| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 97 === Cognitive decline is a common complication in older hospitalized patient. Studies have shown that older hospitalized patients who experienced cognitive decline were about 16 times more likely to develop functional decline. The purpose of this study was to evaluate the effect of daily visit and cognitive stimulation activities on cognitive function of hospitalized elderly.
This study employed a randomized assign and single-blind measurement design. Fifty older patients aged 65 years and older who admitted to a tertiary medical center in northern Taiwan for elective total knee replacement (TKR) or total hip replacement (THR) were recruited from April to August in 2008, and been randomly assigned to experimental or control group. A daily 20 to 30 minutes of visit and cognitive stimulation activities was provided to subjects in the experimental group post surgery till hospital discharge. Subjects in the control group received usual care. The main outcome was cognitive status measured by Mini-Mental State Examination (MMSE) at admission, before discharge and one month post hospitalization. Demographics and clinical information was also collected. The data was analyzed by SPSS software package and Descriptive, Chi-square test, Fisher’s exact test and Mann-Whitney U-test were performed.
The results showed that daily visit and cognitive stimulation activities: (1) could maintain or improve cognitive function for elderly during hospitalization. The MMSE scores of the experimental group showed a improvement of 1.28 points compared with a decline of 0.71 points in the control group (p＜.05). (2) could maintain short-term (from discharge to one month post hospitalization) cognitive function for elderly with high cognitive function at admission. (3) could decrease the incident rate of cognitive decline during hospitalization. Upon discharge, 44% subjects (N=11) in the control group developed cognitive decline (a reduction of≧2 MMSE points), while there was 12% (N=3) in the experimental group (p＜.05). In conclusion, daily visit and cognitive stimulation activities was effective on preventing cognitive decline in hospitalized elderly underwent elective TKR or THR. It will provide the basis for clinical geriatric care.
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