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体弱老年人的个案管理:一项随机对照试验性研究。

Case managers for frail older people: a randomised controlled pilot study.

作者信息

Kristensson Jimmie, Ekwall Anna K, Jakobsson Ulf, Midlöv Patrik, Hallberg Ingalill R

机构信息

Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

出版信息

Scand J Caring Sci. 2010 Dec;24(4):755-63. doi: 10.1111/j.1471-6712.2010.00773.x.

Abstract

AIM

The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living-staircase and Geriatric Depression Scale-20.

METHOD

This pilot study was carried out in a randomised controlled design with repeated follow-ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts.

RESULT

No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow-up after 3 months. Cronbach's alpha showed satisfactory internal consistency for group comparisons.

CONCLUSIONS

The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.

摘要

目的

本试点研究旨在测试抽样方法并探索样本特征,该研究采用了一种病例管理干预措施,针对有功能依赖且多次接触医疗服务的老年人,同时研究该干预措施在3个月后对感知健康和抑郁情绪的影响。此外,还旨在探索生活满意度指数Z、日常生活活动楼梯量表和老年抑郁量表 - 20的内部一致性。

方法

本试点研究采用随机对照设计并进行重复随访。总共46人被连续随机分配到干预组(n = 23)或对照组(n = 23)。两名护士担任病例管理人员并实施干预措施,该措施由四个部分组成。

结果

两组在基线时未发现差异。结果显示,参与者在基线时生活满意度较低(中位数为14对12),有多项健康问题(中位数为11),老年抑郁量表得分较高(中位数为6),表明存在抑郁风险。在3个月后的随访中,组间或组内的抑郁情绪或感知健康方面均未观察到显著影响。Cronbach's alpha系数显示在组间比较中内部一致性令人满意。

结论

抽样程序产生了相似的组。生活满意度、功能依赖和抑郁症状测量方法使用可靠。3个月后未发现感知健康和抑郁症状有变化,表明期望产生效果可能为时过早。低抑郁得分值得关注,需要进一步研究。

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