The Effect of Therapeutic Touch on Behavioral Symptoms and Cortisol in Persons with Dementia
The Effect of Therapeutic Touch on Behavioral Symptoms and Cortisol in Persons with Dementia
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治疗性触摸对痴呆症患者行为症状和皮质醇的影响
DOI：
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发表时间：
2009
影响因子：
1.8
通讯作者：
Karabi Sinha
中科院分区：
文献类型：
--
作者：
D. Woods;C. Beck;Karabi Sinha
背景：75-90% 患有痴呆症的疗养院 (NH) 居民会出现行为症状 (BSD)，这可能与压力反应有关。治疗性触摸已被证明可以减少新罕布什尔州居民的不安，但其机制尚不清楚。这项随机对照试验 (RCT) 的目的是检查治疗性触摸对新罕布什尔州痴呆症居民 BSD 和基础皮质醇水平的影响。参与者和方法：采用双盲实验中断时间序列 ABAB 设计，65 名参与者被分配到三组之一。实验组接受颈部和肩部接触治疗触摸，每天两次，持续 3 天（分 2 个单独的治疗周期进行）；安慰剂组接受外观相同的模拟治疗，对照组接受常规护理。研究结果是BSD（通过改良的激动行为评定量表（mARS）测量）和唾液皮质醇水平（通过酶联免疫吸附测定（ELISA）测量）。结果：64 名居民，年龄 67-93 岁（M = 85.5，SD = 5.50）完成了研究。与对照组相比，实验组的烦躁情绪显着减少（p = 0.03）。不同时间段各组之间的早晨皮质醇变异性存在显着差异（<0.0001）。研究结果表明，治疗性触摸可能可以有效控制烦躁不安和减轻压力等症状。当成本控制成为医疗保健中的一个考虑因素时，治疗性触摸是一种非侵入性、易于学习的干预措施，并且可以为选定的 BSD 患者提供非药物替代方案。
Background: Between 75–90% of nursing home (NH) residents with dementia develop behavioral symptoms (BSD) which may be associated with a stress response. Therapeutic touch has been shown to decrease restlessness in NH residents, however the mechanism is unknown. The purpose of this randomized controlled trial (RCT) was to examine the effect of therapeutic touch on BSD and basal cortisol levels among NH residents with dementia. Participants and Methods: Using a double blind experimental interrupted time series ABAB design, 65 participants were assigned to one of three groups. The experimental group received therapeutic touch with contact on the neck and shoulders delivered twice daily for 3 days (administered over 2 separate treatment periods); the placebo group received a mimic treatment identical in appearance, and the control group received routine care. Study outcomes were BSD, measured by the modified Agitated Behavior Rating Scale (mABRS), and salivary cortisol levels, measured by enzyme-linked immunosorbent assay (ELISA). Results: 64 residents, aged 67–93 years (M = 85.5, SD = 5.50), completed the study. Restlessness was significantly reduced in the experimental group compared to the control group (p = 0.03). There was a significant difference in morning cortisol variability among groups across time periods (<0.0001). Findings suggest that therapeutic touch may be effective for management of symptoms like restlessness coupled with stress reduction. At a time when cost containment is a consideration in health care, therapeutic touch is an intervention that is non-invasive, readily learned, and can provide a non-pharmacologic alternative for selected persons with BSD.
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