| Summary: | 碩士 === 長庚大學 === 護理學研究所 === 97 === Objective: The purpose of this study was to discuss the relationship between sleep disturbance and wandering behavior in patients with early to moderate dementia in community, by using the Need-Driven Dementia-Compromised Behavior Model (NDB) Model. Methods: It was a cross-sectional design with a purposeful sampling. Patient with dementia and their main family caregivers were recruited from outpatient memory clinics of four teaching hospitals and one day-care center for dementia in northern Taiwan. The exclusive criteria included acute illnesses, sensory impairment, chronic alcohol abuse or current use of drugs with possibly central nerve system effects. A comprehensive battery included the Clinical Dementia Rating (CDR), the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), the Chinese Revised Algase Wandering Scale-Community Version (CRAWS-CV) and the Lee’s Sleep Disturbance scale (SD). Data Analyses: Data was analyzed by using descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s product moment correlation, partial correlation, and hierarchical regression models. Results: One hundred and eighty dyads of patient with dementia and their family caregivers were enrolled. 1. The mean of SD score was 65.54 (SD =37.68), representing a low to middle level of sleep disturbance in patients, while the mean of SD Severity subscore was 58.15 (SD = 28.52), and the mean of SD Influence subscore was 7.39 (SD=13.62).2.The mean of CRAWS score was 54.61 (SD=18.69),showing a low to middle level of wandering behaviors. the most frequently-observed wandering behavior was meal-time impulsivity / temporal aspect, the second one was pacing, and The third one was getting lost outdoor. The less frequently observed wandering behavior was random pattern.3. The overall wandering behavior was significantly correlated with years of education, dementia diagnoses, language, anxiety, CDR, MMSE, and SD.4. The partial correlation coefficients showed that only sleep disturbance significantly correlated with overall wandering behavior and its’ negative outcome. 5. The significant predictors of wandering behaviors were years of education, diagnoses of dementia, language, anxiety, CDR, MMSE, and SD, explaining 26.7%-39.7% of variance by using hierarchical regression models. Conclusions: NDB model is helpful when assessing wandering behaviors in dementia. In addition, sleep disturbance can be and should be managed to reduce wandering behavior in patients with dementia living in communities.
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