Department of Psychiatry, Veterans Affairs Healthcare System , La Jolla, California, USA.
J Palliat Med. 2011 Mar;14(3):275-9. doi: 10.1089/jpm.2010.0179. Epub 2011 Jan 19.
Major depression and delirium are prevalent, underrecognized, and undertreated in hospice and palliative care settings. Furthermore, they are both associated with significant morbidity and mortality.
A screening study of patients receiving inpatient hospice care was conducted in order to determine the ease of screening for depression and delirium in patients with advanced, life-threatening illnesses by hospice social workers and nurses, respectively.
A two-question depression screening tool was administered to 20 consecutive patients on admission to a hospice general inpatient care center by social work staff during their initial assessment. A delirium-screening tool was administered daily to 22 consecutive patients admitted to the ICC daily by nursing staff. Screening results were collected, as were patient and staff feelings about the burden of the screening process.
Of the 20 patients screened on admission for depression by social work, 70% (14/20) screened positive. Of the 22 patients screened daily for delirium by nursing, 64% (14/22) screened positive at least once during their admission. Screening for both conditions was considered relatively easy to accomplish by the hospice staff. There were no significant associations between a positive screen of depression or delirium and patient gender, age, ethnicity, terminal diagnosis, or marital status.
These results support the notion that depression and delirium are very common in hospice inpatients, and that screening for both is relatively easy and practical for hospice clinicians to conduct.
在临终关怀和姑息治疗环境中，重度抑郁症和谵妄症普遍存在，认识不足且治疗不足。此外，它们都与重大发病率和死亡率有关。
对接受住院临终关怀的患者进行了一项筛查研究，以确定临终关怀社会工作人员和护士分别对患有晚期、威胁生命的疾病的患者进行抑郁和谵妄筛查的简便程度。
在临终关怀综合住院护理中心入院时，社会工作者对 20 名连续患者进行了一项两问题抑郁筛查工具的评估。护理人员每天对 22 名连续入住 ICC 的患者进行谵妄筛查工具的评估。收集筛查结果，以及患者和工作人员对筛查过程负担的感受。
在社会工作者对抑郁进行入院筛查的 20 名患者中，70%（14/20）筛查阳性。在护理人员每天对谵妄进行筛查的 22 名患者中，64%（14/22）在入院期间至少有一次筛查阳性。临终关怀工作人员认为这两种情况的筛查都相对容易完成。抑郁或谵妄筛查阳性与患者性别、年龄、种族、终末诊断或婚姻状况之间没有显著关联。
这些结果支持了这样一种观点，即在临终关怀住院患者中，抑郁症和谵妄症非常常见，而且对于临终关怀临床医生来说，筛查这两种疾病相对容易且实用。
