The Tailored Activity Program to Reduce Behavioral Symptoms in Individuals With Dementia: Feasibility, Acceptability, and Replication Potential
The Tailored Activity Program to Reduce Behavioral Symptoms in Individuals With Dementia: Feasibility, Acceptability, and Replication Potential
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DOI：
10.1093/geront/gnp087
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发表时间：
2009-06-01
期刊：
影响因子：
5.7
通讯作者：
Burke, Janice P.
中科院分区：
文献类型：
--
作者：
Gitlin, Laura N.;Winter, Laraine;Burke, Janice P.
目的：量身定制活动计划（TAP）是一项基于家庭的职业治疗干预，在一项随机试验中显示可以减少行为症状和照顾者负担。本文描述了TAP、它的评估、可接受性和复制潜力。设计与方法：TAP包括8个阶段，为期4个月。干预主义者确定痴呆症患者保留的能力、以前的角色、习惯和兴趣；开发针对个人资料的活动；培训家庭使用活动。干预医生记录了进行评估所花费的时间和难度，并观察了TAP的接受程度。对于每一项实施规定的活动，护理人员报告了他们的亲属花在活动上的时间和感知到的好处。结果：TAP评估结合了神经心理学测试、标准化的基于表现的观察和临床访谈，得出了识别和定制活动的能力信息。评估很容易管理，平均两次1小时的会议。在170项规定的活动中，81.5%的家庭在治疗期间平均使用了4次，每次23分钟，持续数月。护理人员报告说，他们对使用活动有很高的信心，对行为症状不那么不安（86%），并提高了技能（93%）和个人控制（95%）。干预学家观察到，在治疗过程中，痴呆患者的参与度（100%）和愉悦度（98%）都有所提高。含义：TAP为家庭提供了有关其亲属能力和易于使用的活动的知识。这个项目受到了护理人员的好评。对于痴呆症患者来说，规定的活动似乎是令人愉快和吸引人的。TAP值得进一步评估，以在更大更多样化的人群中建立疗效，并考虑作为管理行为症状的非药物方法。
Purpose: The Tailored Activity Program (TAP) is a home-based occupational therapy intervention shown to reduce behavioral symptoms and caregiver burden in a randomized trial. This article describes TAP, its assessments, acceptability, and replication potential. Design and Methods: TAP involves 8 sessions for a period of 4 months. Interventionists identify preserved capabilities, previous roles, habits, and interests of individuals with dementia; develop activities customized to individual profiles; and train families in activity use. Interventionists documented time spent and ease conducting assessments, and observed receptivity of TAP. For each implemented prescribed activity, caregivers reported the amount of time their relative spent in activity and perceived benefits. Results: The TAP assessment, a combination of neuropsychological tests, standardized performance-based observations, and clinical interviewing, yielded information on capabilities from which to identify and tailor activities. Assessments were easy to administer, taking an average of two 1-hr sessions. Of 170 prescribed activities, 81.5% were used, for an average of 4 times for 23 min by families between treatment sessions for a period of months. Caregivers reported high confidence in using activities, being less upset with behavioral symptoms (86%), and enhanced skills (93%) and personal control (95%). Interventionists observed enhanced engagement (100%) and pleasure (98%) in individuals with dementia during sessions. Implications: TAP offers families knowledge of their relative's capabilities and easy-to-use activities. The program was well received by caregivers. Prescribed activities appeared to be pleasurable and engaging to individuals with dementia. TAP merits further evaluation to establish efficacy with larger more diverse populations and consideration as a nonpharmacological approach to manage behavioral symptoms.