The Effect Of Simulated Presence Therapy Based On Attachment Theory And Need-driven Dementia-compromised Behavior On Agitated Behaviors Of The Elderly People With Dementia

Research Purposes:1.To explore the production of personalized simulated presence videos.2.To explore the intervention effect of Simulated Presence Therapy on senile dementia patients with aggression.Research Method:1.This study construct the simulation presence video production scheme through literature review and expert consultation method and create personalized simulated presence video based on the simulation presence video production scheme,and expert consultation was conducted on its applicability.2.A randomized controlled trial was conducted to verify the intervention effect of Simulated Presence Therapy.61 patients with dementia were selected in a tertiary specialist hospital of Huzhou City and randomly divided into intervention group and control group,30 cases in intervention group and 31 cases in control group by random number table method.The baseline data such as general data and clinical data of the two groups of study subjects were tested,and the difference was not statistically significant(P>0.05),which was comparable.The control group was given routine nursing intervention,and the intervention group was given Simulated Presence Therapy intervention on the basis of routine nursing intervention for 4 weeks.After 2 and 4 weeks of intervention,the Cohen-Mansfield Agitation Inventory,Mini-Mental Status Examination,self-made medication and protective restraint use questionnaire,and Caregiver Burden Inventory were used to evaluate the intervention effects of the two groups of study subjects.At the same time,the research object of apathy situation was evaluated by the Apathy Evaluation Scale-Informant after 4 weeks of intervention.Research Result:1.Constructed the simulated presence video recording scheme,and based on the simulated presence video recording scheme,produced 60 personalized and well-suited simulated presence videos.2.The effect of Simulated Presence Therapy on patients with dementia(1)Comparison of baseline data between the two groups: A total of 61 study subjects wereinvolved in the entire intervention,30 in the intervention group and 31 in the control group.There were no significant differences in general data,protection constraints,usage,cognitive level,level of agitation behaviors,emotional indifference,and caregiver burden score between the intervention group and the control group before intervention(P >0.05).(2)Comparison of Cohen-Mansfield Agitation Inventory scores between the two groups: 1)Comparison between the two groups: independent sample t test was used to compare the CMAI scores of the intervention group and the control group at three different time points,and the CMAI scores of the two groups showed statistical differences after 2 weeks and 4 weeks of intervention(P<0.05).2)Intra-group comparison: one-way repeated measurement analysis of variance was used for intra-group comparison.There were significant differences in CMAI score at 3 time points before,2 weeks after and 4 weeks after intervention in the intervention group(P<0.05).Further pairwise comparison showed significant differences in CMAI score at any two time points(P<0.05).There was no statistically significant difference in the CMAI score of subjects in the control group at 3 time points before,2 weeks after and 4 weeks after intervention(P>0.05).(3)Comparison of scores of Apathy Evaluation Scale-Informant between the two groups: 1)Comparison between the two groups: independent sample t test was used to compare the AES-I scores of the intervention group and the control group before and after the intervention,respectively,and the results showed that there was no statistically significant difference between the two groups before the intervention(P>0.05).After the completion of the intervention,the difference of AES-I score between the two groups was statistically significant(P<0.05).2)Intra-group comparison: paired sample t test was used for comparison before and after intervention in the group,and the results showed that the difference of AES-I score before and after intervention in the intervention group was statistically significant(P<0.05),which was significantly lower than that before intervention.There was no statistically significant difference in AES-I score before and after intervention in the control group(P>0.05).The comparison of the difference between the two groups before and after the intervention showed that the difference was statistically significant(P<0.05),and the difference in the intervention group was much lower than that in the control group.(4)Comparison of scores of Mini-mental State Examination between the two groups:1)Comparison between groups: independent sample t test was used to compare MMSE scores of theintervention group and control group at three time points before,2 weeks after and 4 weeks after intervention,respectively,with no statistical difference(P>0.05).2)Intra-group comparison:one-way repeated measurement analysis of variance was used for intra-group comparison.There was no statistically significant difference in MMSE scores between the two groups before,2weeks after and 3 time points after 4 weeks of intervention(P>0.05).(5)Comparison of the use of protective constraints between the two groups: there was no significant change in the use of protective constraints between the two groups,and there was no statistical difference in the use of protective constraints between the two groups during the intervention.(6)Comparison of scores of Caregiver Burden Inventory between the two groups:1)Comparison between groups: independent sample t test was used to compare the CBI scores of the intervention group and the control group at three different time points,and the CBI scores of the two groups showed statistical differences after 2 weeks and 4 weeks of intervention(P<0.05).2)Intra-group comparison: one-way repeated measurement analysis of variance was used for intra-group comparison.(1)the intervention group was pairwise compared at 3 time points before,2 weeks after and 4 weeks after intervention,and there were significant differences in CBI scores(P<0.05).There was no statistically significant difference in CBI scores of the control group at 3time points before,2 weeks after and 4 weeks after intervention(P>0.05).Research Conclusion:1.The simulated presence video recording scheme is practical and feasible.The content of simulated presence videos have the characteristics of personalized and positive evocative effect.2.Simulated presence therapy can improve the aggression behavior and emotional apathy of dementia patients and reduce the care burden of their caregivers.It is a better non-drug intervention method to improve agitation behavior and maintain mental health.However,whether the simulated presence therapy improves the cognitive,medication and protective restraint use of dementia patients needs further research to verify.