Macdonald A J D, Carpenter G I
Section of Old Age Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Guy's, King's and St. Thomas' Schools of Medicine, Dentistry and Biomedical Sciences, King's College, London, UK.
Int J Geriatr Psychiatry. 2003 Feb;18(2):105-8. doi: 10.1002/gps.779.
To estimate the agreement between nursing staff's recognition of dementia and results of MMSE assessment in a probability sample of non-specialist nursing home residents in South East England, and to identify correlates of disagreement.
Prospective survey. The most senior nurse on duty was interviewed about each resident sampled, and optionally about their own training and experience. Residents were interviewed using the MMSE, and assessed using the Cornell Scale for Depression in Dementia, the Barthel ADL index, and the Behave-AD scale for behavioural problems.
135 nurses were interviewed about 445 residents-116 reported on of the 291 residents scoring 23 or less on the MMSE-34% of these were acknowledged to have dementia. 46.4% of those with MMSE scores of 15 or less were acknowledged to have dementia. "Missed dementia" was associated with higher MMSE and lower Behave-AD scores, and inversely associated with RMN training and private home ownership for profit. It was not associated with training or duration of staff employment.
Most cognitive impairment in non-specialist nursing homes appeared to be unrecognised. This has implications for the prospects of good dementia care in these homes.
在英格兰东南部非专科养老院居民的概率样本中，评估护理人员对痴呆症的认知与简易精神状态检查表（MMSE）评估结果之间的一致性，并确定不一致的相关因素。
前瞻性调查。就每位被抽样的居民询问当班的最高级护士，还可选择询问其自身的培训和经验情况。使用MMSE对居民进行访谈，并使用痴呆症抑郁康奈尔量表、巴氏日常生活活动指数以及行为问题Behave - AD量表进行评估。
就445名居民对135名护士进行了访谈，其中116名报告了291名MMSE得分在23分及以下的居民，这些居民中有34%被认为患有痴呆症。MMSE得分在15分及以下的居民中，有46.4%被认为患有痴呆症。“漏诊痴呆症”与较高的MMSE得分和较低的Behave - AD得分相关，与精神科护士培训以及盈利性私立养老院呈负相关。它与培训或员工工作时长无关。
非专科养老院中大多数认知障碍似乎未被识别。这对这些养老院中良好的痴呆症护理前景有影响。
