腹主動脈瘤微創手術病人之手術全期護理經驗

Perioperative Nursing Experience of a Patient Receiving a Mini-invasive AAA Stent Graft

失智症老人隨著病情的進展會逐漸喪失社交及自我照顧功能，並出現情緒及躁動行為。機器寵物輔助治療是近年來國外常用來緩解老人情緒及躁動行為的一種治療性活動，本研究目的惟探討機器寵物輔助治療對長期照護機構失智症老人情緒及躁動行為之影響。使用單組前後測設計，以立意取樣選取12位失智症老人運用機器海豹(Paro)接受團體機器寵物輔助治療，由護理人員引導失智老人與機器海豹進行語言及肢體的互動，每週2次，每次40分鐘，執行4週，以康乃爾失智者憂鬱量表與躁動行為紀錄表進行前測及第四週後測。無母數分析發現失智症老人在接受團體機器寵物輔助治療後，其前測憂鬱平均分數由13.08(SD±5.42)顯著降低至後測的2.83(SD±1.59)(z=-3.06,p=.002)；而前測躁動行為平均分數由39.67(SD±9.98)顯著地降至後測32(SD±2.89)(z=-2.55,p=.011)。透過與機器海豹的互動，失智老人的情緒和躁動行為可獲得改善，建議機器寵物輔助治療可以納入長期照護機構失智老人照護常規及活動設計中，以促進其心理健康。

Older people with dementia gradually lose social and self-care abilities as the disease progresses. These people often exhibit emotional and behavioral problems. The use of animal assisted therapy as part of a therapeutic activity to manage the emotional and agitated behaviors of older people has increased in numerous countries. The purpose of this study was to explore the effects of robot-assisted therapy on older people with dementia in long-term care facilities. This study used a one-group pretest and posttest design to evaluate the effects of robot-assisted therapy on depression and agitated behaviors among institutionalized older people with dementia. A purposive sample of 12 older people with dementia received group robot-assisted therapy that involved using Paro for 40 minutes, twice a week for 4 weeks. A nurse facilitated the verbal and body interactions between the older people with dementia and Paro. All of the participants were assessed using the Cornell Scale for Depression in Dementia (CSDD) and the Cohen-Mansfield Agitation Inventory (CMAI) at baseline and at week 4. A Wilcoxon signed-rank test indicated that the participants’ mean depression score significantly decreased from 13.08 (standard deviation [SD] ±5.42) at baseline to 2.83 (SD ± 1.59) at posttest (z = -3.06, p = .002), and the mean CMAI score also significantly decreased from 39.67 (SD ± 9.98) at baseline to 32 (SD ± 2.89) at posttest (z = -2.55, p = .011) after receiving 4-week group robot-assisted therapy. Interacting with a robot pet, such as Paro, improved both the depression and agitated behaviors of the older people with dementia. Robot-assisted therapy can be provided as a routine activity program, and demonstrates the potential to improve the mental health of older people with dementia in long-term care facilities.