多感官環境治療介入對失智患者行為精神症狀改善之成效探討

The Efficacy of Multi-Sensory Environment Therapy on Psychological, Behavioral Symptoms Among Elderly Patients With Dementia

背景：失智症患者的照護與治療是台灣當前最主要的醫療與社會問題之ㄧ。許多研究已驗證多感官環境治療有助於改善失智症患者的情緒症狀，並減少其干擾行為。多感官環境治療的介入技巧也已廣泛地應用於西方先進國家的臨床，但台灣尚無以失智症患者為對象進行多感官環境治療之研究。
目的：本研究探討多感官環境治療，對於改善失智症患者之行為精神症狀之成效。
方法：採類實驗研究設計，受試者為來自北部某家養護中心之失智症患者共20人，研究者先依受試者的簡易智能量表（Mini-Mental State Examination, MMSE）分數，將受試者分為輕、中、重度認知障礙，再分層隨機分派至實驗組與控制組各10位。控制組維持養護中心之常規活動及護理人員的關懷措施，實驗組則再施予每週兩次的多感官環境治療活動，每次50分鐘，共進行24次。兩組分別於治療前、治療後第6週及治療後第12週，施測神經精神病徵量表（Neuropsychatric Inventory, NPI），以評估治療的成效。
結果：實驗組於治療6週後，在NPI項目之怪異動作的改善即顯著地優於控制組；治療12週後，實驗組在NPI總分，以及怪異動作、暴躁易怒／情緒易變等項目的改善上，均顯著地優於控制組。
結論：本研究結果顯示多感官環境治療有助於改善失智老人之行為與情緒症狀，藉以提升其生活品質，進而減少照護者的負擔。

Background: The treatment and care of demented elderly represents a major medical and social issue in Taiwan. Many empirical studies have demonstrated the efficacy of applying multi-sensory environment therapy to improve mood symptoms and reduce disturbed behavior frequencies among this population. While the technique has been widely applied in various clinical settings in the West, a study focusing on the treatment efficacy of multi-sensory environment therapy has yet to be conducted in Taiwan. Purpose: The purpose of the current study was to investigate the treatment efficacy of multi-sensory environment therapy on psychological and behavioral symptomatology among elderly patients with dementia. Methods: This quasi-experimental study recruited 20 study participants from a nursing home in northern Taiwan. Treatment and control groups were arranged to contain 10 cases each. Participants were stratified by Mini-Mental State Examination (MMSE) score before random assignment to one of the two groups. The treatment group received a total of 24 sessions of multi-sensory environment therapy for 12 weeks. The control group received routine nursing home care. Researchers assessed treatment outcomes by comparing Neuropsychiatry Inventory (NPI) scores at baseline, week 6, and week 12, respectively. Results: The experimental group showed a significant improvement over the control group on the NPI item “Motor Disturbance” at week 6. The experimental group scored significantly better than the control group on overall NPI score and on NPI items “Irritability or Liability” and “Motor Disturbance” after completion of the 12-week treatment regimen. Conclusions: Multi-sensory environment therapy helps improve behavioral and emotional symptoms in elderly patients with dementia. This technique may offer the potential to both improve the life quality of this population and reduce caretaker burdens.