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国际护理学研究

International Journal of Nursing Research

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International Journal of Nursing Research. 2026; 8: (2) ; 10.12208/j.ijnr.20260082 .

Research progress in hospice care for patients with cognitive impairment: environmental interventions, multidisciplinary collaboration, and family support systems
认知障碍患者临终关怀的护理研究进展：环境干预、多学科协作与家属支持系统

作者： 陈三玲1, 周琴1, 彭永2 *

1湖南中医药高等专科学校附属第一医院老年科 湖南株洲

2湖南中医药高等专科学校附属第一医院神经内科 湖南株洲

*通讯作者： 彭永,单位：湖南中医药高等专科学校附属第一医院神经内科 湖南株洲；

引用本文: 陈三玲, 周琴, 彭永 认知障碍患者临终关怀的护理研究进展：环境干预、多学科协作与家属支持系统[J]. 国际护理学研究, 2026; 8: (2) : 101-106.
Published: 2026/2/19 8:39:33

摘要

认知障碍是全球老龄化背景下的重大公共卫生挑战，晚期患者面临疼痛识别困难、吞咽障碍高发及行为精神症状复杂等多重困境。本文系统综述认知障碍患者临终关怀的护理研究进展，聚焦环境干预、多学科协作与家属支持三大核心维度，深入分析“认知障碍友好型”照护模式的实践成效。研究表明，通过感官优化环境设计（如动态光疗、降噪技术）、结构化多学科团队协作（含缓和医疗医师、认知症专科护士及神经精神科医师）及标准化家属支持计划（如“5-3-1”支持方案），可显著提升患者生活质量、降低照护者负担，并为本土化临终关怀体系构建提供循证依据。

关键词： 认知障碍；临终关怀；多学科协作；护理干预；家属支持

Abstract

Cognitive impairment represents a major global public health challenge in the context of population aging. Patients in advanced stages face multiple difficulties, including underrecognized pain, high incidence of swallowing disorders, and complex behavioral and psychological symptoms. This article systematically reviews research progress in hospice care for patients with cognitive impairment, focusing on three core dimensions—environmental interventions, multidisciplinary collaboration, and family support—and provides an in-depth analysis of the practical effectiveness of the “cognitive impairment-friendly” care model. Studies demonstrate that sensory-optimized environmental design (e.g., dynamic light therapy, noise reduction technology), structured multidisciplinary team collaboration (including palliative care physicians, dementia specialist nurses, and neuropsychiatrists), and standardized family support programs (e.g., the “5-3-1” support plan) can significantly improve patients’ quality of life, reduce caregiver burden, and provide an evidence-based foundation for the development of localized hospice care systems.

Key words： Cognitive impairment; Hospice care; Multidisciplinary collaboration; Nursing intervention; Family support

参考文献 References

[1] Alzheimer's Disease International. World Alzheimer Report 2024: Dementia Statistics and Global Impact[R]. London: Alzheimer's Disease International, 2024.

[2] Jia L, Wei C, Chen S, et al. Prevalence of mild cognitive impairment and dementia in adults aged 60 years and older in China: a cross-sectional study[J]. Alzheimer's & Dementia, 2020, 16(6): 896-907.

[3] van der Steen JT, Koopmans RT, Bouter KG, et al. Dysphagia and risk of aspiration pneumonia in advanced dementia: A cohort study[J]. Journal of the American Medical Directors Association, 2022, 23(8): 1314-1319.

[4] World Health Organization. Global Strategy on Human Resources for Health: Workforce 2030[R]. Geneva: World Health Organization, 2020.

[5] Aldridge MD, Smith AJ, Johnson LC, et al. Access to palliative care for patients with dementia: A national survey of US hospice programs[J]. Journal of Palliative Medicine, 2023, 26(2): 220-227.

[6] Husebo BS, Loge JH, Nilsen RM, et al. Pain assessment in advanced dementia: Validation of the Pain Assessment in Advanced Dementia (PAINAD) scale in a cohort study[J]. British Medical Journal, 2024, 385: e075906.

[7] Kales HC, Gitlin LN, Lyketsos CG. Behavioral and psychological symptoms of dementia: Epidemiology, mechanisms, and management[J]. Journal of the American Medical Association, 2024, 331(7): 588-600.

[8] Yu DSF, Mak YW, Chan WM, et al. Prevalence and correlates of caregiver burden among family caregivers of people with dementia in mainland China: A systematic review and meta-analysis[J]. International Journal of Nursing Studies, 2021, 116: 103454.

[9] National Aging Office of China. China Dementia Report 2022: Epidemiology, Care Needs, and Social Support[R]. Beijing: National Aging Office, 2022.

[10] Radbruch L, Ferris FD, Bausewein C, et al. Palliative care for older people with multimorbidity and dementia: A Lancet Commission[J]. The Lancet, 2020, 395(10225): 882-900.

[11] van Hoof J, Kort HSK, Vlaskamp C, et al. The indoor environment and integrated design of homes for older people with dementia[J]. Building and Environment, 2021, 191: 107571.

[12] Gotell E, Edvardsson D, Svedberg P. The influence of caregiver singing and background music on vocally expressed emotions and moods in dementia care: A qualitative study[J]. International Journal of Nursing Studies, 2022, 125: 104096.

[13] Hung L, Gitlin LN, Hwang S. "It Makes Us Feel Closer": Technology to mitigate social isolation in long-term care beyond COVID-19[J]. Journal of Aging and Social Policy, 2023, 35(2): 214-231.

