MESSAGE沟通策略引导下的团体怀旧疗法对轻度认知功能障碍老人的干预研究

发布时间：2018-01-27 17:11

本文关键词： MESSAGE沟通策略团体怀旧疗法轻度认知功能障碍老人养老机构　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究依据先前国内外研究中所运用的怀旧疗法方案,结合我国社会文化背景,针对吉林省长春市养老机构轻度认知功能障碍(MCI)老人,以MESSAGE沟通策略为原型,拟设计出适用于本地区养老机构MCI老人的具有中国特色的、并融入低水平多媒体技术的团体怀旧疗法方案,并评估该方案对MCI老人认知功能、生活质量的干预效果,以期寻找能够延缓MCI老人认知障碍发展,降低其向痴呆转变的有效途径。方法:本研究为类实验性研究,研究对象为养老机构60岁以上MCI老人,干预组26人,对照组27人。干预组实施每次60~90分钟,每周1次,连续12周的经MESSAGE沟通策略引导所制定的团体怀旧疗法方案;对照组没有接受任何干预措施。干预前采用日常生活能力量表(ADL)、老年抑郁量表(GDS)、简易智力状态检查量表(MMSE)、北京版蒙特利尔认知评估量表(Mo CA)、中文版健康状况问卷(SF-36)来评估MCI老人的基线资料,干预6周后和12周后这两个时间段采用北京版Mo CA、中文版SF-36来评估团体怀旧疗法对MCI老人认知功能和生活质量的干预效果。结果:1.一般资料对两组MCI老人的年龄、性别、婚姻状况、文化程度、职业、宗教信仰、吸烟情况、饮酒情况、患病情况、遗传史一般资料进行对比,结果显示差异不具有统计学意义(P0.05),两组具有可比性。2.认知功能干预前两组MCI老人的Mo CA总分及各维度得分比较差异不具有统计学意义(P0.05)。干预组MCI老人在干预6周后和12周后的Mo CA总分均有所提高,与对照组相比差异具有统计学意义(P0.05),且Mo CA总分的干预主效应和时间主效应存在交互效应(P0.05);其中语言和延迟回忆这两个维度得分高于对照组,差异具有统计学意义(P0.05),且延迟回忆维度得分会随时间变化呈现上升趋势;虽然定向力维度得分与对照组相比差异具有统计学意义(P0.05),但是两组MCI老人得分均随时间变化呈现下降趋势,且对照组得分仍然低于干预组。3.生活质量干预前两组MCI老人的生活质量各维度得分比较差异不具有统计学意义(P0.05)。干预组MCI老人干预6周后的一般健康状况、精力、精神健康这三个维度得分均有所提高,与对照组相比差异具有统计学意义(P0.05);干预组MCI老人干预12周后的一般健康状况、精力、情感职能、精神健康这四个维度得分高于对照组,差异具有统计学意义(P0.05);且一般健康状况、精力、情感职能、精神健康这四个维度的干预主效应和时间主效应均存在交互效应(P0.05),其中两组MCI老人的精神健康维度得分均随时间变化呈现上升趋势,但对照组得分仍然低于干预组。结论:MESSAGE沟通策略引导下的团体怀旧疗法在短期内可以提高养老机构MCI老人的认知功能,改善其生活质量,从而延缓认知障碍发展的进程,降低痴呆发生的风险。同时,低水平多媒体技术的使用能够丰富活动主题内容,为老人提供视觉和感官的双重刺激,增加了团体怀旧活动的乐趣和吸引力。
[Abstract]:Objective: this study was based on the nostalgia therapy program used in previous studies at home and abroad, combined with the social and cultural background of our country, aimed at the elderly with mild cognitive impairment in Changchun, Jilin Province. Based on the MESSAGE communication strategy, a group nostalgia therapy scheme with Chinese characteristics and low level multimedia technology was designed for MCI elderly in local pension institutions. The effects of the program on cognitive function and quality of life of the elderly with MCI were evaluated in order to delay the development of cognitive impairment in the elderly with MCI. Methods: this study was a kind of experimental study. The subjects of the study were aged over 60 years old MCI elderly, intervention group of 26 people. Control group (27 cases). The intervention group was given the group nostalgia therapy program guided by MESSAGE communication strategy for 12 weeks, 60 minutes per week, once a week; The control group did not receive any intervention measures. Before intervention, ADL, GDSs and MMSE were used before intervention. Beijing Montreal Cognitive Assessment scale (MOCAA), Chinese version of Health status questionnaire (SF-36) was used to evaluate baseline data of MCI elderly. After 6 weeks and 12 weeks of intervention, Beijing version of Mo CA was used. The Chinese version of SF-36 was used to evaluate the intervention effect of group nostalgia therapy on cognitive function and quality of life of MCI elderly. Results: 1. General data on the age, sex and marital status of the two groups of MCI elderly. Education, occupation, religion, smoking, alcohol consumption, prevalence, genetic history of general data were compared, the results showed that the difference was not statistically significant (P 0.05). Before cognitive function intervention, there was no significant difference in the total score of Mo CA and the scores of each dimension between the two groups of MCI patients (P 0.05). After 6 weeks and 12 weeks of intervention, the total score of Mo CA in the intervention group was increased. Compared with the control group, the difference was statistically significant (P 0.05), and there was an interactive effect between the main effect and the time effect of the total score of Mo CA. The scores of language and delayed recall were significantly higher than those of the control group (P 0.05), and the scores of delayed recall increased with time. Although there was a significant difference between the orientation dimension score and the control group, the scores of MCI in the two groups showed a downward trend with the change of time. The scores of the control group were still lower than that of the intervention group .3.There was no significant difference in the quality of life scores between the two groups before the intervention (P 0.05). The general health status of the MCI elderly in the intervention group after 6 weeks of intervention. The scores of three dimensions of energy and mental health were all improved, compared with the control group, the difference was statistically significant (P 0.05). The scores of general health status, energy, emotional function and mental health of the MCI elderly in the intervention group were higher than those in the control group after 12 weeks of intervention, and the difference was statistically significant (P 0.05). And general health status, energy, emotional function, mental health in the four dimensions of the main effect of intervention and the main effect of time exist interactive effects (P0.05). The mental health dimension scores of the two groups of MCI showed an upward trend with the change of time. But the score of control group is still lower than that of intervention group. Conclusion Group nostalgia therapy under the guidance of communication strategy can improve the cognitive function and quality of life of MCI elderly in the short term. At the same time, the use of low-level multimedia technology can enrich the theme of activities and provide both visual and sensory stimulation for the elderly. It increases the fun and appeal of group nostalgia activities.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74

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