL-AD and positive coping in MCMQ of both groups were higher than those of the same group before intervention,and the scores of the observation group were higher than those of the control group(P<0.05);the score of negative coping in MCMQ of both groups was lower than that of the same group before intervention,and the score of the observation group was lower than that of the control group(P<0.05);the levels of TNF-α,IL-1βand IL-6 of both groups were lower than those of the same group before intervention,and the levels of above indexes of the observation group were lower than those of the control group(P<0.05).The nursing satisfaction rate in the observation group was higher than that in the control group(93.18%vs 77.27%,P<0.05).Conclusion The combination of multi-channel continuous nursing and empathy intervention can improve the cognitive function of elderly AD patients,effectively enhance their psychological resilience,change their disease coping styles,reduce the level of inflammatory factors,thereby improving their cognitive function,self-care ability,quality of life and satisfaction,and promote rehabilitation.The nursing effect is significant,and it has certain clinical application value.