Prevalence of and associations with agitation in residents with dementia living in care homes: MARQUE cross-sectional study
Prevalence of and associations with agitation in residents with dementia living in care homes: MARQUE cross-sectional study
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DOI：
10.1192/bjpo.bp.117.005181
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发表时间：
2017-07-01
期刊：
影响因子：
5.4
通讯作者：
Cooper, Claudia
中科院分区：
文献类型：
--
作者：
Livingston, Gill;Barber, Julie;Cooper, Claudia
背景据报道，躁动是痴呆症护理院居民中最常见的神经精神症状。目的是在一项大型护理院调查中报告痴呆症居民躁动的患病率和决定因素。方法我们在 2014 年 1 月 13 日至 2015 年 11 月 12 日期间采访了 86 个护理院的工作人员，了解痴呆症居民的躁动（科恩-曼斯菲尔德躁动量表（CMAI））、生活质量 （DEMQOL-proxy）和痴呆严重程度（临床痴呆评级）。我们还采访了居民及其亲属。我们使用根据居民年龄、性别、痴呆症严重程度和护理院类型进行调整的随机效应模型，并以 CMAI 作为连续评分。结果 在 3053 名患有痴呆症的居民中（86.2%），有 1489 名符合资格的居民参与。 15% 的极轻度痴呆居民有临床上显着的躁动，而轻度痴呆的比例为 33%（比值比 (OR)= 4.49 95% 置信区间 (CI)= 2.30），中度或重度痴呆的比例为 45%（OR= 6.95 95% CI= 3.63、13.31 和 OR= 6.23 95% CI=分别为 3.25、11.94）。更多的躁动与较低的生活质量相关（回归系数（rc）=-0.53；95% CI=-0.61，-0.46），但与人员配置或居民比例（rc= 0.03；95% CI=-0.04，0.11）、居民参与家庭活动水平（rc= 3.21；95% CI=-0.82，7.21）或家属探访人数 （rc=-0.03；95% CI=-0.15，0.08）。它与抗精神病药物的使用相关（rc= 6.45；95% CI= 3.98, 8.91）。 结论 患有痴呆和躁动的护理院居民的生活质量较低。目前提供的更多人员配备时间和活动与较低的骚动程度无关。需要开发和测试培养员工理解和应对个体住院医师躁动的根本原因的技能的新方法。版权和使用(C)皇家精神病学家学院 2017 年。
BackgroundAgitation is reportedly the most common neuropsychiatric symptom in care home residents with dementia.AimsTo report, in a large care home survey, prevalence and determinants of agitation in residents with dementia.MethodWe interviewed staff from 86 care homes between 13 January 2014 and 12 November 2015 about residents with dementia with respect to agitation (Cohen-Mansfield Agitation Inventory (CMAI)), quality of life (DEMQOL-proxy) and dementia severity (Clinical Dementia Rating). We also interviewed residents and their relatives. We used random effects models adjusted for resident age, gender, dementia severity and care home type with CMAI as a continuous score.ResultsOut of 3053 (86.2%) residents who had dementia, 1489 (52.7%) eligible residents participated. Fifteen per cent of residents with very mild dementia had clinically significant agitation compared with 33% with mild (odds ratios (ORs)= 4.49 95% confidence interval (CI)= 2.30) and 45% with moderate or severe dementia (OR= 6.95 95% CI= 3.63, 13.31 and OR= 6.23 95% CI= 3.25, 11.94, respectively). More agitation was associated with lower quality of life (regression coefficient (rc)=-0.53; 95% CI=-0.61, -0.46) but not with staffing or resident ratio (rc= 0.03; 95% CI=-0.04, 0.11), level of residents' engagement in home activities (rc= 3.21; 95% CI=-0.82, 7.21) or family visit numbers (rc=-0.03; 95% CI=-0.15, 0.08). It was correlated with antipsychotic use (rc= 6.45; 95% CI= 3.98, 8.91).ConclusionsCare home residents with dementia and agitation have lower quality of life. More staffing time and activities as currently provided are not associated with lower agitation levels. New approaches to develop staff skills in understanding and responding to the underlying reasons for individual resident's agitation require development and testing.Copyright and usage(C) The Royal College of Psychiatrists 2017.