本文關(guān)鍵詞： MESSAGE溝通策略 團(tuán)體懷舊療法 輕度認(rèn)知功能障礙 老人 養(yǎng)老機(jī)構(gòu)　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究依據(jù)先前國(guó)內(nèi)外研究中所運(yùn)用的懷舊療法方案,結(jié)合我國(guó)社會(huì)文化背景,針對(duì)吉林省長(zhǎng)春市養(yǎng)老機(jī)構(gòu)輕度認(rèn)知功能障礙(MCI)老人,以MESSAGE溝通策略為原型,擬設(shè)計(jì)出適用于本地區(qū)養(yǎng)老機(jī)構(gòu)MCI老人的具有中國(guó)特色的、并融入低水平多媒體技術(shù)的團(tuán)體懷舊療法方案,并評(píng)估該方案對(duì)MCI老人認(rèn)知功能、生活質(zhì)量的干預(yù)效果,以期尋找能夠延緩MCI老人認(rèn)知障礙發(fā)展,降低其向癡呆轉(zhuǎn)變的有效途徑。方法:本研究為類實(shí)驗(yàn)性研究,研究對(duì)象為養(yǎng)老機(jī)構(gòu)60歲以上MCI老人,干預(yù)組26人,對(duì)照組27人。干預(yù)組實(shí)施每次60~90分鐘,每周1次,連續(xù)12周的經(jīng)MESSAGE溝通策略引導(dǎo)所制定的團(tuán)體懷舊療法方案;對(duì)照組沒有接受任何干預(yù)措施。干預(yù)前采用日常生活能力量表(ADL)、老年抑郁量表(GDS)、簡(jiǎn)易智力狀態(tài)檢查量表(MMSE)、北京版蒙特利爾認(rèn)知評(píng)估量表(Mo CA)、中文版健康狀況問卷(SF-36)來評(píng)估MCI老人的基線資料,干預(yù)6周后和12周后這兩個(gè)時(shí)間段采用北京版Mo CA、中文版SF-36來評(píng)估團(tuán)體懷舊療法對(duì)MCI老人認(rèn)知功能和生活質(zhì)量的干預(yù)效果。結(jié)果:1.一般資料對(duì)兩組MCI老人的年齡、性別、婚姻狀況、文化程度、職業(yè)、宗教信仰、吸煙情況、飲酒情況、患病情況、遺傳史一般資料進(jìn)行對(duì)比,結(jié)果顯示差異不具有統(tǒng)計(jì)學(xué)意義(P0.05),兩組具有可比性。2.認(rèn)知功能干預(yù)前兩組MCI老人的Mo CA總分及各維度得分比較差異不具有統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)組MCI老人在干預(yù)6周后和12周后的Mo CA總分均有所提高,與對(duì)照組相比差異具有統(tǒng)計(jì)學(xué)意義(P0.05),且Mo CA總分的干預(yù)主效應(yīng)和時(shí)間主效應(yīng)存在交互效應(yīng)(P0.05);其中語(yǔ)言和延遲回憶這兩個(gè)維度得分高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),且延遲回憶維度得分會(huì)隨時(shí)間變化呈現(xiàn)上升趨勢(shì);雖然定向力維度得分與對(duì)照組相比差異具有統(tǒng)計(jì)學(xué)意義(P0.05),但是兩組MCI老人得分均隨時(shí)間變化呈現(xiàn)下降趨勢(shì),且對(duì)照組得分仍然低于干預(yù)組。3.生活質(zhì)量干預(yù)前兩組MCI老人的生活質(zhì)量各維度得分比較差異不具有統(tǒng)計(jì)學(xué)意義(P0.05)。干預(yù)組MCI老人干預(yù)6周后的一般健康狀況、精力、精神健康這三個(gè)維度得分均有所提高,與對(duì)照組相比差異具有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)組MCI老人干預(yù)12周后的一般健康狀況、精力、情感職能、精神健康這四個(gè)維度得分高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);且一般健康狀況、精力、情感職能、精神健康這四個(gè)維度的干預(yù)主效應(yīng)和時(shí)間主效應(yīng)均存在交互效應(yīng)(P0.05),其中兩組MCI老人的精神健康維度得分均隨時(shí)間變化呈現(xiàn)上升趨勢(shì),但對(duì)照組得分仍然低于干預(yù)組。結(jié)論:MESSAGE溝通策略引導(dǎo)下的團(tuán)體懷舊療法在短期內(nèi)可以提高養(yǎng)老機(jī)構(gòu)MCI老人的認(rèn)知功能,改善其生活質(zhì)量,從而延緩認(rèn)知障礙發(fā)展的進(jìn)程,降低癡呆發(fā)生的風(fēng)險(xiǎn)。同時(shí),低水平多媒體技術(shù)的使用能夠豐富活動(dòng)主題內(nèi)容,為老人提供視覺和感官的雙重刺激,增加了團(tuán)體懷舊活動(dòng)的樂趣和吸引力。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.74

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