Identification of community-residing individuals with dementia and their unmet needs for care
Identification of community-residing individuals with dementia and their unmet needs for care
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DOI：
10.1002/gps.2527
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发表时间：
2011-03-01
影响因子：
4
通讯作者：
Black, B. S.
中科院分区：
文献类型：
--
作者：
Johnston, D.;Samus, Q. M.;Black, B. S.
背景：需要创新的方法来广泛提供循证痴呆护理。本研究的目的是确定电话筛查方法是否能有效地识别社区中需要痴呆症护理的个体，并开发一种多维需求评估工具，用于识别家庭环境中与记忆障碍相关的未满足需求的类型和频率。方法：对马里兰州292名70岁及以上的社区居民进行横断面评估。参与者接受了简短的认知电话筛选。一个子样本（n = 43）接受了痴呆症和痴呆症相关需求的综合家庭评估。评估认知、功能、行为和临床因素。约翰霍普金斯大学痴呆护理需求评估（JHDCNA）用于识别与痴呆相关的未满足需求。结果：对样本进行电话筛查耗时350小时，27%的筛查结果为痴呆阳性。几乎所有接受家庭评估的痴呆症患者都至少有一项未满足的需求，其中最常见的未满足需求是痴呆症检查、一般医疗保健、环境安全、帮助自理能力受损以及参与有意义的活动。当护理人员在场时，也有许多未满足的需求，其中最常见的是关于痴呆症的护理人员教育，社区资源知识和护理人员心理健康护理。结论：需要有效和高效的方法来识别社区居住的痴呆症患者，以便提供痴呆症护理干预措施，以解决患者及其照顾者未满足的护理需求。版权所有John Wiley & Sons， Ltd。
Background: Innovative approaches to the widespread delivery of evidence-based dementia care are needed. The aims of this study were to determine whether a telephone screening method could efficiently identify individuals in the community in need of care for dementia and to develop a multidimensional needs assessment tool for identifying the type and frequency of unmet needs related to memory disorders in the home setting.Methods: This was a cross-sectional evaluation of 292 community-residing individuals aged 70 and older in Maryland. Participants were given a brief cognitive telephone screen. A subsample (n = 43) received a comprehensive in-home assessment for dementia and dementia-related needs. Cognitive, functional, behavioral, and clinical factors were assessed. The Johns Hopkins Dementia Care Needs Assessment (JHDCNA) was used to identify unmet needs related to dementia.Results: Telephone screening for the sample took 350 h, and 27% screened positive for dementia. Virtually all participants with dementia who received an in-home assessment had at least one unmet need, with the most frequent unmet needs being for a dementia workup, general medical care, environmental safety, assistance with ADL impairments, and access to meaningful activities. Caregivers, when present, also had a number of unmet needs, with the most common being caregiver education about dementia, knowledge of community resources, and caregiver mental health care.Conclusions: Effective and efficient means for identifying community-residing individuals with dementia are needed so that dementia care interventions can be provided to address unmet care needs of patients and their caregivers. Copyright (C) 2010 John Wiley & Sons, Ltd.