Development of a Minimum Data Set-based depression rating scale for use in nursing homes
Development of a Minimum Data Set-based depression rating scale for use in nursing homes
复制标题
DOI：
10.1093/ageing/29.2.165
复制
发表时间：
2000-03-01
期刊：
影响因子：
6.7
通讯作者：
Phillips, C
中科院分区：
文献类型：
--
作者：
Burrows, AB;Morris, JN;Phillips, C
背景：抑郁症在疗养院居民中很常见，但诊断不足。有必要建立一个标准化的筛查工具，其中包括日常观察的nursing-home staff.Aim：开发和验证抑郁症筛查工具，使用的项目从最小数据集的居民评估工具。我们对来自两家养老院的108名居民进行了半结构化访谈，使用17-项目汉密尔顿抑郁量表和康奈尔痴呆抑郁量表。护理人员完成了最小数据集评估。在随机分配的衍生样本（n = 81）中，我们确定了与汉密尔顿和康奈尔评级相关（P < 0.05）的最小数据集情绪项目。这些项目被分解使用倾斜旋转产生五个概念上不同的因素。使用线性回归，每组因子项目对汉密尔顿和康奈尔评级进行回归，以确定一组核心的七个最小数据集情绪项目，包括最小数据集抑郁评定量表。然后，我们测试了最小数据集抑郁评定量表对公认的截止值和精神病诊断的性能。最小数据集抑郁评定量表的临界点评分为3，（汉密尔顿为94%，康奈尔为78%），特异性损失极小（汉密尔顿为72%，康奈尔为77%），当对照衍生样本中轻度至中度抑郁的临界值进行测试时。验证样品的结果相似。当测试对诊断的主要或非主要抑郁症的一个子集的82个科目，灵敏度为91%，特异性为69%，性能相比有利的15项老年抑郁Scale.Conclusion：项目从最小数据集可以组织筛选抑郁症的疗养院居民。现在需要进一步测试该仪器。
Background: depression is common but under-diagnosed in nursing-home residents. There is a need for a standardized screening instrument which incorporates daily observations of nursing-home staff.Aim: to develop and validate a screening instrument for depression using items from the Minimum Data Set of the Resident Assessment Instrument.Methods: we conducted semi-structured interviews with 108 residents from two nursing homes to obtain depression ratings using the 17-item Hamilton Depression Rating Scale and the Cornell Scale for Depression in Dementia. Nursing staff completed Minimum Data Set assessments. In a randomly assigned derivation sample (n = 81), we identified Minimum Data Set mood items that were correlated (P < 0.05) with Hamilton and Cornell ratings. These items were factored using an oblique rotation to yield five conceptually distinct factors. Using linear regression, each set of factored items was regressed against Hamilton and Cornell ratings to identify a core set of seven Minimum Data Set mood items which comprise the Minimum Data Set Depression Rating Scale. We then tested the performance of the Minimum Data Set Depression Rating Scale against accepted cut-offs and psychiatric diagnoses.Results: a cutpoint score of 3 on the Minimum Data Set Depression Rating Scale maximized sensitivity (94% for Hamilton, 78% for Cornell) with minimal loss of specificity (72% for Hamilton, 77% for Cornell) when tested against cut-offs for mild to moderate depression in the derivation sample. Results were similar in the validation sample. When tested against diagnoses of major or non-major depression in a subset of 82 subjects, sensitivity was 91% and specificity was 69%, Performance compared favourably with the 15-item Geriatric Depression Scale.Conclusion: items from the Minimum Data Set can be organized to screen for depression in nursing-home residents. Further testing of the instrument is now needed.