Problem behavior in the last year of life: prevalence, risks, and care receipt in older Americans.
Problem behavior in the last year of life: prevalence, risks, and care receipt in older Americans.
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生命最后一年的问题行为：美国老年人的患病率、风险和护理接受情况。
DOI：
10.1046/j.1532-5415.2001.49119.x
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发表时间：
2001
影响因子：
6.3
通讯作者：
Guralnik,J
中科院分区：
文献类型：
--
作者：
Bedford,S;Melzer,D;Guralnik,J
目的：估计老年人生命最后一年中问题行为的患病率，探索危险因素，评估行为对获得护理的影响。设计：对1993年国家死亡率随访调查数据进行回顾性分析，由国家卫生统计中心（NCHS）进行。参与者：纳入了7684例65岁及以上的死亡者，其中6,748例死者（88%）获得了完整的知情者访谈数据。收集了关于家庭成员行为投诉频率、社区其他人投诉频率、怪异行为投诉频率、破坏财产投诉频率、结果：总体而言，20%的死者被报告为在生命的最后一年中有时或经常有任何问题行为。死亡年龄或性别的比率差别不大。那些临床诊断为痴呆、精神疾病、酗酒、支气管炎或肺气肿的人有问题行为的风险更高。在有行为问题的人中，有27%的人被诊断为痴呆症。疗养院或医疗机构是32%的人在生命的最后一年有时或经常有任何行为问题的通常住所。告密者的死者谁破坏了财产或暴力威胁的2.3倍（95%置信区间（CI）= 1.2-4.4）更有可能报告说，受试者没有得到照顾，他们需要在生命的最后一年的life.CONCLUSION：问题行为是比较常见的老年人在生命的最后一年，并不局限于养老院居民或患有痴呆症的人。
OBJECTIVES:To estimate the prevalence of problem behavior in the last year of life in older people and to explore risk factors and assess the effect of behaviors on access to care.DESIGN:Retrospective analysis of data from the 1993 National Mortality Followback Survey, conducted by the National Center for Health Statistics (NCHS).SETTING:Persons who resided and died in the United States (except South Dakota) in 1993.PARTICIPANTS:Seven thousand six hundred and eighty‐four deaths in people age 65 and older were included, from which full informant interview data were available for 6,748 decedents (88%).MEASUREMENTS:Informant data were collected on frequency of complaints about behavior from family members, complaints from others in the community, bizarre behavior, destroying property, violent threats or attempts, and temper tantrums.RESULTS:Overall, 20% of decedents were reported as having any of the problem behaviors sometimes or often in the last year of life. Rates differed little by age at death or gender. Risks of having problem behaviors were higher for those with clinically diagnosed dementia, mental illness, alcohol abuse, and bronchitis or emphysema. A diagnosis of dementia had been made in 27% of those with behavior problems. Nursing homes or healthcare facilities were the usual residence of 32% of people with any behavior problems sometimes or often during their last year of life. Informants for decedents who had destroyed property or made violent threats were 2.3 times (95% confidence interval (CI) = 1.2–4.4) more likely to report that the subject had not received the care they had needed during the last year of life.CONCLUSION:Problem behavior is relatively common in older people in the last year of life and is not confined to nursing home residents or people suffering from dementia.