目的：台灣隨著年齡層提高及人口老化速度加快，失智症盛行率也隨著增加。八成以上的失智症患者都在社區，除了藥物治療，急需發展良好的措施及服務模式，以促進患者的身心健康，減輕照顧者的負擔。本研究探討以職能治療計畫介入對於日間照顧中心失智症患者日常生活、社交功能以及照顧者負荷之成效。方法：研究為前後測之實驗設計，符合選入標準之受試者被隨機分配至實驗組及控制組，介入時間為十週職能治療計畫。分別有實驗組23位（平均年齡79.22歲，6位男性、17位女性）及控制組19位（平均年齡81.58歲，9位男性、10位女性）完成整個介入過程。治療前後分別接受「失智症功能障礙評估量表」、「失智症生活品質評估量表」、「失智症照顧者的負荷調查表」與「溝通及互動技巧評量表」四種量表評估，以探討日間照顧中心失智症患者日常生活與社交功能及照顧者負荷之成效。結果：在「失智症功能障礙評估量表」(DAD)部分，介入後實驗組顯著高於控制組(p<.001)。在「溝通及互動技巧評量表」(ACIS)部分，實驗組也顯著高於控制組(p<.01)。在「失智症生活品質評估量表」(QOL-AD)部分，患者主觀之生活品質，介入後實驗組平均分數雖高於控制組，但並無顯著差異(p=.09)，而照顧者代理評測之生活品質實驗組則顯著高於控制組(p=.03)。在「失智症照顧者的負荷調查表」(CZBI)部分，實驗組則顯著低於控制組(p=.03)。結論：以職能治療計畫介入後，相較於參與控制組，對於日照中心失智症患者更能促進生活及社交功能，提升生活品質，減輕照顧者負荷。本研究提供以職能治療計畫介入措施，可顯著改善日間照顧中心失智症患者之日常生活、社交功能以及生活品質，並可減輕照顧者照顧負荷。期待透過此研究結果，能讓日照中心更瞭解職能治療人員的角色，更貼近患者的需求安排活動。

The prevalence of dementia is increased in Taiwan in recent years due to rising life expectancy and increasing rate of population aging. More than 80% of dementia patients live in the community, not in institutions. It is urgent to develop feasible strategies and services to reduce the burden of caregivers and enhance physical and mental health of the patient beyond medication. The effect of occupational therapy on activities of daily living and social function in people with dementia and their caregivers were investigated. The study used a randomized pre-test and post-test control group design. Eligible participants were randomly assigned to the experimental group (OT group) or the control group. The intervention lasted ten weeks.

Twenty three participants in the experimental group (6 males, 17 females, mean age = 79.22 years) and 19 participants in the control group (9 males, 10 females, mean age = 81.58 years) completed the entire intervention. No significant difference in the demographic data was found between these two groups except the duration of received day-care services. Analyses of covariance (ANCOVAs) were used to assess the effectiveness of the occupational therapy. The experimental group showed significantly higher score in Disability Assessment for Dementia (DAD) than the control group (p<.001). In the Quality of Life in Alzheimer\\\'s Disease (QOL-AD), the average rating of the experimental group was higher than that of the control group after intervention, but not statistically significant (p = .09); average rating from the caregiver of the experimental group was significantly higher than that of the control group (p = .03). In the Chinese version of the Zarit Burden Interview (CZBI), the experimental group showed significantly lower score than the control group (p = .03). In the Assessment of Communication and Interaction Skills (ACIS), the score of the experimental group was significantly higher than that of the control group (p < .01).

The results showed that occupational therapy could improve daily function and quality of live (based on caregiver’s perspective) of dementia patients. Caregiver burden was reduced, and social interaction and communication skills were enhanced compared to the control group.

This study shows that occupational therapy intervention can improve activities of daily living, social function, and quality of life in people with dementia in day-care centers. In addition, caregiver burden could also be reduced. Hopefully, this study could provide better understanding of the role of caregivers in day-care centers, and assist therapists to manage activities matching patients’ needs. Occupational therapists can improve physical and mental health of dementia patients by their professional knowledge and develop better strategies for community care.