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中医药研究论丛
 264.2 中医治疗对於居家与机构病患激动情绪及照护压力的改善成效
TJ TCM.26(4) : 17-30, 2023
DOI : 10.6516/TJTCM.202309_26(4).0002
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中医治疗对於居家与机构病患激动情绪及照护压力的改善成效
Effectiveness of Traditional Chinese
Medicine Treatment on Agitation and
Caregiver Burden in Home Care and Institutional Patients
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谢旭东 1 林舜谷 1,2,3,*
1 台北市立联合医院仁爱院区仁爱院区中医科，台北，台湾
2 国立阳明交通大学公共卫生研究所，台北，台湾 3 台北市立大学，台北，台湾
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【摘要】
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背景：激动包含过度、破坏性和不恰当的言语、声音和动作症状。在长期照护 设施中，激动是最常见的症状之一。本研究的目的是探讨针灸治疗对於居家与 机构病患的激动情绪和照护压力的缓解效果。
方法：本研究为前瞻性、单中心、不同治疗频率对照的研究。叁与者被分为每周接受针灸治疗一次与三次的两组，并在研究进行前、治疗四周与八周後分别评估个案的激动情绪与照护者的负担。我们使用中文版柯恩—曼斯费尔德激动情表绪行为量表（Cohen-Mansfield Agitation Inventory, CMAI）评估患者的激动情绪，并以照顾者负担量表 Caregiver Burden Inventory （CBI）来评估照顾者压力强度。本次研究共采集三笔数据（治疗前、治疗四星期与治疗八星期），并使用无母数统计分析中的 Friedman test 和 rank sun test 来分析治疗结果。
结果：本研究共纳入41位失能病患，其中有23位接受每周三次针灸，其馀则每 周接受一次治疗。每周治疗三次的病患，其激动情绪行为量表量表由治疗前的 116.0±5.5分，显着下降到治疗四周後的87.0±5.5分，与治疗八周後的44.0±5.5分，并且具有统计显着差异。其照顾者负担量表总分也由99.0±5.5分下降至 75.0±7.5分（四周）与36.0±6.0分（8周）。相比而言，每周仅接受一次治疗的患者，在治疗四周後并未显着改善激动情绪症状或减轻照护压力，仅在八周後才达到显着的疗效
结论：研究结果显示，针灸治疗是一种有效的治疗方法，对於激动情绪的治疗特别有效，并且能够减轻照护者的负担。此外，针灸频率也会影响治疗效果，每周三次的针灸可以获得最佳的治疗效果。
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【关键词】 长期照护、居家照护、针灸治疗、柯恩-曼斯费尔德激越情表绪行为 量表、照顾者负担
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Hsh-Tung Hsieh1 Shun-Ku Lin1,2,3,*
1 Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei 106, Taiwan
2 Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
3 General Education Center, University of Taipei, Taipei 100, Taiwan
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【Summary】
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Background: Agitation refers to excessive, destructive, and inappropriate symptoms of speech, sound, and movement. It is one of the most common symptoms in long-term care facilities. The aim of this study was to investigate the effects of acupuncture treatment on agitated emotions and caregiver stress among home and institutional patients.
Method: This study was a prospective, single-center, clinical trial with different treatment frequencies. Participants were divided into two groups, receiving acupuncture once or three times a week, and their agitated behavior and caregiver burden were evaluated before treatment, after 4 weeks, and after 8 weeks of treatment. The Cohen-Mansfield Agitation Inventory (CMAI) was used to evaluate patient agitation, and the Caregiver Burden Inventory (CBI) was used to evaluate caregiver stress. Friedman test and rank sum test were used to analyze the treatment results.
Result: A total of 41 disabled patients were enrolled in the study, with 23 receiving three weekly acupuncture sessions and the rest receiving once-weekly treatment. Patients receiving three weekly acupuncture sessions showed a significant decrease in agitated behavior, as measured by the CMAI, from 116.0 ± 5.5 at baseline to 87.0 ± 5.5 after 4 weeks and 44.0 ± 5.5 after 8 weeks. Their caregiver burden, as measured by the CBI, also decreased from 99.0 ± 5.5 to 75.0 ± 7.5 (4 weeks) and 36.0 ± 6.0 (8 weeks). In comparison, patients receiving only once-weekly treatment showed no significant improvement in agitated behavior or caregiver burden after 4 weeks and only showed significant improvement after 8 weeks.
Conclusion: The results showed that acupuncture treatment is an effective therapy, especially for treating agitated behavior, and can reduce caregiver burden. Additionally, the frequency of acupuncture affects the treatment outcome, with three weekly sessions yielding the best results.
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【Keywords】
Long-term Care; Home Care; Acupuncture Treatment; Cohen-Mansfield Agitation Inventory; Caregiver Burden
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