非正式照顧者接受溝通技巧訓練對於失智症病人照顧之成效

The Effects of Communication Skills Training on Patient Care of Dementia among the Informal Caregivers

失智症照顧過程中若照顧者和病人有良好溝通互動，可減少彼此衝突及提高病人生活品質。因此，本文以文獻回顧方式探討溝通技巧訓練對於非正式照顧者照顧失智症病人之成效。結果發現每週執行一次，每次45-150 分鐘( 平均98.3 分)，至少持續2 週以上之溝通技巧訓練對於輕度或中度失智症病人之非正式照顧者有其成效，訓練內容包括FOCUSED、TANDEM、RECAPS 和MESSAGE、TRACED 溝通訓練、溝通技巧訓練工作坊、言語講話指導課程、心理教育介入等。介入措施執行者以專業的語言病理治療師最為常見，溝通訓練大部份以團體型式進行，訓練方法主要透過錄音錄影、角色扮演之溝通問題討論。溝通技巧訓練介入後可顯著的增加非正式照顧者對於失智症溝通知識、改善有效溝通技巧及策略使用、降低溝通困擾及溝通困難之干擾感受程度、減少ADL 和IADL 照顧困擾及負向情緒、改善溝通和記憶問題，以及增加與失智症病人溝通之自我效能。然而溝通技巧訓練對於失智症病人行為問題、照顧者溝通態度及溝通困難感受、照顧者壓力、照顧者負荷、生活品質及幸福感、照顧者憂鬱及照顧者健康狀況等未能達到顯著的改善。期待本文能提供規劃失智症照顧者溝通技巧訓練之參考，並期許增加非正式照顧者與失智症病人間有效的互動，以提升照顧品質，亦減少非正式照護人員的負擔。

When caregivers and patients have good communication and interaction with one another during dementia care process, conflict can be reduced and the quality of life for the elderly with dementia will be improved. Therefore, this literature review was to explore the effects of the communication skill training on dementia care among informal caregivers. The communication skill training has been shown to be effective among informal caregivers who provided care for patients with mild to moderate dementia. Implementation of training usually was once a week, 45-150 minutes (mean 98.3 minutes) per session for at least 2 weeks. Communication skill training included FOCUSED, TANDEM, RECAPS and MESSAGE, TRACED, communication skills training workshops, speech-language orientation program, and psycho-educational intervention. The most common interventional performer was professional speech language pathologist. The most common type of communication training was group model. Training methods were mainly through video recordings, role play of communication, and discussion. Communication skill training is an intervention that can improve knowledge about dementia and communication skills for informal caregivers, increasing the effectiveness of communication skills and the use of communication strategies, to reduce distress and feeling of communication difficulties, to decrease ADL and IADL care problems, to minimize negative emotions, to improve communication and memory problems, and to increased self-efficacy of communication with dementia. However, the improvement in behavioral problems were insignificant, including attitudes of caregivers communication difficulties, caregiver stress, caregiver burden, quality of life and happiness, or caregiver depression and caregiver health status. The results provided communication skill training for inform caregivers with the hope to increase interaction between caregivers and patients, and improve care quality and reduce the burden of informal caregivers.