Use of the Minimum Data Set to rate incontinence severity.
Use of the Minimum Data Set to rate incontinence severity.
复制标题
使用最小数据集来评估失禁严重程度。
DOI：
10.1111/j.1532-5415.1995.tb06615.x
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发表时间：
1995
影响因子：
6.3
通讯作者：
McNees,MP
中科院分区：
文献类型：
--
作者：
Crooks,VC;Schnelle,JF;Ouslander,JP;McNees,MP
目的：评估MDS尿失禁严重程度分级与尿失禁频率的直接测量之间的关系。设计：比较两种测量尿失禁的方法：疗养院(NH)工作人员记录的MDS评分和研究人员进行的尿湿体格检查。设置和参与者：来自爱荷华州、华盛顿州和洛杉矶地区的9家养老院的293名老年居民进行了一次评估。对49名大小便失禁患者进行了两次评估，在实施提示排尿计划之前和之后。干预：这项研究是评估计算机辅助尿失禁管理系统(IMS)使用情况的更大研究的一部分。对失禁患者进行评估，如果他们符合预定的标准，他们将接受提示排尿治疗。测量方法：使用三种尿失禁指标：由NH工作人员记录的MDS评分，由NH工作人员在评估居民并进行提示排尿治疗时进行的尿湿体检，以及由研究人员独立进行的尿湿检查。结果：研究人员的尿检与MDS评分之间有统计学意义的相关性(r=0.49；P≤.001)，但NH工作人员进行的尿检与MDS评分无显著相关性(r=0.003；P<；0.914)。NHS内部和之间的相关性存在很大差异。对于被置于提示排尿计划的居民，研究人员测量的尿湿率显著改善(从28%到14%；t=6.73；df=48；P<；.001)，而尿失禁前的评分没有显著变化(从1.7%到2.0；t=−1.42；df=4s；p<；.075)。结论：尽管尿失禁检查系统似乎能准确地识别失禁NH患者，但它的临床应用可能受到实际湿检数据与已知失禁患者的MDS分类严重程度排名之间的不一致的限制。我们观察到的尿湿程度的直接观察测量和表示失禁严重程度的MDS评分之间的广泛差异可能限制了MDS在检测失禁严重程度变化方面的潜在有用性。完成MDS的工作人员可能需要更多的信息和说明，如果目标是区分不同程度的大小便失禁严重程度，并测量随着时间的推移对治疗干预的变化。
OBJECTIVES:To assess the relationship of the MDS incontinence severity ratings to direct measures of incontinence frequency.DESIGN:Two methods of measuring incontinence were compared: the MDS rating as recorded by nursing home (NH) staff and physical checks for wetness performed by research staff.SETTING AND PARTICIPANTS:A total sample of 293 older residents from nine nursing homes located in Iowa, the State of Washington, and the Los Angeles area were assessed once. A subsample of 49 incontinent residents were assessed twice, before and after the implementation of a prompted voiding program.INTERVENTION:This study is a part of a larger study evaluating the use of a computer‐aided incontinence management system (IMS). Incontinent residents were assessed, and, if they met predefined criteria, they were treated with prompted voiding.MEASUREMENTS:Three measures of incontinence were used: the MDS rating recorded by NH staff, physical checks for wetness performed by NH staff while assessing residents for and treating them with prompted voiding, and physical checks for wetness performed independently by research staff.RESULTS:There was a statistically significant correlation (r = .49; P ≤.001) between research staff wet checks and the MDS ratings, but wetness checks performed by NH staff had an insignificant correlation with MDS ratings (r = .003; P < 0.914). There was wide variability within and between NHs in the correlation. For residents who were placed on the prompted voiding program, the pre to post wet rate, as measured by research staff, improved significantly (from 28 to 14%; t = 6.73; df= 48; P < .001), whereas the pre to post MDS ratings did not change significantly (from 1.7 to 2.0; t = −1.42;df=4S;P< .075).CONCLUSIONS:Although the MDS appears to identify incontinent NH residents accurately, its clinical utility may be limited by disagreements between actual wet check data and MDS categorical severity rankings for residents known to be incontinent. The wide variability between direct observational measures of wetness and the MDS scores denoting incontinence severity we observed may limit the potential usefulness of the MDS for detecting changes in incontinence severity. It is possible that more information and instructions are needed for staff completing the MDS if the goal is to discriminate between different levels of incontinence severity and measure changes over time in response to therapeutic interventions.