대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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치매 환자의 문제행동을 위한 자극지향적 중재의 효과 연구: 체계적 고찰과 메타분석

Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis

  • 김은영 (경일대학교 간호보건대학 심리치료학과) ;
  • 황성동 (경북대학교 사회과학대학 사회복지학과) ;
  • 김은주 (대전대학교 보건의료과학대학 간호학과)
  • Kim, Eun Young (Department of Psychotherapy, College of Nursing and Public Health, Kyungil University) ;
  • Hwang, Sung-Dong (Department of Social Welfare, College of Social Science, Kyungpook National University) ;
  • Kim, Eun Joo (Department of Nursing, College of Health and Medical Science, Daejeon University)
  • 투고 : 2015.08.31
  • 심사 : 2015.12.17
  • 발행 : 2016.08.31
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초록

Purpose: This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program. Results: Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity ($I^2=62.8%$), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.

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