School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Department of Health Care and Nursing Science, Maastricht University, the Netherlands.
BMC Health Serv Res. 2010 Jan 29;10:30. doi: 10.1186/1472-6963-10-30.
Nursing home care for people with dementia is increasingly organized in small-scale and homelike care settings, in which normal daily life is emphasized. Despite this increase, relatively little is known about residents' characteristics and whether these differ from residents in traditional nursing homes. This study explored and compared characteristics of residents with dementia living in small-scale, homelike facilities and regular psychogeriatric wards in nursing homes, focusing on functional status and cognition.
A cross-sectional study was conducted, including 769 residents with dementia requiring an intensive level of nursing home care: 586 from regular psychogeriatric wards and 183 residents from small-scale living facilities. Functional status and cognition were assessed using two subscales from the Resident Assessment Instrument Minimum Data Set (RAI-MDS): the Activities of Daily Living-Hierarchy scale (ADL-H) and the Cognitive Performance Scale (CPS). In addition, care dependency was measured using Dutch Care Severity Packages (DCSP). Finally, gender, age, living condition prior to admission and length of stay were recorded. Descriptive analyses, including independent samples t- tests and chi-square tests, were used. To analyze data in more detail, multivariate logistic regression analyses were performed.
Residents living in small-scale, homelike facilities had a significantly higher functional status and cognitive performance compared with residents in regular psychogeriatric wards. In addition, they had a shorter length of stay, were less frequently admitted from home and were more often female than residents in regular wards. No differences were found in age and care dependency. While controlling for demographic variables, the association between dementia care setting and functional status and cognition remained.
Although residents require a similar intensive level of nursing home care, their characteristics differ among small-scale living facilities and regular psychogeriatric wards. These differences may limit research into effects and feasibility of various types of dementia care settings. Therefore, these studies should take resident characteristics into account in their design, for example by using a matching procedure.
为痴呆症患者提供的养老院护理越来越多地组织在小规模和家庭式的护理环境中，强调正常的日常生活。尽管这种情况有所增加，但对于居民的特征以及这些特征是否与传统养老院的居民不同，了解相对较少。本研究探讨并比较了居住在小规模、家庭式设施和养老院常规精神科病房的痴呆症患者的特征，重点是功能状态和认知能力。
进行了一项横断面研究，纳入了 769 名需要强化护理的痴呆症患者：586 名来自常规精神科病房，183 名来自小规模生活设施。使用居民评估工具最低数据集中的两个子量表评估功能状态和认知能力：日常生活活动-层次量表（ADL-H）和认知表现量表（CPS）。此外，使用荷兰护理严重程度包（DCSP）测量护理依赖程度。最后，记录了性别、年龄、入院前的生活状况和入住时间。进行了描述性分析，包括独立样本 t 检验和卡方检验。为了更详细地分析数据，进行了多变量逻辑回归分析。
居住在小规模、家庭式设施中的居民的功能状态和认知表现明显高于常规精神科病房的居民。此外，他们的入住时间较短，更多地从家中入院，更多地为女性，而不是常规病房的居民。在年龄和护理依赖方面没有差异。在控制人口统计学变量后，痴呆症护理环境与功能状态和认知之间的关联仍然存在。
尽管居民需要类似的强化养老院护理，但他们的特征在小规模生活设施和常规精神科病房之间存在差异。这些差异可能限制了对各种类型的痴呆症护理环境的效果和可行性的研究。因此，这些研究在设计中应考虑到居民的特征，例如采用匹配程序。
