• Title/Summary/Keyword: 초조행동

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Effects of Music Therapy on Cognitive function and Agitation, Anxiety and Depression in Dementia Elderly: a Systematic Review and Meta-analysis of Randomized Controlled Trials (음악요법이 치매노인의 인지기능, 초조행동, 불안 및 우울에 미치는 효과: 체계적 고찰 및 메타분석)

  • Chai, Gong Ju;Lee, Mi-Kyung;Nam, Eun Sook;Lee, Ho Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.520-530
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    • 2021
  • Objectives: This study aimed to identify the effects of music therapy on cognitive function, agitation, anxiety and depression in the elderly with dementia. Method: A comprehensive literature search was performed on PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar and PsycINFO, for the period 2010 to 2019. In the meta-analysis, the standardized mean difference (Hedges' g) and 95% confidence interval were calculated as summary measure, and the random effect model and inverse variance method were applied using the RevMan 5.4 program. A total of 13 studies were included; all were determined to be acceptable, based on the Cochrane collaboration's tool for assessing risk of bias. Results: The effect size (Hedges' g) was 0.31 (95% CI: -0.02, 0.65) for cognition and -0.03 (95% CI: -0.17, 0.11) for agitation behavior as the primary outcomes, and 0.61 (95% CI: -1.17, -0.05) for anxiety and -0.44(95% CI: -0.88, 0.00) for depression as the secondary outcomes. Subgroup analysis by type of music intervention revealed that combined music therapy has a significantly increasing beneficial effect on cognition of dementia patients (g=0.45[95% CI: 0.03, 0.87]). Conclusion: Music therapy was determined to exert beneficial effects in reducing anxiety and depression, and combined music therapy demonstrated improved cognitive functions in elderly patients with dementia.

Effects of Aromatherapy on Agitation in Patients with Dementia: A Systematic Literature Review and Meta-analysis (아로마 요법이 치매 환자의 초조행동에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Eun Kyung;Park, Heeok;Lee, Chun Hee;Park, Eunsil
    • Research in Community and Public Health Nursing
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    • v.30 no.2
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    • pp.183-194
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    • 2019
  • Purpose: The purpose of this study is to identify the effects of aromatherapy on agitation in patients with dementia using a meta-analysis and systemic literature review. Methods: The EMBASE, CINAHL, MEDLINE, and other databases were searched up to November 2017. Results: Of 419 publications identified, 12 met inclusion criteria, and 9 studies were used to estimate the effect size of aromatherapy. A total of 837 participants across all studies were included. The commonly applied methods were massage (50%), type of oil lavender (75%), and instrument Cohen-Mansfield Agitation Inventory (75%). A medium effect size of aromatherapy on agitation was identified (d=-0.56, $I^2=65.0%$, p=.001). The massage group has lower effect size than the other group (d=-0.98, $I^2=0.0%$, p=.001). Conclusion: Aromatherapy appears to be effective in improving agitation in patients with dementia. However, further studies for home-dwelling patients with dementia and with different types of aroma oil should be conducted in the future. In addition, research with well-designed are needed to assess the effects or aromatherapy on agitation.

Correlation between Behavioral Psychological Symptoms and Caregiver Burden in Alzheimer's Disease (알츠하이머병에서 행동심리증상과 간병인의 부양부담 사이의 상관관계)

  • Kim, Yo Sup;Lee, Kang Joon;Kim, Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.200-207
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    • 2016
  • Objectives : Alzheimer's disease(AD) is characterized by progressive decline of cognitive function and also by various behavioral psychological symptoms of dementia(BPSD) which causes distress to their caregivers. The purpose of this study was to investigate association between each AD patients' behavioral psychological symptoms and their caregivers' burden. Methods : Participants were 80 AD patients and their caregivers. We used Korean neuropsychiatric inventory (K-NPI) to assess the symptoms of patients and Korean version of Zarit Burden Interview(ZBI) to evaluate caregivers' burden. Results : The results showed ZBI score, which is the index for caregivers' burden, had a statistically significant positive correlation with the frequency of delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition and irritability, the severity of hallucination, agitation/aggression, anxiety, disinhibition, aberrant motor, and sleep, and the global score(frequency${\times}$severity) for delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition, aberrant motor, and sleep. There were significant correlations between each scale for cognitive function(i.e. MMSE-KC, CDR, GDS) and ZBI scale. Correlations between each scale for activity of daily living(i.e. Barthel -ADL, K-ADL) and ZBI scale were also significant. Conclusions : There were a significant correlation between BPSD and caregiver burden. Caregiver burden was also correlated with cognitive function and activity of daily living. Early detection and preventive treatment of these symptoms in BPSD might make improvement of caregivers' quality of life as well as AD patients'.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

Effects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-analysis (음악요법이 치매의 초조행동에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kong, Eun-Hi;Park, Myonghwa
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.106-116
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    • 2015
  • Purpose: The purpose of this review was to assess the quality and to evaluate the effectiveness of music interventions in reducing agitation in older adults with dementia. Methods: Randomized controlled studies and randomized crossover studies were identified by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AGELINE, Cochrane Central Register of Controlled Trials, Korea Med, Kmbase, RISS, National Assembly Digital Library, KISS, and RICH. Two reviewers independently retrieved articles, extracted data, and assessed the quality of studies. Results: In total, 10 studies were selected from 1095 unique citations. All included studies were conducted in long term care settings. Overall, risk of bias for included studies was low to moderate. The weighted average effect size across studies was -0.39 (95%CI [-0.69, -0.10], p=.009, $I^2=63%$). Music therapy was effective to reduce agitation of the older adults with dementia. Conclusion: Music intervention can be an effective non-pharmacological intervention for the reduction of agitation in dementia. Future studies need to use rigorous research method and to provide description of research methods in greater detail. In addition, future studies are required to explore the effects of music therapy according to severity of agitation and dementia.

