The General Medical Health Rating: A bedside global rating of medical comorbidity in patients with dementia
The General Medical Health Rating: A bedside global rating of medical comorbidity in patients with dementia
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DOI：
10.1111/j.1532-5415.1999.tb07245.x
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发表时间：
1999-04-01
影响因子：
6.3
通讯作者：
Brandt, J
中科院分区：
文献类型：
--
作者：
Lyketsos, CG;Galik, E;Brandt, J
目的：痴呆症是一个严重的公共卫生问题。一般医学合并症在痴呆患者中很常见，对他们的护理至关重要。然而，对这些患者的医学合并症知之甚少，并且没有直接的床旁总体评分量表来评估合并症的严重性。本文介绍了一般医疗健康评分（GHMR）的发展和测量特性，这是一个快速的痴呆患者医疗并发症的全球评分量表。设计：报告了GMHR的评分者间信度、同时效度和预测效度。共有819个连续的痴呆症门诊患者和180个连续入院铜岭，长期护理居住的人与痴呆症，被列入了study.RESULTS：GMHR被认为是高度可靠的（加权Kappa = .91）。在所有阶段和类型的痴呆症中，GMHR评分与共病医疗条件的数量，共病条件下服用的药物数量以及日常生活障碍的活动相关，即使在对痴呆症的严重程度进行调整后。GMHR评级也是一个强有力的预测福尔斯和死亡率在长期护理居民调整后的年龄和严重程度dementions.CONCLUSION：GMHR是一个可靠的，有效的，全球床边措施的严重程度，一般医疗合并症的痴呆患者，可用于临床和研究目的。
OBJECTIVE: Dementia is a serious public health problem. General medical comorbidity is common in dementia patients and critical to their care. However, little is known about medical comorbidity in these patients, and there are no straightforward bedside global rating scales for the seriousness of comorbid medical illness. This paper describes the development and measurement properties of the General Medical Health Rating (GHMR), a rapid global rating scale of medical comorbidity in dementia patients.DESIGN: Interrater reliability, concurrent validity, and predictive validity of the GMHR are reported.SETTING: An outpatient dementia clinic, assisted living, and nursing home.PARTICIPANTS: A total of 819 consecutive dementia clinic outpatients and 180 consecutive admissions to Copper Ridge, a long-term care residence for people with dementia, were included in the study.RESULTS: GMHR was found to be highly reliable (weighted kappa = .91). Across all stages and types of dementia, GMHR ratings were correlated with number of comorbid medical conditions, number of medications being taken for comorbid conditions, and with activity of daily living impairment, even after adjustment for severity of dementia. GMHR ratings were also a strong predictor of falls and of mortality in long-term care residents after adjustment for age and severity of dementia.CONCLUSION: GMHR is a reliable, valid, global bedside measure of severity of general medical comorbidity for patients with dementia that can be used for clinical and research purposes.