Demanslı Yaşlılarda Oyuncak Bebek Terapisinin Bilişsel Durum ve Ajitasyona Etkisi

Abstract

Amaç: Demanslı kişilerde bilişsel bozulma ile birlikte görülen ve kişinin hayatını etkileyen en önemli nöropsikiyatrik semptomlardan biri ajitasyondur. Oyuncak Bebek Terapisi (OBT), genellikle demansın orta veya ağır dönemlerinde olan kişiler için ajitasyon gibi davranışsal belirtilerin yönetiminde kullanılan farmakolojik olmayan yöntemdir. Bu doğrultuda bu çalışma uzun süreli kurumsal bakım alan demanslı yaşlılarda OBT’nin bilişsel durum ve ajitasyona etkisinin incelenmesi amacıyla deneysel tasarımda yürütülmüştür. Gereç ve Yöntemler: Araştırmanın evrenini, bir ilde bir kurumsal bakım merkezinde yaşayan 110 yaşlı birey oluşturmuştur. Uygulama grubunun büyüklüğü güç analizi yöntemi ile hesaplanarak OBT ve Kontrol (K) grubuna sırasıyla 16 ve 19 olmak üzere toplam 35 yaşlı birey alınmıştır. Veri toplama aracı olarak Cohen-Mansfield Ajitasyon Envanteri (CMAE) ve Mini Mental Durum Değerlendirme Testi (MMT) kullanılmıştır. Bulgular: Araştırmanın sonuçları başlangıçta (T0), OBT’den hemen sonraki hafta (T1), 3 ay sonra (T2) ölçülmüştür. Gruplardaki yaşlılar sosyo-demografik değişkenler, kurumsal bakım alma özellikleri, psikiyatrik ve fiziksel hastalıkları, bilişsel ve ajitasyon düzeyleri yönünden benzerdir. Bu çalışmada OBT ve K grubu arasında CMAE toplam ajitasyon düzeyi ve Fiziksel Agresif Olmayan ajitasyon düzeyi OBT grubu lehine anlamlı olarak farklı bulunmuştur. Ancak CMAE Sözel Agresif Olmayan, Sözel Agresif Olan ve Fiziksel Agresif Olan ajitasyon alt boyutlarındaki ve MMT düzeyindeki değişimin gruplararası farkı anlamlı bulunmamıştır. Sonuç: Sonuçlar, OBT’nin geriletici değil ama durdurucu etkisini ortaya koymuştur.

Keywords

• Oyuncak bebek terapisi
• demans
• yaşlı
• ajitasyon
• bilişsel durum

The Effect of Doll Therapy on Cognitive Status and Agitation among Elderly with Dementia

Abstract

Aim: Agitation is one of the most important neuropsychiatric symptoms which affect the daily life of the patients along with cognitive decline among people with dementia. Doll therapy is a non-pharmacological method utilized in the management of behavioral symptoms like agitation for people diagnosed with moderate to severe dementia. In this respect, this study was conducted as an experimental design in order to test the effect of DT on cognitive state and agitation among long term institutionalized dementia patients. Material and Methods: The universe of the study is 110 elderly patients hospitalized in an institutionalized care center in a city. The size of the sampling was calculated using power analysis. The sample of the study consisted of DT (Doll Therapy) Group and C (Control group) including 16 and 19 patients respectively. Cohen-Mansfield Agitation Inventory (CMAI) and Mini Mental State Examination (MMSE) were used as data gathering tools. Results: The results were categorized as the beginning (T0), the week right after DT (T1), and as 3-months application (T2). The elderly in the group are similar in their socio-demographic features, nature of their institutional care, psychiatric and physical diseases, cognitive and agitation levels. A meaningful difference was found between DT and K groups in their CMAI total agitation level and Physical Non-Aggressive agitation level in favor of DT sample. However, the difference among CMAI Verbal Non-Aggressive, Verbal Aggressive and Physical Aggressive agitation sub dimensions and the change in MMSE levels did not prove to be significant. Conclusion: The results proved DT effective in stopping the progression of dementia but not the reversal of the process.

Keywords

• Doll therapy
• dementia
• elderly
• agitation
• cognitive status

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