The Comprehensive Process Model of Engagement
The Comprehensive Process Model of Engagement
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DOI：
10.1097/jgp.0b013e318202bf5b
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发表时间：
2011-10-01
影响因子：
7.2
通讯作者：
Dakheel-Ali, Maha
中科院分区：
文献类型：
--
作者：
Cohen-Mansfield, Jiska;Marx, Marcia S.;Dakheel-Ali, Maha
背景：参与是指被外部刺激占据或参与的行为。在痴呆症中，参与是冷漠的对立面。目的：参与的综合过程模型进行了研究，其中环境，个人和刺激特性影响的参与程度。方法：研究对象为马里兰州7个社区的193名被诊断为痴呆的护理人员。刺激参与度通过参与度的观察测量进行评估，测量持续时间，注意力和对刺激的态度。25个刺激，分为真人社会刺激，模拟社会刺激，无生命的社会刺激，阅读刺激，操纵刺激，音乐刺激，任务和工作相关的刺激，和两个不同的自我认同刺激。结果：所有的刺激引起显着更大的参与相比，控制刺激。在多变量模型中，音乐显着增加参与时间，而所有其他刺激显着增加持续时间，注意力和态度。在多变量模型中，增加参与度的重要环境变量是：使用长时间的建模介绍（相对于最小介绍），任何级别的声音（特别是中等声音），以及房间中2到24人的存在。重要的个人属性包括简易精神状态检查分数，日常生活活动表现和言语清晰度，这与较高的参与分数呈正相关。结论：结果与参与的综合过程模型一致。个人属性，环境因素和刺激特征都有助于参与的水平和性质，与第二个发现是，暴露于任何刺激elaborates参与痴呆症患者。(Am J Geriatr Psychiatry 2011; 19：859-870）
Background: Engagement refers to the act of being occupied or involved with an external stimulus. In dementia, engagement is the antithesis of apathy. Objective: The Comprehensive Process Model of Engagement was examined, in which environmental, personal, and stimulus characteristics impact the level of engagement. Methods: Participants were 193 residents of 7 Maryland nursing with a diagnosis of dementia. Stimulus engagement was assessed via the Observational Measure of Engagement, measuring duration, attention, and attitude to the stimulus. Twenty-five stimuli were presented, which were categorized as live human social stimuli, simulated social stimuli, inanimate social stimuli, a reading stimulus, manipulative stimuli, a music stimulus, task and work-related stimuli, and two different self-identity stimuli. Results: All stimuli elicited significantly greater engagement in comparison to the control stimulus. In the multivariate model, music significantly increased engagement duration, whereas all other stimuli significantly increased duration, attention, and attitude. Significant environmental variables in the multivariate model that increased engagement were: use of the long introduction with modeling (relative to minimal introduction), any level of sound (especially moderate sound), and the presence of between 2 and 24 people in the room. Significant personal attributes included Mini-Mental State Examination scores, activities of daily living performance and clarity of speech, which were positively associated with higher engagement scores. Conclusions: Results are consistent with the Comprehensive Process Model of Engagement. Personal attributes, environmental factors, and stimulus characteristics all contribute to the level and nature of engagement, with a secondary finding being that exposure to any stimulus elicits engagement in persons with dementia. (Am J Geriatr Psychiatry 2011; 19: 859-870)