Study On The Current Situation And The Intervention Of The Elderly People With Alexithymia In Nursing Institutions Of Taiyuan

Objective:1.To describe the current status and the issues of alexithymia's nursing in China by bibliometric analysis.2.To investigate the level and influence factors of alexithymia in institutional older people in Taiyuan.3.To develop the group cognitive intervention for institutional older people with alexithymia.4.To explore the effects of group cognitive intervention among institutional older people with alexithymia.Methods:1.CNKI,Wanfang,VIP,CBM,PubMed and CINAHL databases were screened for published papers on alexithymia's nursing in China from their inauguration to 30 th September 2016.Bibliometric data were extracted and analyzed using metrological analysis.2.Totally 216 elderly residents from 6 nursing homes in Taiyuan were investigated with a demographic data questionnaire,Toronto Alexithymia Scale(TAS-20)and Barthel Index Scale(BI).3.On the basis of bibliometric analysis,current situation survey and expert interview,a two-round Delphi technique was used for experts on nursing,geratology and psychology.4.Totally 70 elderly residents with alexithymia were randomly divided into the experimental group(n=35)and the control group(n=35).Patients in the experimental group performed the group cognitive intervention and patients in the control group received regular health education.Two groups were evaluated by TAS-20 and BI before and after the intervention.Results:1.A total of 84 papers were included.Papers were mainly from the central and eastern regions and lack of foundation.The major papers were descriptive studies and accountedfor 59.52%.The main topic was investigation of correlations between alexithymia and psychosomatic symptoms and symptoms of disease,which accounted for 48.84%.Subjects in the study were mainly patients with chronic diseases with a rate of 23.81%.In 23 included clinical trials,alexithymia's nursing was mainly performed in forms of group psychological counseling with a rate of 26.09%.The less common form was realization social support which accounted for 17.39%.The evaluation parameters contained 78.26%of functional indexes of patients and 21.74% of clinical outcome indicators.2.The score of TAS-20 was 57.03±5.51,and 31.01% of institutional older people reported alexithymia.The results of single-factor analysis showed that there was a statistically significant difference in age,gender,education,monthly income,number of illnesses,daily activities,institutional time,frequency of participation in group activities,and frequency of visits by friends and relatives(P<0.05).Pre-retirement occupation and marriage There was no significant difference in the status,number of children,medical insurance,type of medication,nature of institution,living environment and number of hobbies(P>0.05).Multiple logistic regression showed that age,education level,multimorbidity,ADL,the frequency of participation in group activities and the number of visits to friends and relatives were the major influencing factors(P<0.05).3.The effective recovery of two rounds of expert consultation rate was 100%,the coefficient of expert authority degree is 0.95,the importance of interventions assigned to4.00~4.47,the coefficient of variation was 0.14~0.22.The final determination of the group cognitive intervention including 3 modules,8 active subjects and 12 nursing measures.4.Before intervention,there was no statistical significance between the two groups in the difference between the scores of TAS-20(P>0.05).After intervention,TAS-20 in the experimental group was lower than the control group in the dimensions of emotional recognition disorder,outward thinking,and overall scores(P < 0.01).Before and after intervention,There was no statistical significance between the two groups in the difference between the scores of BI(P>0.05).Conclusion:1.The published papers are in small amount and with low quality.It is necessary toexpand the studies on the specialized diseases and establish multidimension nursing model based on the combination of nursing theory and clinical practice.2.The prevalence of alexithymia is high in institutional older people.The nurses should conduct a comprehensive geriatric assessment.Intervention focusing on patients,disease and social support may help to improve the patient's emotional cognitive ability,disease management ability and social adaptability.3.The group cognitive intervention for institutional older people with alexithymia in China is scientific,practical and can be used as a guide for clinical nurses to provide high quality care for institutional older people with alexithymia.4.Group cognitive intervention can reduce the adverse effects of alexithymia on the elderly,and have a certain effect on the prevention and treatment of alexithymia in elderly care institutions.