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題名：職能治療計畫介入對日間照顧中心失智症患者日常與社交功能以及照顧者負荷之成效探討
書刊名：臺灣職能治療研究與實務雜誌
作者：柯宏勳／黃妍華／李美慧／吳菁宜／李冠逸／謝妤葳
作者(外文)：Ko, Hung-hsuin／Huang, Yan-hua／Li, Mei-hui／Wu, Ching-yi／Li, Kuan-yi／Hsieh, Yu-wei
出版日期：2013
卷期：9:2
頁次：頁113-125
主題關鍵詞：失智症；職能治療；日間照顧中心；隨機對照研究；Dementia；Occupational therapy；Day care；Randomized control trial
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(1) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:12
  • 點閱點閱:10
目的：臺灣隨著年齡層提高及人口老化速度加快，失智症盛行率也隨著增加。八成以上的失智症患者都在社區，除了藥物治療，急需發展良好的措施及服務模式，以促進患者的身心健康，減輕照顧者的負擔。本研究探討以職能治療計畫介入對於日間照顧中心失智症患者日常生活、社交功能以及照顧者負荷之成效。方法：研究為前後測之實驗設計，符合選入標準之受試者被隨機分配至實驗組及控制組，介入時間為十週職能治療計畫。分別有實驗組23位（平均年齡79.22歲，6位男性、17位女性）及控制組19位（平均年齡81.58歲，9位男性、10位女性）完成整個介入過程。治療前後分別接受「失智症功能障礙評估量表」、「失智症生活品質評估量表」、「失智症照顧者的負荷調查表」與「溝通及互動技巧評量表」四種量表評估，以探討日間照顧中心失智症患者日常生活與社交功能及照顧者負荷之成效。結果：在「失智症功能障礙評估量表」（DAD）部分，介入後實驗組顯著高於控制組（p
The prevalence of dementia is increased in Taiwan in recent years due to rising life expectancy and increasing rate of population aging. More than 80% of dementia patients live in the community, not in institutions. It is urgent to develop feasible strategies and services to reduce the burden of caregivers and enhance physical and mental health of the patient beyond medication. The effect of occupational therapy on activities of daily living and social function in people with dementia and their caregivers were investigated. The study used a randomized pre-test and post-test control group design. Eligible participants were randomly assigned to the experimental group (OT group) or the control group. The intervention lasted ten weeks.Twenty three participants in the experimental group (6 males, 17 females, mean age = 79.22 years) and 19 participants in the control group (9 males, 10 females, mean age = 81.58 years) completed the entire intervention. No significant difference in the demographic data was found between these two groups except the duration of received day-care services. Analyses of covariance (ANCOVAs) were used to assess the effectiveness of the occupational therapy. The experimental group showed significantly higher score in Disability Assessment for Dementia (DAD) than the control group (p ＜ .001). In the Quality of Life in Alzheimer s Disease (QOL-AD), the average rating of the experimental group was higher than that of the control group after intervention, but not statistically significant (p = .09); average rating from the caregiver of the experimental group was significantly higher than that of the control group (p = .03). In the Chinese version of the Zarit Burden Interview (CZBI), the experimental group showed significantly lower score than the control group (p = .03). In the Assessment of Communication and Interaction Skills (ACIS), the score of the experimental group was significantly higher than that of the control group (p ＜ .01).The results showed that occupational therapy could improve daily function and quality of live (based on caregiver s perspective) of dementia patients. Caregiver burden was reduced, and social interaction and communication skills were enhanced compared to the control group.This study shows that occupational therapy intervention can improve activities of daily living, social function, and quality of life in people with dementia in day-care centers. In addition, caregiver burden could also be reduced. Hopefully, this study could provide better understanding of the role of caregivers in day-care centers, and assist therapists to manage activities matching patients' needs. Occupational therapists can improve physical and mental health of dementia patients by their professional knowledge and develop better strategies for community care.
期刊論文
1.黃敏鳳、徐亞瑛、楊培珊、葉炳強(20040100)。失智症患者及家庭照顧者接受日間照護之服務需求情形探討。長期照護雜誌，7(4)，355-370。  延伸查詢new window
2.邱逸榛、李怡濃、徐文俊、陳獻宗、李佳琳、王鵬智(20100800)。失智症家庭照顧者睡眠障礙及其相關因素。護理雜誌，57(4)，29-39。new window  延伸查詢new window
3.羅鈞令、毛慧芬、吳明宜(20041000)。職能治療人力在各新興領域之需求。職能治療學會雜誌，22，43-55。  延伸查詢new window
4.Carswell, A.、Estwood, R.(1993)。Activities of daily living, cognitive impairment and social function in community residents with Alzheimer disease。Canadian Journal of Occupational Therapy，60(3)，130-136。  new window
5.Collins, C.、King, S.、Kokinakis, C.(1994)。Community service issues before nursing home placement of persons with dementia。Western Journal of Nursing Research，16(1)，40-56。  new window
6.Crabtree, J. L.(1998)。The end of occupational therapy。American Journal of Occupational Therapy，52，205-214。  new window
7.Darzins, P.、Fone, S.、Darzins, S.(2006)。The international classification of functioning, disability and health can help to structure and evaluate therapy。Australian Occupational Therapy Journal，53(2)，127-131。  new window
