機構失智症長者現實導向認知刺激團體之成效

The Effects of Reality Orientation Based Cognitive Stimulation Group for Institutional Senior With Dementia

目前國外對於現實導向認知刺激運用於失智症長者健康促進方面的研究較為豐碩；反觀國內對於失智症現實導向團體成效的研究較為缺少。本研究根據國外系統性實證文獻回顧結果，發展一套失智症現實導向認知刺激團體方案並加以介入，其目的在於了解方案介入對失智症長者認知功能與憂鬱情形的影響。本研究採用準實驗研究法，參與對象為生活在長照機構失智專區中度以上失智症長者，實驗組參與現實導向認知刺激團體活動，控制組參加一般性健康操團體活動，經14次團體活動後評估其成效。在認知功能方面，組內與組間比較皆未達顯著水準，但組間效果量達中度效果，具維持認知成效；在憂鬱情形方面，組內及組間比較未達顯著，但組間效果量達高度效果，且組間基準線較達顯著水準，顯示或許有助於改善失智長者的憂鬱情形。本研究認為現實導向認知刺激團體活動對於失智症長者憂鬱情形或許具有改善效果，對於認知功能退化則具有延緩的效果。

The positive affect of reality orientation therapy to the people with dementia (PD) has been well established, but such research was rarely found in Taiwan. Based on system review, the aim of the paper was to test if reality-oriented cognitive stimulus group program affect cognitive function and depression status in PD. The quasi-experiment design was used in the study. The participants included experimental group received reality-oriented cognitive stimulus, and the control group received general physical activity. Both groups run 14 sessions totally. The results indicated that: (1) For cognitive function, the statistical differences of between-groups and within-group were not significant, but the effect size between the groups was moderate. (2) For depression status, the statistical differences of between-group and within-group were also not significant, but the effect size of between-groups difference was high. Furthermore, the percentage post-test exceed the baseline in treatment group was significantly higher than control group. In conclusion, the program of reality oriented cognitive stimulus group would probably decrease depression status and delay cognitive degradation in the elderly with dementia.