A comparison of two treatments of agitated behavior in nursing home residents with dementia: Simulated family presence and preferred music
A comparison of two treatments of agitated behavior in nursing home residents with dementia: Simulated family presence and preferred music
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DOI：
10.1097/01.jgp.0000249388.37080.b4
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发表时间：
2007-06-01
影响因子：
7.2
通讯作者：
O'Connor, Daniel W.
中科院分区：
文献类型：
--
作者：
Garland, Kathryn;Beer, Edwina;O'Connor, Daniel W.
目的：本研究的目的是比较两种个体化心理社会治疗在减少老年痴呆患者明显行为障碍的肢体和言语激动行为频率方面的效果。方法：研究人员对30名患有频繁严重行为障碍的养老院居民进行了多次随机单盲暴露前、期间和之后的观察，这些15分钟的模拟家庭存在录音带（由家庭成员准备的关于过去积极经历的对话），居民早期生活中喜欢的音乐，以及安慰剂条件下的园艺文本阅读。选定的（通常是多个）身体和语言行为被定期计算为存在或不存在。所有三种治疗条件与常规治疗进行比较。结果：模拟在场和喜欢的音乐都被证明对减少身体激动行为的次数有效。模拟在场，而不是音乐，会显著减少言语激动行为的次数。事实证明，安慰剂胶带比预期的更有效。参与者对模拟在场和音乐的反应差异很大。在许多情况下，行为计数下降了一半或更多。其他居民变得更加不安。结论：参与者对安慰剂磁带的反应好于预期，这表明即使是最简单的技术也可以改善困惑、不安的养老院居民的生活。在两种心理治疗方法中，喜欢的音乐磁带更容易制作，在许多情况下显然是有帮助的。相比之下，家庭成员往往很难回忆起足够多的快乐回忆，来制作一盘模拟在场的磁带。如果亲戚们谈论的话题是他们自己选择的，那么模拟在场可能同样有效。虽然不是所有的居民都得到了这些治疗的帮助，但副作用是轻微和短暂的。
Objective: The objective of this study was to compare the effectiveness of two individualized psychosocial treatments in reducing the frequency of physically and verbally agitated behaviors in nursing home residents whose dementia was complicated by marked behavioral disturbance. Methods: Thirty nursing home residents with frequent, severe behavioral disturbances were observed by research staff before, during, and after multiple, randomized, single-blind exposures to 15-minute audiotapes of simulated family presence ( a conversation prepared by a family member about positive experiences from the past), music preferred by the resident in earlier life, and a placebo condition of a reading from a horticultural text. Selected ( usually multiple) physical and verbal behaviors were counted as present or absent at regular intervals. All three treatment conditions were compared with usual care. Results: Simulated presence and preferred music both proved effective in reducing counts of physically agitated behaviors. Simulated presence, but not music, resulted in significantly reduced counts of verbally agitated behaviors. The placebo tape proved more effective than expected. Participants' responses to simulated presence and music varied widely. Behavior counts fell by one-half or more in many cases. Other residents became more agitated. Conclusion: Participants' better-than-expected responses to the placebo tape suggest that even the simplest technology can improve the lives of confused, disturbed nursing home residents. Of the two psychosocial treatments, preferred music tapes were easier to make and were clearly helpful in many instances. By contrast, family members often struggled to recall enough happy memories to compile a simulated presence tape. Simulated presence might prove just as effective if relatives speak on topics of their own choosing. Although not all residents were helped by these treatments, adverse effects were mild and shortlived.