Investigation And Intervention Study Of Whole Person Care For Patients With Senile Dementia

Objectives:This paper aims to do following two researches: Firstly,through semi-structured interviews and qualitative data analysis to understand the status of whole person care for patients with senile dementia,then develop the questionnaire of whole person care of patients with senile dementia;Secondly,design the intervention program through learning the advanced senile dementia care handbook from domestic and foreign and apply it in daily care of intervention group patients with senile dementia.Then examine the effectiveness of this intervention plan by means of related questionnaires,and do some quantitative analysis.Methods:(1)Investigation Study: Through purpose sampling methods,to conduct semi-structured interviews with senile dementia patients who meet the inclusion and exclusion criteria,at the same time,using qualitative study method to analyse the interview data,and stop the interview when data theory reaches saturation,finally forming a whole person care status questionnaire of patients with senile dementia.Then use Self-designed Whole Person Care Status Questionnaire,Chinese Version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being,Quality of Life-Alzheimer's Disease,Elderly Disability Assessment Scale for the baseline survey of 85 patients with senile dementia,and get 80 valid ones.(2)Intervention Study: The recruited subjects were divided into intervention group and control group.The intervention group accepted a month of whole person care intervention,which is none for control group.The above questionnaires were used to investigate the differences between the two groups before and after the intervention.Descriptive statistics,independent sample t test,variance analysis and pretest and posttest measurement were used for statistical analysis.Results:1.Investigation Study:(1)The self-made questionnaire of whole person care of patients with senile dementia with interviews can effectively measure the holistic needs of patients with senile dementia.(2)The total score of the status of whole person care is 63.38±7.55,and the total score of the needs of whole person care is 66.11±4.08.(3)There was no significant difference in gender and residence of patients with senile dementia in mental condition,quality of life,elderly disability and all the dimensions;There were significant differences in patients with different marital status in total score of quality of life and mental function,communication,activity and total score of elderly disability(p<0.05);There were significant differences in patients with different economical status in belief dimension of spirituality scale,total score of quality of life and mental function,self-care and total score of elderly disability(p<0.05);There were significant differences in patients with different physical status in meaning dimension and total score of spirituality scale,total score of quality of life and mental function,organ function,communication,activity,self-care,family life,economical and social life and total score of elderly disability(p<0.05).(4)There are certain levels of correlation between spirituality,quality of life,and elderly disability(p<0.05).2.Intervention Study:(1)Pre and post intervention paired t test indicate: The score changes of meaning,belief dimension and total score of spirituality scale of intervention group patients with senile dementia were all statistically significant,and there was no significant difference in the score change of the control group.Both groups' pre and post intervention comparison indicate: The dimensions of peace(t=3.395,P=0.001),meaning(t=2.618,P=0.011),belief(t=3.518,P=0.001)and total score(t=4.303,P=0.000)of spirituality scale of intervention group was significantly higher than that of the control group and the difference was statistically significant,while other indicators were not statistically significant.(2)Pre and post intervention paired t test indicate: The score changes of mental function,communication,activity,self-care,family life and total score of elderly disability of intervention group patients with senile dementia were statisticallysignificant,while the score changes of organ function and economical and social life were not there was no significant difference in the score change of all the indicators of the control group.Both groups' pre and post intervention comparison indicate: The dimension mental function(t=0.536,P=0.006),communication(t=0.001,P=0.000),activity(t=4.343,P=0.000),self-care(t=2.859,P=0.006),family life and total score(t=0.470,P=0.002)and the total score of elderly disability of intervention group patients with senile dementia were significantly higher than that of the control group,while the score changes of organ function(t=0.233,P=0.683)and economical and social life(t=0.388,P=0.552)were not statistically significant.(3)Pre and post intervention paired t test indicate: The score changes of meaning,belief dimension and total score of spirituality scale of intervention group patients with senile dementia were all statistically significant,and there was no significant difference in the score change of the control group.Both groups' pre and post intervention comparison indicate:The dimensions of peace(t=3.395,P=0.001),meaning(t=2.618,P=0.011),belief(t=3.518,P=0.001)and total score(t=4.303,P=0.000)of spirituality scale of intervention group was significantly higher than that of the control group and the difference was statistically significant,while other indicators were not statistically significant.(4)The subjective feedback assessment of the whole person care intervention for patients with senile dementia shows that:The needs' satisfaction of all the patients in the hospital and the nursing homes are still in the lower stage,and the medical staff,the patients and the family members have a higher acceptance of the whole person care for patients with senile dementia.Conclusions:(1)The overall status and awareness of whole person care for senile dementia in China are both at a low level.However,the acceptance of whole person care is high among medical staff,patients and their family member.Therefore,the level of whole person care for patients with senile dementia needs to be improved.(2)The self-made whole person care plan for patients with senile dementia can effectively improve the patients' quality of life as well as all aspects of body,mind,society and spirituality,which can be used in daily care of patients with senile dementia.