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轻度老年认知障碍的非药物整合式干预：单个案研究 Non-pharmacological Integrated Interventions in Older Adults with Mild Cognitive Impairment: 作者：王英 1,2,3 董之晓 4 杨克虎 2 作者单位： 1. 730030 甘肃省兰州市，兰州大学哲学社会学院 2. 730030 甘肃省兰州市，兰州大学循证社会科学研究中心 3. 730030 甘肃省兰州市，兰州市社会工作协会 4. 150001 黑龙江省哈尔滨市，哈尔滨工业大学人文社科与法学学院通讯作者：杨克虎 Email:yangkh@lzu.edu.cn 提交时间： 2023-09-12 摘要: 背景认知障碍可导致老年人认知功能下降、抑郁、孤独感，以及自我效能感和生活质量的下降。目的探讨非药物整合式干预对轻度老年认知障碍患者认知功能、抑郁、孤独感、自我效能感和生活质量的干预效果。方法研究基于认知障碍的风险因素研发了认知功能训练、身体运动、情绪管理、社会连结、健康生活习惯五个维度的非药物整合式干预方案，采用 A-B-A 的单受试者类试验设计，于 2021 年 612 月展开对 3 名确诊为轻度认知障碍的老年人进行为期 3 个月，1 次 / 周，60 min/ 次的干预。于基线、干预 3 个月后、干预结束后 3 个月时采用蒙特利尔认知评估量表（MoCA）、自我效能感量表（GSES）、简版老年抑郁量表（GDS-15）、简版生活质量量表（SF-12）、中文版孤独量表（DJGLS）从认知功能、自我效能感、生活质量、抑郁情绪、孤独感 5 个维度评估 3 名老年人各量表得分并分析其变化。并在干预结束后 3 个月进行半结构式访谈，从认知功能、生活质量、抑郁情绪、自我效能感和孤独感维度评估干预效果。结果纳入研究的 3 名老年人年龄为 70~74 岁，均已婚、与配偶和孙辈共同居住。3 名老年人的 MoCA 基线得分为 21、22、24 分，干预 3 个月后为 28、26、27 分，干预结束后 3 个月为 25、19、23 分；GSES基线得分为 25、30、27 分，干预 3 个月后为 29、29、30 分，干预结束后 3 个月为 28、31、28 分。SF-12 基线时得分为 69、32、51 分，干预 3 个月后为 81、81、83 分，干预结束后 3 个月为 78、38、59 分。GDS-15 量表基线得分为 4、8、2 分，干预 3 个月后为 2、6、1 分，干预结束后 3 个月为 1、8、4 分。DJGLS 基线得分为 8、7、8 分，干预 3 个月后为 5、5、4 分，干预结束后 3 个月为 5、5、7 分。半结构访谈资料表明，受试者在认知、生活质量、抑郁、孤独感、自我效能感五个维度均有改善。结论对于患有轻度老年认知障碍的受试老年人而言，从认知功能训练、身体运动、情绪调节、社会连结、健康生活习惯开展非药物整合式的干预是意义的，轻度老年认知障碍老年人的 MoCA、SF-12、GDS-15、DJGLS 得分在干预 3 个月后均有改善，GSES 得分在干预后效果不理想，所有维度得分在干预结束后 3 个月呈递减趋势。 Abstract: Background Cognitive impairment can lead to a decline in cognitive function，depression，and loneliness，as well as decreased self-efficacy and quality of life in older adults. Objective To investigate the effects of non#2;pharmacological integrated interventions on cognitive function，depression，loneliness，self-efficacy，and quality of life in older adults with mild cognitive impairment. Methods Based on risk factors for cognitive impairment，a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training，physical exercise，emotional management，social connection，and healthy lifestyle habits. Using a single-subject A-B-A experimental design，a 3-month intervention，which was conducted once a week for 60 minutes，was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment （MoCA），Geriatric Depression Scale-15 （GDS-15），12-item Short Form Health Survey （SF-12），General Self-Efficacy Scale （GSES），and De Jong Gierveld Loneliness Scale （DJGLS） were administered to the 3 older adults at baseline，3 months of the intervention，and 3 months after the intervention，to assess the scores of each scale from the 5 dimensions of cognitive function，self-efficacy，quality of life，depression，and loneliness，the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function，quality of life，depression，self#2;efficacy，and loneliness dimensions. Results The 3 older adults included in the study were 70-74 years old，all married，living with their spouses and grandchildren. The three older adults had MoCA scores of 21，22，and 24 at baseline，28，26，and 27 at 3 months of intervention，and 25，19，and 23 at 3 months after intervention；GSES scores were 25，30，and 27 at baseline，29，29，and 30 at 3 months of intervention，and 28，31，and 28 at 3 months after intervention. SF-12 scores were 69，32，and 51 at baseline，81，81，and 83 at 3 months of intervention，and 78，38，and 59 at 3 months after intervention. The GDS-15 scale scores were 4，8，and 2 at baseline，2，6，and 1 at 3 months of intervention，and 1，8，and 4 3 months at 3 months after intervention. The DJGLS scores were 8，7，and 8 at baseline，5，5，and 4 at 3 months of intervention，and 5，5，and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function，quality of life，depression，loneliness，and self-efficacy of the subjects. Conclusion For older adults with mild cognitive impairment，it is of great significant to perform a non-pharmacological integrated intervention in terms of cognitive training，physical exercise，emotional management，social connection，and healthy lifestyle habits. The MoCA，SF-12，GDS-15，and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention，while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention. It has the potential to enhance cognitive function，quality of life，depression，and loneliness. Future randomized controlled trials are recommended to further ascertain the effectiveness of this non#2;pharmacological integrated intervention. 非药物整合式干预老年认知功能障碍生活质量抑郁孤独期刊：中国全科医学分类：医学、药学 >> 临床医学引用： ChinaXiv:202309.00122 (或此版本 ChinaXiv:202309.00122V1 ) DOI:10.12114/j.issn.1007-9572.2023.0395 CSTR:32003.36.ChinaXiv.202309.00122.V1 推荐引用方式：王英 ,董之晓,杨克虎.(2023).轻度老年认知障碍的非药物整合式干预：单个案研究.中国全科医学.doi:10.12114/j.issn.1007-9572.2023.0395 版本历史 [V1] 2023-09-12 09:03:27 ChinaXiv:202309.00122V1 下载全文

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