Abstract:
A major proportion (90 %) of patients with Alzheimer\'s disease and related disorders develop during the disease at least one of the Behavioral and Psychological Symptoms of Dementia (BPSD). BPSD often leads to complications for patients (hospitalization, institutionalization). Caregivers are often family members, and it may be difficult for them to manage the disruptive behavior or apathy of their loved ones. This situation often generates physical and psychological symptoms. The Nice University Hospital (France) and the Bien Vieillir Nice 2030 project offer at-home non-pharmacological therapies to reduce BPSD, combined with psychoeducational sessions to improve caregiver skills. A team of psychologists went to the patients\' homes 3 times per week to provide personalized non-pharmacological therapies for the patients and educational programs for their caregivers. The monocentric feasibility study was carried out among 20 patient-caregiver pairs (over 7 months). Cohen-Mansfield Inventory Scales, Zarit Burden Interviews, Caregiver Reaction Inventories, and Dementia Quality of life interviews were performed during the study. The Mederic Alzheimer Foundation (MAF) conducted an external evaluation of the project. Analysis of the results showed a significant reduction (p ≤ 0,05) in the number of BPSD on the Neuropsychiatric Inventory scale (p = 0,034). As well as a significant reduction in the behavioral symptoms of agitation on the CMAI scale (p = 0,041). A non-significant reduction in caregiver burden was also noted. Even if the results are encouraging, it is essential to conduct a medico-economic analysis to validate the feasibility of the PsyDoMa model. More clinical studies are needed to conclude.
摘要:
患有阿尔茨海默病和相关疾病的患者的主要比例(90%)在疾病期间发展为至少一种痴呆的行为和心理症状(BPSD)。BPSD通常会导致患者并发症(住院,制度化)。看护者通常是家庭成员,他们可能很难管理他们所爱的人的破坏性行为或冷漠。这种情况通常会产生身体和心理症状。尼斯大学医院(法国)和BienVieillir尼斯2030项目提供家庭非药物疗法,以减少BPSD,结合心理教育课程,以提高护理人员的技能。一组心理学家每周3次前往患者家中,为患者提供个性化的非药物治疗,并为他们的护理人员提供教育计划。在20对患者-护理人员对(超过7个月)中进行了单中心可行性研究。科恩-曼斯菲尔德库存秤,ZaritBurden采访,护理人员反应清单,在研究期间进行了痴呆症生活质量访谈。MedericAlzheimerFoundation(MAF)对该项目进行了外部评估。结果分析表明,在神经精神量表(p=0.034)上,BPSD的数量显着减少(p≤0.05)。以及在CMAI量表上躁动的行为症状显着减少(p=0.041)。还注意到护理人员负担没有显着降低。即使结果令人鼓舞,必须进行医学经济学分析以验证PsyDoMa模型的可行性。需要更多的临床研究来总结。