Kovach Christine R, Logan Brent R, Joosse Laura L, Noonan Patricia E
University of Wisconsin, Milwaukee, WI, USA.
Res Gerontol Nurs. 2012 Apr;5(2):89-93. doi: 10.3928/19404921-20110503-01. Epub 2011 May 18.
This descriptively designed study examined the sensitivity and specificity of staff nurses' identification of behavior change in nursing home residents with dementia. Behavior changes and whether further physical assessment was indicated were described and compared with judgments made by one expert advanced practice nurse. The convenience sample included 155 residents and 38 staff nurses from 11 nursing homes. Verbal symptoms and body part cues were the most prevalent behaviors, regardless of the assessor. Sensitivity, or probability of identifying a real behavior change, was generally low for the staff nurses, ranging from 35% to 65% for the different types of behaviors, while specificity was high at more than 95%. Additional assessment was believed to be needed for 51% of residents by the staff nurse and for 73% of residents by the expert. This study found that staff nurses are under-identifying behavior changes and the need for additional physical assessment.
这项描述性设计研究检验了护士对痴呆症疗养院居民行为变化识别的敏感性和特异性。描述了行为变化以及是否需要进一步的身体评估，并与一名专家级高级执业护士的判断进行了比较。便利样本包括来自11所疗养院的155名居民和38名护士。无论评估者是谁，言语症状和身体部位线索都是最常见的行为。护士识别真正行为变化的敏感性，即概率，总体较低，不同类型行为的敏感性在35%至65%之间，而特异性则很高，超过95%。护士认为51%的居民需要额外评估，专家认为73%的居民需要额外评估。本研究发现，护士对行为变化的识别不足，且对额外身体评估的需求认识不足。
