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DOI: 10.1055/s-0030-1266137
Wirksamkeit eines beschäftigungstherapeutischen Gruppenangebots bei degenerativen Demenzen: Eine kontrollierte Verlaufsstudie im Pflegeheim
Efficacy of an Occupational Group Therapy in Degenerative Dementias: A Controlled Study in the Nursing Home SettingPublication History
Publication Date:
19 May 2011 (online)
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Zusammenfassung
Anliegen Erforschung der Wirksamkeit eines beschäftigungstherapeutischen Gruppenangebots auf alltagspraktische Fähigkeiten und demenzassoziierte Symptome. Methode In einer kontrollierten 6-monatigen Studie wurden 56 Demenzkranke zu 2 Zeitpunkten mit verblindeten Leistungstests untersucht und regressionsanalytisch ausgewertet. Ergebnisse Die Therapie hat einen signifikant positiven Effekt auf die alltagspraktischen Fähigkeiten und auf die Stimmung, keinen Effekt auf die Kognition. Schlussfolgerung Um alltagspraktische Fähigkeiten länger zu erhalten, müssen diese gezielt trainiert werden.
Abstract
Objective We investigated the effectiveness of an occupational group therapy, tailored to dementia patients, performed regularly 6 days a week, on everyday-practical capabilities and dementia-related behavior. Methods Fifty-six dementia patients in one nursing home in Northern Bavaria (Germany) were observed for 6 months: 28 patients in a therapy group and 28 patients in a matched controlled group. Performance tests, ADAS-kog and E-ADL-Test, were carried out blinded. Data were analyzed using adjusted mean differences for baseline and 6-months follow-up data and multiple regression analysis. Results The therapy leads to stabilization of everyday-practical capabilities (adjusted mean difference 4.0; 95 % CI 1.6–6.3; p = 0.002) and of dementia-related behavior (adjusted mean difference –6.8; 95 % CI –11.8––1.8; p = 0.009) compared to deterioration in the control group who received treatment as usual. The effect power (Cohen d) on everyday-practical capabilities is |0.83|. The therapy had no significant effect on cognitive capacity. Conclusions An occupational therapy program directed particularly to everyday-practical activities cannot slow the progression of all dementia-related symptoms, but has a main target effect on everyday-practical capabilities.
Schlüsselwörter
Demenz - Beschäftigungstherapie - kontrollierte Studie - Pflegeheim
Keywords
dementia - occupational therapy - controlled study - nursing home
Literatur
- 1 IQWiG .Cholinesterasehemmer bei Alzheimer Demenz. Abschlussbericht A05–19A.. Köln: IQWiG; 2007
- 2 Großfeld-Schmitz M, Kornhuber J, Gräßel E. Nichtmedikamentöse Therapie der Demenzen. Psychiatr Psychother up2date. 2008; 2 213-224
- 3 Quayhagen M P, Quayhagen M, Corbeil R R et al. A dyadic remediation program for care recipients with dementia. Nurs Res. 1995; 44 153-159
- 4 Rolland Y, Pillard F, Klapouszczak A et al. Exercise program for nursing home residents with Alzheimer’s disease: A 1-year randomized, controlled trial. J Am Geriatr Soc. 2007; 55 158-165
- 5 Gitlin L N, Winter L, Dennis M P et al. A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: the COPE randomized trial. JAMA. 2010; 304 983-991
- 6 Tárraga L, Boada M, Modinos G et al. A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006; 77 1116-1121
- 7 Onor M L, Trevisiol M, Negro C et al. Impact of a multimodal rehabilitative intervention on demented patients and their caregivers. Am J Alzheimers Dis Other Demen. 2007; 22 261-272
- 8 Chapman S B, Weiner M F, Rackley A et al. Effects of cognitive communication stimulation for Alzheimer’s disease patients treated with Donezepil. J Speech Lang Hear Res. 2004; 47 1149-1163
- 9 Andersen C K, Wittrup-Jensen K U, Lolk A et al. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes. 2004; 2 52
- 10 Riedel-Heller S G, Bramesfeld A, Roick C et al. Der Ruf nach mehr Versorgungsforschung. Psychiat Prax. 2008; 35 157-159
- 11 IQWiG .Nichtmedikamentöse Behandlung der Alzheimer Demenz Abschlussbericht A05–19D.. Köln; 2009: 1-405
- 12 Folstein M, Folstein S, McHugh P. „Mini-Mental State“: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12 189-198
- 13 Reisberg B, Ferris S H, de Leon M J et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982; 139 1136-1139
- 14 Rosen W G, Mohs R C, Davis K L. A new rating scale for Alzheimer’s disease. Am J Psychiatry. 1984; 141 1356-1364
- 15 Graessel E, Viegas R, Stemmer R et al. The Erlangen Test of Activities of Daily Living: first results on reliability and validity of a short performance test to measure fundamental activities of daily living in dementia patients. Int Psychogeriatr. 2009; 21 103-112
- 16 Spiegel R, Brunner C, Ermini-Fünfschilling D et al. A new behavioral assessment scale for geriatric out- and in-patients: the NOSGER (Nurses’ Observation Scale for Geriatric Patients). J Am Geriatr Soc. 1991; 39 339-347
- 17 Hedges L V, Olkin I. Statistical methods for meta-analysis.. Orlando: Academic Press; 1985
- 18 Cohen J. Statistical power analysis for the behavioral sciences.. New York: Academic Press; 1969
- 19 Gitlin L N, Winter L, Burke J et al. Tailored activities to manage neuropsychiatric behaviors in persons with dementia and reduce caregiver burden: a randomized pilot study. Am J Geriatr Psychiatry. 2008; 16 229-239
Sabine Pickel, cand. med.
Psychiatrische Universitätsklinik
Schwabachanlage 6
91054 Erlangen
Email: sabine.pickel@gmail.com