长期足剂量认知数字疗法对认知障碍患者认知功能的效果评价

Evaluation of the effect of long-term full-dose cognitive digital therapy on cognitive function in patients with cognitive disorders

目的探讨长期足剂量认知数字疗法对改善和维持认知障碍患者认知功能的效果,为认知障碍患者的护理管理提供依据。方法采用3组平行随机对照研究设计,采用连续入组便利抽样的方法,于2020年1月至2023年1月选取首都医科大学宣武医院神经内科拟出院的90例认知障碍患者为研究对象。利用随机数字表法分为对照组、门诊组、居家组各30例。对照组接受常规护理,门诊组患者在对照组基础上实施门诊认知数字疗法,居家组患者在对照组基础上实施居家认知数字疗法。分别于干预前和干预后6、12个月,比较3组简易智能精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)等评分。结果最终共入组85例患者。其中对照组28例,男12例,女16例,年龄为(64.68±11.26)岁;门诊组30例,男19例,女11例,年龄为(65.74±8.44)岁;居家组27例,男14例,女13例,年龄为(66.81±11.18)岁。干预前和干预后6、12个月的MMSE总分对照组分别为(22.00±4.82)、(17.25±5.15)、(14.25±4.54)分,门诊组分别为(22.26±3.46)、(22.93±3.77)、(22.30±3.57)分,居家组分别为(22.40±3.72)、(22.03±3.76)、(21.90±4.08)分,重复测量方差分析显示,3组患者组间、时间、交互效应差异均有统计学意义(F_(组间)=15.30,F_(时间)=4.10,F_(交互)=20.25,均P<0.05)。干预前和干预后6、12个月的MoCA总分对照组分别为(16.50±4.87)、(12.64±4.94)、(9.89±4.01)分,门诊组分别为(18.74±4.22)、(18.96±4.31)、(18.41±4.34)分,居家组分别为(17.20±5.12)、(16.93±3.67)、(16.93±4.10)分,重复测量方差分析显示,3组患者组间、时间、交互效应差异均有统计学意义(F_(组间)=16.30,F_(时间)=5.74,F_(交互)=12.08,均P<0.05)。结论长期足剂量的门诊和居家认知数字疗法可有效改善和维持认知障碍患者的认知功能,优化了认知功能训练的管理方案,为认知障碍患者的非药物干预提供循证依据。

ObjectiveTo evaluate the effect of long-term full-dose cognitive digital therapy on improving and maintaining cognitive function in patients with cognitive disorders,and to provide basis for nursing management of patients with cognitive disorders.MethodsThis study adopted three parallel randomized control trial design.By adopting the method of continuous grouping and convenient sampling,from January 2020 to January 2023,90 patients with cognitive disorders who were treated in the neurology outpatient department of Beijing Xuanwu Hospital of Capital Medical University were selected as the study objects.These patients were divided into the control group,outpatient group and home group with 30 patients in each group by using the random digit table method.The control group received routine nursing,patients in the outpatient group received cognitive digital therapy in clinic based on routine nursing,and patients in the home group received cognitive digital therapy at home based on routine.Before intervention,6 and 12 months after intervention,Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were compared among three groups.ResultsA total of 85 patients were enrolled in three groups.There were 28 cases in the control group,including 12 males and 16 females,aged(64.68±11.26)years.There were 30 patients in the outpatient group,including 19 males and 11 females,aged(65.74±8.44)years.There were 27 cases in the home group,including 14 males and 13 females,aged(66.81±11.18)years.The MMSE scores of the control group before intervention,6 and 12 months after intervention were(22.00±4.82),(17.25±5.15),(14.25±4.54)points respectively,and those of the outpatient group were(22.26±3.46),(22.93±3.77),(22.30±3.57)points,while those of the home group were(22.40±3.72),(22.03±3.76),(21.90±4.08)points respectively.The analysis of variance of repeated measurements showed that the intergroup,time and interaction effects were statistically significant(F_(between-group)=15.30,F_(time)=4.10,F_(interaction)=20.25,all P<0.05).The total scores of MoCA in the control group were(16.50±4.87),(12.64±4.94),(9.89±4.01)points before intervention,6 and 12 months after intervention,(18.74±4.22),(18.96±4.31),(18.41±4.34)points in the outpatient group,(17.20±5.12),(16.93±3.67),(16.93±4.10)points in the home group respectively.The analysis of variance of repeated measurements showed that the intergroup,time and interaction effects were statistically significant(F_(between-group)=16.30,F_(time)=5.74,F_(interaction)=12.08,all P<0.05).ConclusionsLong-term adequate outpatient and in-home cognitive digital therapy can effectively improve and maintain cognitive function in patients with cognitive disorders.It optimizes the management scheme of cognitive function training and provides evidence-based basis for non-drug intervention of patients with cognitive disorders.