The utility of the Kohlman evaluation of living skills test is associated with substantiated cases of elder self-neglect
The utility of the Kohlman evaluation of living skills test is associated with substantiated cases of elder self-neglect
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DOI：
10.1111/j.1745-7599.2007.00205.x
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发表时间：
2007-03-01
影响因子：
--
通讯作者：
Dyer, Carmel B.
中科院分区：
文献类型：
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作者：
Pickens, Sabrina;Naik, Aanand D.;Dyer, Carmel B.
目的：自我忽视是向成人保护服务机构报告的案件中最普遍的发现，其特点是无法满足自己的基本需求。Kohlman生活技能评估（KELS）已在老年人群中得到验证，以评估工具性和基本日常生活活动的表现，并作为独立生活能力的评估工具;因此，本分析的目的是比较经证实的自我忽视病例和匹配的社区居住老年人之间的KELS评分。数据来源：这是一项横断面试点研究，纳入了50名年龄在65岁及以上的成年人，他们是从APS招募的自我忽视记录病例，以及从哈里斯县医院区门诊招募的50名对照参与者。对照组参与者的年龄，种族，性别和邮政编码相匹配。一个老年护理从业者（NP）领导的团队在所有研究参与者的家中进行了全面的老年评估。评估包括KELS和简易精神状态检查（MMSE）测试。卡方分析被用来确定是否自我忽视的情况下，显着更有可能失败的KELS测试比匹配controls.Conclusions：分析显示，自我忽视者显着更有可能失败的KELS比非自我忽视者（50%与30%，p = 0.025）。当按MMSE评分分层时，与匹配的认知功能完整的对照组相比，认知功能完整的自我忽视者更有可能无法通过KELS（45%对17%，p = 0.013）。异常的结果使用在家里KELS测试显着相关的证实案件self-neglect.Implications实践：目前没有金标准的措施，以确定能力与自我照顾行为之间的自我忽视的情况下。因此，在许多临床环境中，自我忽视可能仍然无法识别。KELS为临床医生提供了一个客观的衡量个人的能力和日常生活支持任务的表现，因此，提供了信息，可以帮助NPs识别有自我忽视风险的老年人。这些研究结果表明，KELS测试作为综合老年评估的一部分，在疑似自我忽视的情况下，帮助临床医生具有重要的实用性。
Purpose: Self-neglect is the most prevalent finding among cases reported to Adult Protective Services (APS) and is characterized by an inability to meet one's own basic needs. The Kohlman evaluation of living skills (KELS) has been validated in geriatric populations to assess performance with both instrumental and basic activities of daily living and as an assessment tool for the capacity to live independently; therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders.Data sources: This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from APS as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender, and ZIP code. A geriatric nurse practitioner (NP)-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and mini-mental state examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls.Conclusions: The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p = .025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p = .013). Abnormal results using an in-home KELS test were significantly associated with substantiated cases of self-neglect.Implications for practice: There is currently no gold-standard measure for identifying capacity with self-care behaviors among cases of self-neglect. As a result, self-neglect may remain unidentified in many clinical settings. The KELS provides clinicians with an objective measure of an individual's capacity and performance with everyday life-supporting tasks and thus, provides information that can help NPs identify elders at risk for self-neglect. These findings suggest that the KELS test has significant utility as part of a comprehensive geriatric assessment to aid clinicians in suspected cases of self-neglect.