8.Dooley, N. R.、Hinojosa, J.(2004)。Improving quality of life for persons with Alzheimer's disease and their family caregivers: Brief occupational therapy intervention。American Journal of Occupational Therapy，58(5)，561-569。  new window
9.Egan, M.、Hobson, S.、Fearing, V. G.(2006)。Dementia and occupation: A review of the literature。Canadian Journal of Occupational Therapy，73(3)，132-140。  new window
10.Forsyth, K.、Lai, J. S.、Kielhofner, G.(1999)。The assessment of communication and interaction skills (ACIS):Measurement properties。British Journal of Occupational Therapy，62(2)，69-74。  new window
11.Fuh, J. L.、Wang, S. J.(2006)。Assessing quality of life in Taiwanese patients with Alzheimer's disease。International Journal of Geriatric Psychiatry，21(2)，103-107。  new window
12.Gelinas, I.、Gauthier, L.、McIntyre, M.、Gauthier, S.(1999)。Development of a functional measure for persons with Alzheimer's disease: The disability assessment for dementia。The American Journal of Occupational Therapy，53(5)，471-481。  new window
13.Graff, M. J. L.、Vernooij-Dassen, M. J. M.、Thijssen, M.、Dekker, J.、Hoefnagels, W. H. L.、Olde Rikkert, M. G. M.(2006)。Community based occupational therapy for patients with dementia and their care givers: Randomised controlled trial。British Medical Journal，333(7580)，1196-1201。  new window
14.Graff, M. J. L.、Vernooij-Dassen, M. J. M.、Thijssen, M.、Dekker, J.、Hoefnagels, W. H. L.、Olde Rikkert, M. G. M.(2007)。Effects of community occupational therapy on quality of life, mood, and health status in dementia patients and their caregivers: A randomized controlled trial。Journals of Gerontology Series A-Biological Sciences and Medical Sciences，62(9)，1002-1009。  new window
15.Hemmingsson, H.、Jonsson, H.(2005)。The issue is-An occupational perspective on the concept of participation in the international classification of functioning, disability and health-Some critical remarks。American Journal of Occupational Therapy，59(5)，569-576。  new window
16.Horowitz, B. P.、Chang, P. F.(2004)。Promoting well-being and engagement in life through occupational therapy lifestyle redesign: A pilot study within adult day programs。Topics in Geriatric Rehabilitation，20(1)，46-58。  new window
17.Ko, K. T.、Yip, P.-K.、Liu, S.-I.、Huang, C. R.(2008)。Chinese Version of the Zarit Caregiver Burden Interview: A validation study。American Journal of Geriatric Psychiatry，16(6)，513-518。  new window
18.Matuska, K.、Giles-Heinz, A.、Flinn, N.、Neighbor, M.、Bass-Haugen, J.(2003)。Outcomes of a pilot occupational therapy wellness program for older adults。American Journal of Occupational Therapy，57(2)，220-224。  new window
19.Mok, C. C. M.、Siu, A. M. H.、Chan, W. C.、Yeung, K. M.、Pan, P. C.、Li, S. W.(2005)。Functional disabilities profile of Chinese elderly people with Alzheimer's disease-A validation study on the Chinese version of the disability assessment for dementia。Dementia and Geriatric Cognitive Disorders，20，112-119。  new window
20.Monahan, D. J.(1993)。Utilization of dementiaspecific respite day care for clients and their caregivers in a social model program。Journal of Gerontological Social Work，20(3/4)，57-70。  new window
21.Toseland, R. W.、McCallion, P.(1999)。Use of health and human and human services by community residing people with dementia。Social Work，44(6)，535-548。  new window
22.Wilcock, A. A.(1998)。Reflections on doing, being, and becoming。Canadian Journal of Occupational Therapy，65，248-257。  new window
23.甄瑞興、周歆凱、蔡明足、王心怡、林於諍、郭穎樺、謝佩秀、吳宗燕、劉秀雯、翁林仲(20101200)。多層面模式之失智症照護經驗。北市醫學雜誌，7(4)，424-434。  延伸查詢new window
24.戴玉慈、葉炳強、黃貴薰、羅美芳(19990500)。住院年老病患的認知功能。臺灣醫學，3(3)，279-286。  延伸查詢new window
25.林淑錦、白明奇(20061200)。失智症病患主要照顧者的壓力--以家庭生態觀點論之。長期照護雜誌，10(4)，412-425。  延伸查詢new window
26.于漱、吳淑瓊、楊桂鳳(20030900)。失智症患者的長期照護服務模式。長期照護雜誌，7(3)，251-264。  延伸查詢new window
27.Clark, F.、Azen, S. P.、Zemke, R.、Jackson, J.、Carlson, M.、Mandel, D.(1997)。Occupational therapy for independent-living older adults: A randomized controlled trial。Journal of the American Medical Association，278(16)，1321-1326。  new window
28.謝美娥(20050900)。失智症日間照顧服務使用狀況與其評估--以嘉義聖馬爾定與三鶯地區健順失智症日間照顧中心為例。中華心理衛生學刊，18(3)，39-69。new window  延伸查詢new window
29.Logsdon, R. G.、Gibbons, L. E.、McCurry, S. M.、Teri, L.(1999)。Quality of life in Alzheimer's disease: patient and caregiver reports。Journal of Mental Health and Aging，5(1)，21-32。  new window
研究報告
1.陳榮基(2004)。台灣失智症機構照顧需求之調查--長期照護機構失智症患者之盛行率調查初步成果報告。台北市：行政院衛生署。  延伸查詢new window
學位論文
1.李薇(2007)。失智老人社會心理適應的護理人類學研究(碩士論文)。慈濟大學，花蓮。  延伸查詢new window
圖書
1.Forsyth, K.、Salamy, M.、Simon, S.、Kielhofner, G.(1998)。A user's guide to the Assessment of Communication and Interaction Skills。Chicago：UIC。  new window
2.邱銘章、湯麗玉(2006)。失智症照護指南。臺北市：原水文化出版社。  延伸查詢new window
 
 
 
 
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