居家痴呆症病人精神行为症状及相关因素的研究

摘要

[目的]探讨居家痴呆症病人精神行为症状及其相关因素.[方法]采用多点横断面研究设计,应用一般资料问卷、神经精神科问卷知情者版、社会支持评定量表和照顾者负担量表对152例居家痴呆症病人及其主要家庭照顾者进行测评,分析痴呆症精神行为症状的发生情况,探讨其影响因素及其对照顾者负担的影响.[结果]本组高达98.7％的痴呆症病人存在一种或多种精神行为症状,病人痴呆症病程及自理情况对精神行为症状严重性有影响(P＜0.05);最常见的精神行为症状为情感淡漠/漠不关心、抑郁/心境恶劣、夜间行为与睡眠障碍、焦虑以及食欲/进食异常;社会支持3个维度中,客观支持对精神行为症状的影响大;精神行为症状对照顾者生理性负担的影响最大.[结论]我国居家痴呆症病人精神行为症状及各单项症状的患病率均较高,提示精神行为症状管理与干预措施的制定应针对病人具有挑战性的行为,基于研究证据,依托于社区,同时适合我国国情、符合我国传统文化,这样才可能有较好的有效性、可及性和推广性.%Objective:To explore the behavioral and psychological symptoms of dementia (BPSD) and related factors in home patients with Alzheimers disease.Methods:Using multi-point cross-sectional study design,general data questionnaire,Neuropsychiatric Inventory-Questionnaire (NPI-Q),Social Support Rating Scale (SSRS),and Caregiver Burden Inventory (CBI) were conducted in 152 cases of home and family caregivers of dementia patients for assessment.The status quo of BPSD was analyzed and the influence of its related factors on caregiver burden was discussed.Results:There were one or more BPSD exist in the 98.7 ％ patients with dementia,and the BPSD severity was affected by the course of dementia and self-care (P＜0.05).The most common BPSD were emotional indifference/apathy,depression/dysthymia,nocturnal behavior and somnipathy,anxiety,and appetite/eating disorders.In the three dimensions of social support,objective support had great influence on the BPSD;the effect of BPSD on caregivers' physiological burden was great.Conclusions:There was a higher prevalence of BPSD and individual symptoms in home patients with Alzheimer's disease in China.The BPSD management and intervention measures which focused on the challenging behavior,based on the evidence research,relied upon the community,suit for China's national conditions,and confirmed to the Chinese traditional culture could have better efficiency,accessibility,and extension.