背景：全球失智症病人激增，失智症病人行為和精神症狀是常見且困擾的，包括躁動、重複行為、不安、妄想、焦慮和情緒低落等，其中的躁動行為常困擾照顧者、增加照顧者的負擔、影響病患及照顧者的生活品質，且於失智症病人住院期間更甚，進而造成較長的住院時間及較高的併發症發生率。目前全世界雖有發展失智症病人的照顧指引，然而尚未針對急性醫療的失智症躁動行為制定單一照護指引，台灣亦無針對急性醫療環境中住院失智症病人躁動行為的指引。因此，本研究欲發展急性醫療住院失智症病人躁動行為之臨床照護指引。
目的：透過實證方式發展急性醫療住院失智症病人躁動行為之臨床照護指引。
方法：依據台灣實證臨床指引發展及更新手冊分為八步驟，分別為(1)成立照護指引發展團隊、(2)以PICO架構發展關鍵問題、(3)系統性文獻搜尋、(4)文獻評讀、(5)初步擬定照護指引臨床建議、(6)德菲法專家共識決策程序、(7)外部專家及方法學專家審查、(8)照護指引臨床適用性評值。首先於南部某醫學中心神經內科病房成立指引發展小組，選定指引主題並建構臨床問題。後續進行系統性文獻搜尋，由二位研究者進行文獻篩選及評讀，初步擬定照護指引臨床建議，使用德菲法專家共識決策程序進行內部審查，修正後再進行外部專家及方法學專家審查，最後於臨床執行照護指引臨床適用性評值。
結果與討論：住院失智症病人躁動行為之臨床照護共包含3類別含有15項建議。3類別分別為躁動之評估、一般照護及非藥物輔助療法。每個建議都有提供詳細的資訊，例如頻率、時間、地點、步驟、注意事項等。指引透過德菲法專家共識決策程序進行修訂，直至80%的專家同意為止。所有建議的I-CVI為0.8-1。最後由2位外部及2位方法學專家對於本指引進行評價，同時調查30位護理師對於本指引之臨床適用性。
結論：本指引可供急性醫療專業人員或照顧者參考，用於照護住院失智症病人。並且期望能成為國家醫療政策推展之資源。另外也能成為各急性病房制定切合自己病房狀況與需求的護理照護路徑或規範，同時也可提供護理人員或其他專業醫療人員失智症照護教育或訓練計畫之依據。

Agitation often increases the burden on caregivers and healthcare providers. Moreover, agitation leads PwDs to longer hospital stays and higher complication rates. Few guidelines for dementia care have been developed for PwDs in acute settings. The purpose of this study was to develop a clinical care guideline for the agitation of PwDs in acute settings. This guideline will be used as a reference for acute care professionals or caregivers caring for hospitalized patients with dementia, and is expected to further serve as the basis for dementia care education or training programs for nursing staff or other medical professionals. The study was approved by the University Ethical Committee.

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