Barriers to seeking care for memory problems: A vignette study.
Barriers to seeking care for memory problems: A vignette study.
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DOI：
10.1002/trc2.12238
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Zissimopoulos J
中科院分区：
文献类型：
--
作者：
Jacobson M;Joe E;Zissimopoulos J
简介：本研究比较了老年人在对自己和同龄人做出反应时如何判断是否需要对记忆相关问题进行后续护理。方法：“了解美国研究”（一个具有全国代表性的互联网小组）中 65 岁及以上的成年人被邀请参加一项简短的调查，其中包含三个小插图，描述与正常衰老、轻度认知障碍和轻度痴呆相关的记忆相关问题。受访者被随机分配到有关自己或同龄人的小插曲，并询问这些问题是否值得与医疗保健提供者进行后续讨论。对随机分配到自我和他人框架的小插曲的受访者进行比较，对后续讨论的肯定反应百分比和指数（范围从 0 到 3）的肯定反应总和进行了未经调整和协变量调整的差异。结果：1628 名小组成员 (81.6%) 完成了调查（平均年龄 72.3 [范围，65-102]，801 名女性 [49.2%] 和 827 名男性 [50.8%]），其中 796 名（48.9%）人被随机分配到关于自己的小插曲，832 名（51.1%）被分配到关于同龄个体的小插曲。确认需要跟进的百分比从 66.9% 到 90.5% 不等，对于那些随机分配有关自己的小插曲的人来说，这一比例系统性较低。差异范围从最严重的 –10.8 个百分点（95% 置信区间 [CI]，–13.6 至 –7.9 个百分点）到最轻微的记忆相关问题片段的 –13.9 个百分点（95% CI，‐18.1 至 –9.7 个百分点）。对于参与者自己相对于其他人的场景，总结指数为 –0.444 点（95% CI，0.563 至 –0.326）或 0.491 个标准差（95% CI，0.622σ 至 ‐0.362σ）。讨论：与影响自己的记忆相关问题相比，老年人更有可能认识到并建议对影响他人的记忆相关问题进行随访，这表明仅靠症状教育可能无法提高检测损伤和痴呆的认知评估率。
Introduction: This study compares how older adults judge the need for follow‐up care for memory‐related problems when they are responding about themselves versus someone of the same age. Methods: Adults ages 65 and over in the Understanding America Study, a nationally representative internet panel, were invited to participate in a short survey with three vignettes describing memory‐related problems associated with normal aging, mild cognitive impairment, and mild dementia. Respondents were randomly assigned to vignettes about themselves or about an individual of the same age and asked whether the problems warranted follow‐up discussion with a health‐care provider. Unadjusted and covariate‐adjusted differences in the percent of affirmative responses to follow‐up discussion and an index, ranging from 0 to 3, that summed affirmative responses, were compared across respondents randomly assigned to self‐ versus other‐framed vignettes. Results: One thousand six hundred twenty‐eight panel members (81.6%) completed the survey (mean age, 72.3 [range, 65–102], 801 female [49.2%] and 827 male [50.8%]) with 796 (48.9%) randomly assigned to vignettes about themselves and 832 (51.1%) to vignettes about individuals of the same age. Percent affirming need for follow‐up ranged from 66.9% to 90.5% and was systematically lower for those randomized to vignettes about themselves. The differences ranged from –10.8 percentage points (95% confidence interval [CI], –13.6 to –7.9 percentage points) for the most severe to –13.9 percentage points (95% CI, ‐18.1 to –9.7 percentage points) for the mildest memory‐related problem vignettes. The summary index was –0.444 points (95% CI, 0.563 to –0.326) or 0.491 of a standard deviation (95% CI, 0.622σ to ‐0.362σ) lower for scenarios about participants themselves relative to others. Discussion: Seniors were more likely to recognize and recommend follow‐up for memory‐related problems affecting someone else than the same problems affecting themselves, suggesting symptom education alone may not improve rates of cognitive assessment for detection of impairment and dementia.
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影响因子：
2.1
作者：
Bradford A;Kunik ME;Schulz P;Williams SP;Singh H
通讯作者：
Singh H
影响因子：
14
作者：
通讯作者：
--
影响因子：
7.2
作者：
Orfei, Maria Donata;Varsi, Ambra Erika;Spalletta, Gianfranco
通讯作者：
Spalletta, Gianfranco
影响因子：
4
作者：
Werner, P;Heinik, J
通讯作者：
Heinik, J
影响因子：
4
作者：
Werner, P
通讯作者：
Werner, P