背景:照顾阿尔茨海默病和相关痴呆症患者的一个共同挑战是管理痴呆症(BPSD)的行为和心理症状。有效管理BPSD将提高痴呆症患者的生活质量,减轻护理人员的负担,降低医疗成本。
目的:在这篇综述中,我们寻求(1)研究与光有关的室内环境质量参数,噪音,温度,和湿度与BPSD相关,以及如何控制这些参数可以帮助管理这些症状和(2)确定该领域的当前知识状态,目前的研究空白,和潜在的未来方向。
方法:在CINAHL中进行了搜索,Embase,MEDLINE,和PsycINFO数据库,用于2007年1月至2024年2月发表的论文。我们搜索了研究与光有关的室内环境质量参数之间的关系的研究,噪音,温度,湿度和BPSD。
结果:在2020年10月的原始搜索中总共确定了3123篇论文。经过另外2次搜索和筛选,纳入了5476篇论文中的38篇(0.69%)。在包括的论文中,光是研究最多的环境因素(34/38,89%),而研究其他环境因素与BPSD之间关系的研究较少(从5/38,13%到11/38,29%)。在38项研究中,8(21%)检测了多个室内环境质量参数。在38项研究中,有6项(16%)是环境评估的唯一来源。关于躁动和光疗之间关系的发现是矛盾的,而研究BPSD与温度或湿度之间关系的研究都是观察性的。结果表明,当环境因素被认为对痴呆症患者刺激过度或刺激不足时,行为症状往往会加剧。
结论:这项范围审查的结果可能会为长期护理单位和老年人住房的设计提供信息,以支持就地老龄化。还需要更多的研究来更好地了解室内环境质量参数与BPSD之间的关系,并且需要对室内环境质量参数和行为症状进行更客观的测量。未来的一个方向是在实时评估中纳入客观感知和先进的计算方法,以启动及时的环境干预措施。更好地管理BPSD将使患者受益,看护者,和医疗保健系统。
BACKGROUND: A common challenge for individuals caring for people with Alzheimer disease and related dementias is managing the behavioral and psychological symptoms of dementia (BPSD). Effective management of BPSD will increase the quality of life of people living with dementia, lessen caregivers\' burden, and lower health care cost.
OBJECTIVE: In this
review, we seek to (1) examine how indoor environmental quality parameters pertaining to
light, noise, temperature, and humidity are associated with BPSD and how controlling these parameters can help manage these symptoms and (2) identify the current state of knowledge in this area, current gaps in the research, and potential future directions.
METHODS: Searches were conducted in the CINAHL, Embase, MEDLINE, and PsycINFO databases for papers published from January 2007 to February 2024. We searched for studies examining the relationship between indoor environmental quality parameters pertaining to light, noise, temperature, and humidity and BPSD.
RESULTS: A total of 3123 papers were identified in the original search in October 2020. After an additional 2 searches and screening, 38 (0.69%) of the 5476 papers were included. Among the included papers,
light was the most studied environmental factor (34/38, 89%), while there were fewer studies (from 5/38, 13% to 11/38, 29%) examining the relationships between other environmental factors and BPSD. Of the 38 studies, 8 (21%) examined multiple indoor environmental quality parameters. Subjective data were the only source of environmental assessments in 6 (16%) of the 38 studies. The findings regarding the relationship between agitation and
light therapy are conflicted, while the studies that examined the relationship between BPSD and temperature or humidity are all observational. The results suggest that when the environmental factors are deemed overstimulating or understimulating for an individual with dementia, the behavioral symptoms tend to be exacerbated.
CONCLUSIONS: The findings of this scoping
review may inform the design of long-term care units and older adult housing to support aging in place. More research is still needed to better understand the relationship between indoor environmental quality parameters and BPSD, and there is a need for more objective measurements of both the indoor environmental quality parameters and behavioral symptoms. One future direction is to incorporate objective sensing and advanced computational methods in real-time assessments to initiate just-in-time environmental interventions. Better management of BPSD will benefit patients, caregivers, and the health care system.