Cognitive Defusion Therapy On The Management Of Perceived Stress In Older Adults With Mild Cognitive Impairment

Research Background:The problem of perceived stress in older adults with mild cognitive impairment is more prominent,and effective perceived stress management has a positive effect on the maintenance of cognitive function.However,previous studies have not focused on perceived stress management in people with MCI.In addition,the transfer effect of cognitive defusion therapy on perceived stress is not clear.Research Purpose:Based on the Liverpool mindfulness model,this study designed and implemented a cognitive defusion training program in line with the characteristics of mild cognitive impairment population,and systematically observed the direct effect of the project on perceived stress and transfer effect on cognitive function(overall cognitive function,psychomotor speed,memory function)and mindfulness awareness level of MCI people.Research Methods:This study is a kind of experimental study.From August 2019 to January 2021,the residents’ communities in Renhuangshan Street,Wuxing District,Huzhou City were selected as the research site.51 MCI people who met the inclusion and exclusion criteria were selected as the subjects of the intervention group and the control group.The control group was given health lectures on MCI-related disease knowledge and issued health education manuals.The intervention group received an 8-week cognitive defusion training program.Chinese Perceived Stress Scale,Montreal Cognitive Assessment-Basic,Finger Tapping Test,Purdue Pegboard Test and Auditory Verbal Learning Test were used to assess the perceived stress level and cognitive function(overall cognitive function,psychomotor speed,memory function)of the two groups at baseline(T0),intervention for 8 weeks(T2),and follow-up for three months(T3).The level of mindfulness awareness was evaluated by Five Facet Mindfulness Questionnaire at baseline(T0),intervention for 4 weeks(T1),intervention for 8 weeks(T2)and follow-up for 3 months(T3).The feasibility and acceptance of the project were evaluated by the compliance rate and the incidence of adverse events of the subjects in the intervention group participating in the cognitive defusion training program.Research Results:A total of 102 people were enrolled in this study,of which 87 subjects completed all the projects of this study(43 in the intervention group and 44 in the control group).During the 8-week intervention,there were no adverse events in both groups.The compliance rate of cognitive defusion training in the intervention group was 84.3%,which was at a high level.1.Repeated measurement ANOVA shows: at baseline,8 weeks of intervention and 3 months of follow-up,the overall perceived stress level and its dimension score,the Mo CA-B score,Finger Tapping Test,Purdue pegboard test and AVLT score and at baseline,intervention 4 weeks,intervention 8 weeks,follow-up 3 months,FFMQ level and its dimension score between groups,time effects and inter-group-time interaction effects were significantly different(P<0.05).2.Simple effects analysis shows: compared with the control group,the cognitive defusion training program had a significant direct effect on reducing the overall perceived stress and the dimensions of tension and out of control,and the training effect could be maintained until 3months of follow-up.The scores of Mo CA-B,finger tapping,Purdue nailboard and AVLT in the intervention group were significantly higher than those in the control group after 3 months of follow-up,and the total score of FFMQ and the score of observation dimension in the intervention group were significantly higher than those in the control group at 4 weeks(P<0.05).After 8 weeks of intervention,the total score of FFMQ and the scores of observation,conscious action,non-judgment and non-reaction in the intervention group were significantly different from those in the control group(P<0.05),and at 3 months of follow-up,there were significant differences in the total score of FFMQ and its observation,description,conscious action,non-judgment and non-reaction between the intervention group and the control group(P<0.05).Research Conclusion:Cognitive defusion training program can effectively reduce the perceived stress level of elderly MCI people,and promote cognitive function(overall cognitive function,psychomotor speed,memory function)and mindfulness awareness level.MCI participants had a high degree of participation in cognitive defusion training programs and no adverse events occurred.In addition,cognitive defusion training has the characteristics of low cost,simple and easy to operate.By focusing on perceived stress management,we can open up a new path for cognitive management of elderly MCI people,and then provide a set of standardized nursing intervention measures for grass-roots medical institutions to carry out cognitive management of elderly MCI people.