Development of an International Schedule for the Assessment and Staging of Care for Dementia
Development of an International Schedule for the Assessment and Staging of Care for Dementia
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DOI：
10.3233/jad-141599
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发表时间：
2015-01-01
影响因子：
4
通讯作者：
Sartorius, Norman
中科院分区：
文献类型：
--
作者：
Semrau, Maya;Burns, Alistair;Sartorius, Norman
背景资料：一个可靠和有效的全球分期规模一直缺乏在痴呆care.Objective：制定一个易于使用的多维临床分期schedule痴呆schedule.方法：该时间表是通过以下方式开发的：㈠两个系列的重点小组（分别为40和48名参加者），分别在丹麦、法国、德国、荷兰、西班牙、瑞士、和英国与痴呆症护理领域的多学科专业人员小组合作，评估对痴呆症分期工具的需求，并就其设计和特征获得建议;二）一个试点研究，在三轮测试新开发的时间表使用书面的案例历史，与该项目的指导委员会的五名成员和27名来自荷兰，法国和西班牙的同事作为参与者的评分员之间的可靠性;和iii）一项实地研究，在法国、德国、荷兰、西班牙、意大利、土耳其、韩国、罗马尼亚和塞尔维亚的临床实践中测试该时间表的评分者间可靠性，其中包括209名痴呆患者和217名他们的护理人员作为参与者。焦点小组的参与者表示，明确需要一个文化公平的国际痴呆分期量表，并达成共识的表面效度和内容效度。因此，该时间表由七个维度组成，包括行为，认知，身体，功能，社会和护理方面。总体而言，时间表显示了足够的表面效度，内容效度和评分员间的可靠性;在9个现场，组内相关系数（ICC;绝对一致性）为个别尺寸范围在0.38和1.0之间，84.4%的ICC超过0.7。ICCs的总分在0.89和0.99之间的9个字段sites.Conclusion：理想的时间表看起来很有前途的工具，为全球范围内的痴呆症患者的临床和社会管理，但需要进一步的信度和效度测试。
Background: A reliable and valid global staging scale has been lacking within dementia care.Objective: To develop an easy-to-use multi-dimensional clinical staging schedule for dementia.Methods: The schedule was developed through: i) Two series of focus groups (40 and 48 participants, respectively) in Denmark, France, Germany, Netherlands, Spain, Switzerland, and UK with a multi-disciplinary group of professionals working within dementia care, to assess the need for a dementia-staging tool and to obtain suggestions on its design and characteristics; ii) A pilot-study over three rounds to test inter-rater reliability of the newly developed schedule using written case histories, with five members of the project's steering committee and 27 of their colleagues from Netherlands, France, and Spain as participants; and iii) A field-study to test the schedule's inter-rater reliability in clinical practice in France, Germany, Netherlands, Spain, Italy, Turkey, South Korea, Romania, and Serbia, which included 209 dementia patients and 217 of their caregivers as participants.Results: Focus group participants indicated a clear need for a culture-fair international dementia staging scale and reached consensus on face validity and content validity. Accordingly, the schedule has been composed of seven dimensions including behavioral, cognitive, physical, functional, social, and care aspects. Overall, the schedule showed adequate face validity, content validity, and inter-rater reliability; in the nine field-sites, intraclass correlation coefficients (ICCs; absolute agreement) for individual dimensions ranged between 0.38 and 1.0, with 84.4% of ICCs over 0.7. ICCs for total sum scores ranged between 0.89 and 0.99 in the nine field-sites.Conclusion: The IDEAL schedule looks promising as tool for the clinical and social management of people with dementia globally, though further reliability and validity testing is needed.