A Meta-Analysis of the Variables related to Agitation in Patients with Dementia (치매 환자의 초조행동 관련변인에 관한 메타분석)

  • Park, Heeok;Gang, Minsuk;Park, Eunsil
    • Korean Journal of Adult Nursing
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    • v.28 no.2
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    • pp.213-225
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    • 2016
  • Purpose: The purpose of this study was to provide basic data about agitation in patients with dementia by surveying the literature. Method: Key words used for search through hand-search and electronic database (CINHAL, Pubmed, Google scholar, Riss, Kiss, DBpia) included 'dementia', 'Alzheimer disease', 'agitation', 'aggression or aggressive behavior', 'problem or disruptive behavior', and 'abnormal behavior.' Seventeen studies met the inclusion criteria for the Meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that variables related to agitation were identified as the demographic (age, gender), dementia-related (cognition, medication uses), physical (Activity of Daily Living [ADL], pain), psychological (depression, psychotic symptom, caregiver burden) and environmental (psychosocial environment) factors. The effect size between the correlated variables and agitation were low to moderate (caregiver burden .36; ADL -.24; psychotic symptom and depression .21; pain .19; cognition -.15; medication uses .12; and psychosocial environment -.12). Conclusion: Based on the findings of this study, strategies to improve patients' depressive and psychotic symptoms and ADL and to reduce caregivers' burden are needed for prevention and management of agitation in patients with dementia.

The Effect of Hand-Massage on the Relaxation of Dementia Patients (치매환자에 대한 손마사지 효과 연구)

  • Oh, Jin-Joo
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.825-835
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    • 2000
  • The agitation of dementia patient is a factor which aggravates the care-givers' burdon, and it is needed to develop intervention methods. Hall and Buckwalter hypothesized that an increase in agitation behavior occur when persons experience high levels of stress. This study was conducted to explore the efficacy of hand massage in producing relaxation and decreasing agitation behaviors in persons with dementia. Hand massage was administered once a day in afternoon for 8days to 24 patients and 4days to 23 patients. There was no difference in result between the two groups. Significant differences were found in systolic blood pressure, pulse rate, emotional state from pre to post -intervention with the use of hand massage. The change of systolic blood pressure was 26% explained by ADL, MMSE-K and institutionalized period. The most significant variable was institutionalized period. The change of diastolic blood pressure was 11% explained by ADL, and it was significant. But no decrease in agitation behavior was observed and no increase in functional capacity.

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Coping with dementia related behavior problems of the elderly and care providers (치매노인 문제행동과 간호제공자의 대처행동 관계)

  • Lim, Dong Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4805-4815
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    • 2015
  • Dementia is targeted at the elderly and dependent family members, care providers, and the types of problem behaviors of the elderly with dementia by care providers learn how to cope with the relationship was tried for. Dementia in the elderly problem behaviour is the program's descriptive statistics, t-test, ANOVA, and dementia in the elderly problem behaviors for coping with behavior and the relationship between discrete variable using correlation analysis. The findings support the family and nursing experience of senile elderly issues, acting as a provider edge actions appeared the most high, and repeat the same question or request. ', ' Making loud noises or shouting. ' and '. 'Being stubborn, not listening to the words of the caregiver.' etc. In addition, this study, which appeared in dementia in the elderly cope with behavior based on behavioral problems and discuss the ' Verbal discussion ', ' Removal of the cause for incidents ' and ' Restriction of actions ' action causes this correlation. Therefore, caring for the elderly with dementia in a nursing institution and sanction providers related to dementia in the elderly appear to be frequently problem behaviors of the problematic behavior is not much need to be able to cope with the regular education, this study to the development of behavioral problems in dementia patients by an individualized nursing intervention program for caregivers caring for dementia patients, as basic materials will be provided.

Neuropsychiatric Symptoms in Patients with Mild Cognitive Impairment and Dementia of Alzheimer's Type (경도인지장애 및 알쯔하이머형 치매 환자에서의 신경정신증상)

  • HwangBo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.105-111
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    • 2012
  • Objectives : We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. Methods : A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuro-psychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. Results : The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. Conclusions : Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.

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The Effect of Nonpharmacologic Interventions on Behavioral and Psychological Symptoms of Dementia : A Meta-Analysis (치매환자의 행동심리증상에 비약물적 중재가 미치는 효과 - 메타분석)

  • Kwon, Mi-Hwa;Lee, Jae-Shin
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.540-550
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    • 2017
  • To investigate a variety of nonpharmacologic interventions have confirmed what the symptoms and effects, mainly interventions by acting on behavioral and psychological symptoms of dementia was conducted a meta-analysis. Data were collected from online search engines using search words from domestic and foreign article database. The researcher independently and among the pre-post experimental studies published from January 2000 to June 2016, recalled applying for the elderly with dementia presents the effect of treatment group and the control group RCT in this study were included in the study. The results of this meta-analysis showed that, effect size of the nonpharmacologic interventions of total -0.33, occupational therapy - 0.26, multi-sensory stimulation intervention -0.65 was significant beneficial effects to elderly with dementia(p<.05). According to interventions as a major affected the symptoms associated with behavioral problems, mainly aggression, memory-related problem behavior in the home-based program. Also, reminiscence therapy and occupational therapy is generally apathy, multi-sensory stimulation and music therapy was confirmed that there was a major change in behavior anxiety or agitation. The results of this study confirmed that various nonpharmacologic interventions were effective on behavioral psychological symptoms of dementia patients and confirmed the main symptoms of intervention.