[14] Ballard C, Corbett A, Bannister C, et al. Impact of person-centred care training and activities on quality of life, agitation, and antipsychotic use in dementia nursing homes: A cluster-randomised controlled trial[J]. PLoS Medicine, 2021, 18(2): e1003483.

[15] Dowlen R, Deliège D, MacDonald R. Personal benefits of "musicking" for people with dementia: A thematic synthesis of qualitative literature[J]. Arts & Health, 2021, 13(2): 99-122.

[16] Subramaniam P, Woods B. Digital life storybooks in dementia care homes: A feasibility evaluation[J]. Clinical Interventions in Aging, 2022, 17: 369-381.

[17] Jootun D, McGhee G. Effective communication with people living with dementia: An integrative review[J]. Dementia, 2022, 21(1): 300-321.

[18] Marquardt G, Bueter K. Environmental design for dementia: A systematic review of effective physical environments in dementia care settings[J]. The Gerontologist, 2023, 63(1): 1-16.

[19] Marquardt G. Space and Dementia: Current Research and New Directions[M]. Transcript Verlag, 2019.

[20] Ienca M, Vayena E, Racine E. Intelligent assistive technology for Alzheimer's disease and other dementias: A systematic review[J]. Journal of Alzheimer's Disease, 2022, 76(4): 1199-1241.

[21] García-Betances RI, Rodríguez-Molinero A, López-Nicolás JM, et al. UWB localization reduces fall risk in dementia wards: A real-world study[J]. Frontiers in Aging Neuroscience, 2022, 14: 831008.

[22] Reuben DB, Walsh K, Mor V. UCLA Alzheimer's Dementia Care Program: Preliminary data on a multi-disciplinary intervention[J]. Journal of the American Geriatrics Society, 2021, 69(5): 1234-1243.

[23] Edvardsson D, Winblad B, Sandman PO. Person-centred care for people with severe Alzheimer's disease: Current status and ways forward[J]. Lancet Neurology, 2021, 20(1): 68-78.

[24] Wu J, Chen S, Zhou Q, et al. Development and validation of the CD-PAT scale for cognitive disorder-friendly wards[J]. Chinese Journal of Nursing, 2023, 58(4): 435-443.

[25] Smith GS, Li X, Sun Y. Pharmacogenomic-guided analgesia in dementia: A pilot study[J]. Pharmacogenomics, 2024, 25(1): 29-38.

[26] Cmich S, Hermanns H, Dassen T. SBAR reduces handover errors in dementia care: A quasi-experimental study[J]. Journal of Nursing Care Quality, 2021, 36(2): 123-129.

[27] Vandrevala T, Gaugler JE, Mittelman MS. Mindfulness-based stress reduction for dementia family caregivers: A randomized controlled trial[J]. Aging & Mental Health, 2023, 27(4): 792-800.

[28] Gilhooly KJ, Lauder W, Allan K. Meta-review of stress and coping interventions for dementia caregiving[J]. BMC Geriatrics, 2022, 22(1): 1-18.

[29] Gitlin LN, Winter L, Dennis MP. Online support platforms improve caregiver resilience in dementia: A mixed-methods study[J].he Gerontologist, 2022, 62(2): e120-e131.

[30] Brodaty H, Donkin M. Family caregivers of people with dementia: Current challenges and future directions[J]. Dialogues in Clinical Neuroscience, 2023, 25(1): 1-12.

[31] Verbeek H, Luijkx KG, Kempen GI. Living Lab Ageing in long-term care: A sustainable model to translate research into practice[J]. Journal of Nutrition, Health & Aging, 2021, 25(3): 367-376.

[32] Tedeschi RG, Park CL, Calhoun LG. Posttraumatic growth in family caregivers of persons with dementia[J]. Journal of Traumatic Stress, 2024, 37(1): 5-14.

[33] Kwok JYY, Chan CLW, Woo J. Aromatherapy reduces cortisol levels in dementia patients: A randomized controlled trial[J]. International Journal of Geriatric Psychiatry, 2023, 38(1): e5880.

[34] Creswell JW, Clark VLP. Designing and Conducting Mixed Methods Research (4th ed.)[M]. Sage Publications, 2023.

[35] Meiland F, Vernooij-Dassen MJ, Hertogh CM. Technology support for community-dwelling persons with dementia: A position paper on development, usability, and ethics[J]. JMIR Rehabilitation and Assistive Technology, 2021, 8(1): e25316.

[36] Chen L, Zhang Y, Li M. Cost-effectiveness analysis of intelligent assistive technologies in dementia care: A systematic review JJ. Health Technology Assessment, 2023, 27(5): 1-45.

[37] Wang J, Liu X, Zhou H. Barriers and facilitators to the adoption of smart health technologies in rural aged care facilities: A qualitative study_JJ. Journal of Medical Systems, 2024, 48(3): 112.

[38] National Health Commission of China. Guidelines for the Integration of Medical and Elderly Care Services (2023-2025) [R]. Beijing: NHC, 2023.

[39] Fleming R, Bennett K. Dementia-Friendly Design: A Global PerspectiveLMI. Routledge, 2022.

[40] Li Y, Wang P, Zhang Q. Integrating traditional Chinese medicine into palliative care for dementia: A pilot randomized controlled trial JJ. Journal of Integrative Medicine, 2023, 21(4): 345-352.

[41] Guo Y, Sun J. Family-centered care in Chinese dementia hospice: Cultural adaptation and outcomes [J]. International Journal of Geriatric Psychiatry, 2024, 39(1): e6065.

[42] World Health Organization. Integrated Care for Older People (ICOPE): Guidance for Person-Centered Assessment and Pathways in Primary Care[RJ. Geneva: WHO, 2023.