「憶」起幸福：社區失智長者現實導向無錯誤學習團體之成效

Remembering Happiness: Effects of Reality Orientation Program with Errorless Learning on Older Adults with Dementia

"目前國外對於現實導向、無錯誤學習等認知刺激介入失智症相關研究已具一定成效，反觀國內對於這方面實徵文獻較為缺少。本文根據國外系統性實徵文獻回顧結果，發展一套失智現實導向無錯誤學習團體方案（Reality Orientation program by Errorless Learning, ROEL）並加以介入，以了解其成效。具體而言，本研究提出二個研究目的：（1）評估現實導向無錯誤學習團體方案（ROEL）應用於社區失智長者之成效；（2）評估現實導向無錯誤學習團體方案（ROEL）應用於社區失智長者之追蹤成效。本研究採用準實驗方法，分成實驗組與控制組二組，以社區日照中心輕中度失智長者為研究對象，實驗組（n=10）採用ROEL團體活動，控制組（n=10）實施既定的健康促進團體活動。二組每週進行2次，每次1小時，共進行7週，14次團體活動。研究發現ROEL有助於認知功能及生活品質的提升，而憂鬱狀況及衰弱指數則未有顯著差異。本研究於三個月後進行追蹤後測，發現ROEL對於長者生活品質仍有良好成效，但認知功能則已無顯著效果。最後，本研究建議社區日間中心或失智據點實施ROEL團體方案，增進或維持長者的認知與生活品質。"

"Objectives: The positive effects of reality orientation therapy and errorless learning theory on people with dementia have been well established, but such research has rarely been performed in Taiwan. In this study, we developed a reality orientation program incorporating errorless learning (ROEL) for older adults with dementia and implemented it in day-care centers. Our objectives were to evaluate the immediate and follow-up effects of the program. Method: A quasi-experimental design was employed. The treatment group (n=10) participated in ROEL, and the control group (n=10) participated in general group activities. After 14 twice-weekly group sessions, we evaluated the effects of the program. Results: Analysis of covariance was used to analyze Montreal cognitive assessment (MOCA), geriatric depression scale, quality of life in Alzheimer disease (QoL-AD), and Kihon checklist results. Significant improvements were observed in cognition (MOCA) and quality of life (QoL-AD) for the treatment group relative to the control group (p<0.05). After 3 months, the QoL-AD follow-up results still indicated improvement relative to the controls. Conclusion: The ROEL improved the cognition and quality of life of people with dementia in day-care settings in Taiwan. A large randomized controlled trial is now required to validate these results."