介護老人保健施設入所者の抑うつに対するリハビリテーション効果の検討:前後比較研究  [in Japanese] The Effects of Cognitive Rehabilitation on Patients with Post-stroke Depression in Long-term Care Facilities: A Before-and-after Comparison Trial  [in Japanese]

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Abstract

<p><b>目的:</b>介護老人保健施設(老健)の脳卒中後うつ病(PSD)状態にある入所者に対して認知リハビリテーション(リハ)を実施し,抑うつに対する治療効果を検討した.また,認知機能,ADL,QOLへどのような影響を及ぼすのか検討した.さらに,リハに対する顧客満足度への認知リハの影響も検討した.</p><p><b>方法:</b>茨城県内の老健入所者で,PSD状態にある8名を対象とした.通常のリハに加えて,認知リハを週3回,20分/回,12週間実施した.主要評価項目は,老年期うつ病評価尺度(15項目)(GDS),Zung Self Depression Scale(SDS),脳卒中うつスケール(JSS-D),前頭葉機能検査(FAB)を用いて実施した.副次的評価項目は,QOL評価にはSF-8を用い,顧客満足度については,リハに対する顧客満足度を用いて調査した.これらの評価は,認知リハ実施前後で実施した.</p><p><b>結果:</b>GDS,SDS,JSS-D,FAB得点の向上が認められ,介入前と比較して有意な差が得られた.また,QOL,リハに対する顧客満足度総合得点に有意な改善を示した.</p><p><b>結論:</b>今回行った認知リハは,抑うつに一定の効果があった可能性があり,その機構は,前頭葉機能の賦活を介しているのではないだろうか.</p>

<p><b>Introduction: </b>The purpose of this study was to examine the effects of cognitive rehabilitation for depression, cognitive function, ADL, and QOL in patients with post-stroke depression (PSD). In addition, we evaluated the effects of cognitive rehabilitation on customer satisfaction with long-term care facilities and rehabilitation.</p><p><b>Methods: </b>This study included 8 participants with PSD who were residents of a long-term care facility located in Ibaraki Prefecture, Japan. In addition to their ordinary rehabilitation (2 sessions per week, 20 minutes per session), participants underwent 36 sessions of cognitive rehabilitation (3 sessions per week, 20 minutes per session, for 12 weeks). Primary outcome measures: Depression severity was measured using the Geriatric Depression Scale (GDS), Zung Self Depression Scale (SDS), and the Depression Scale of the Japan Stroke Scale (JSS-D). Frontal lobe function was assessed using the Frontal Assessment Battery (FAB). Secondary outcome measures: QOL was assessed using SF-8. Customer Satisfaction with the rehabilitation was measured using the Customer Satisfaction Scale based on Need Satisfaction (CSSNS). Assessments were performed before and after the rehabilitation.</p><p><b>Results: </b>The severity scores of depression, frontal lobe function, and customer satisfaction with the rehabilitation all significantly improved after the cognitive rehabilitation sessions.</p><p><b>Conclusions: </b>The results obtained in this trial indicate that, for patients with PSD depressive symptoms, frontal lobe function, QOL, and rehabilitation customer satisfaction may be improved by the inclusion of cognitive rehabilitation sessions alongside regular rehabilitation.</p>

Journal

  • An Official Journal of the Japan Primary Care Association

    An Official Journal of the Japan Primary Care Association 41(1), 8-14, 2018

    JAPAN PRIMARY CARE ASSOCIATION

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