Pain, delirium, and physical function in skilled nursing home patients with dementia.
Pain, delirium, and physical function in skilled nursing home patients with dementia.
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DOI：
10.1016/j.jamda.2014.07.002
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发表时间：
2015-01
影响因子：
7.6
通讯作者：
Behrens, Liza
中科院分区：
文献类型：
--
作者：
Kolanowski, Ann;Mogle, Jacqueline;Fick, Donna M.;Hill, Nikki;Mulhall, Paula;Nadler, Jamie;Colancecco, Elise;Behrens, Liza
专业护理机构（SNF）是痴呆患者急性期后护理的主要场所。监察主任办公室最近的一份报告指出，由于治疗质量差，包括未能提供所需的护理，SNF的结果并不理想。在痴呆症患者中，疼痛通常未被识别和治疗。这项探索性研究的目的是检查日常疼痛对SNF痴呆患者谵妄和身体功能的影响。还检查了每日疼痛与出院处置的关联。正在进行的随机临床试验数据的次要分析。位于宾夕法尼亚州中部和东北部的八个SNF。103例被判定为痴呆和谵妄诊断的SNF患者，平均年龄为86（± 6.8）岁;大多数为女性（66%）和白人（98%）。每天测量疼痛（晚期痴呆的疼痛评估）、谵妄（混乱评估方法）和身体功能（Barthel指数），持续30天或直至出院。当参与者经历的疼痛超过平均水平时，他们也会经历更多的谵妄症状（p <0.001）和较低的身体功能（p <0.001）。与3个月随访时返回社区相比，平均每日疼痛水平较高的参与者更有可能死亡（OR = 6.306，95% CI：1.914 - 20.771，p =.003）或被安置在养老院（OR = 4.77，95% CI：1.7 - 13.2，p =.003）。更多地关注痴呆症患者的疼痛可能是SNF中一些质量问题和高成本护理的潜在解决方案
Skilled Nursing Facilities (SNFs) are major sites of post-acute care for patients with dementia. A recent Office of the Inspector General report indicated that outcomes in SNFs are sub-optimal due to poor-quality treatment, including the failure to provide needed care. Pain is frequently un-recognized and un-treated in patients with dementia. The aim of this exploratory study was to examine the effect daily pain has on delirium and physical function in patients with dementia in SNFs. The association of daily pain with discharge disposition was also examined. Secondary analysis of data from an on-going randomized clinical trial. Eight SNFs located in central and northeast Pennsylvania. One hundred and three SNF patients with adjudicated dementia and delirium diagnoses and a mean age of 86 (±6.8) years; most were female (66%) and Caucasian (98%). Measures of pain (Pain Assessment in Advanced Dementia), delirium (Confusion Assessment Method), and physical function (Barthel Index) were taken daily for 30 days or until discharge. On days when participants experienced greater than their average level of pain they also experienced more delirium symptoms (p < .001) and lower physical function (p < .001). Participants with higher levels of average daily pain were more likely to die (OR = 6.306, 95% CI: 1.914–20.771, p = .003) or be placed in a nursing home (OR= 4.77, 95% CI:1.7–13.2, p=.003) compared to returning to the community at 3-month follow-up. Greater attention to pain in patients with dementia may be a potential solution to some of the quality problems and high costs of care in SNFs
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DOI：
10.1093/geronb/gbq085
发表时间：
2011-07-01
影响因子：
6.2
作者：
Payette, Helene;Gueye, N'Deye Rokhaya;Gray-Donald, Katherine
通讯作者：
Gray-Donald, Katherine
影响因子：
16.4
作者：
Molton, Ivan R.;Terrill, Alexandra L.
通讯作者：
Terrill, Alexandra L.
DOI：
10.1016/j.jamda.2013.03.013
发表时间：
2013-10
影响因子：
7.6
作者：
Morandi A;Bellelli G;Vasilevskis EE;Turco R;Guerini F;Torpilliesi T;Speciale S;Emiliani V;Gentile S;Schnelle J;Trabucchi M
通讯作者：
Trabucchi M
影响因子：
2.6
作者：
Fick, Donna M.;Steis, Melinda R.;Waller, Jennifer L.;Inouye, Sharon K.
通讯作者：
Inouye, Sharon K.
DOI：
10.1377/hlthaff.2009.0629
发表时间：
2010-01
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Mor V;Intrator O;Feng Z;Grabowski DC
通讯作者：
Grabowski DC