失智症個案之精神行為症狀（Behavioral and Psychological Symptoms of Dementia, BPSD）容易 造成照顧者的負荷，其中針對攻擊行為及躁動行 為，更是家屬將之送至機構照顧的主因。臨床上最 常使用物理性約束、精神科藥物和降低刺激源以因 應。特殊專區（Special Care Unit, SCU）可提供失 智症者個別化的照護模式，本文之目的即依據護 理實證的步驟探討「人本環境對失智症住民之精 神行為問題是否具改善成效」之議題。設定PICO 為：P：機構中的失智症老人；I：住在SCU； C：未住在SCU；O：住在SCU之失智老人可有 效改善躁動及攻擊行為。透過PubMed、Cochrane Library、CINAHL Plus、CEPS等資料庫進行蒐集 資料，關鍵字則為「失智症（Dementia）」、「特 殊專區（Special Care Units）」、「團體（Group Living）」、「護理機構（Nursing Facility）」、 「環境（Environment）」，並透過收入及排除條 件，以隨機試驗和類實驗研究為篩選條件，共獲得 8篇文獻。研究結果：一、確實可以透過特殊專區 的環境，改善住民的攻擊及躁動行為問題（p<0.05 至0.0005）。二、小單元以人為中心的照護模式， 能滿足失智症的多元化需求，降低攻擊與躁動行 為（agitated behavior）。人本環境設計對失智症住 民之精神行為問題的確具改善成效。目前世界各國 推動的情形、國家政策的支持度皆不一，這是國際 失智症照護應努力的方向。

Behavioral and psychological symptoms of dementia (BPSD) can cause a burden on caretakers. In particular, attack behavior and agitated behavior are the major reasons why family members send their relatives with BPSD to nursing facilities. In clinics, the most common treatments for BPSD are physical restraints, administration of psychotropic drugs, and reduced stimulation. Special Care Units (SCUs) can provide personalized care for patients with BPSD. This study aimed to assess whether a humanistic environment would have a positive effect on residents with BPSD. PICO was designated as follows: “P,” elderly patients with dementia in nursing facilities; “I,” admission of elderly patients with dementia to SCUs; “C,” elderly patients with dementia not admitted to SCUs; “O,” improvement in agitated and attack behavior in elderly patients with dementia in SCUs. Data were collected from databases (i.e., PubMed, Cochrane Library, CINAHL Plus, and CEPS) using the following keywords: “Dementia”, “Special Care Units”, “Group Living”, “Nursing Facility” and “Environment”. The inclusion criteria included randomized controlled trials and quasi-experimental studies. A total of eight studies were selected for the analysis. The results were as follows: 1. Attack behavior and agitated behavior was, indeed, improved by an SCU environment (p<0.05 to 0.0005); 2. A small-unit humancentered care mode was able to satisfy the various requirements of patients with dementia, and in turn ameliorated attack and agitated behavior. Thus, a humanistic environment can improve the BPSD of patients with dementia. Given that the degree of national promotion and national policy support of humanistic environments in the treatment of dementia have not been consistent among different nations to date, the international dementia care community should be committed to establishing a consensus regarding these in the future.