Marie Curie Palliative Care Research Unit, UCL Mental Health Sciences Unit University College Medical School, London, W1W 7EJ, UK.
BMC Geriatr. 2011 Oct 17;11:61. doi: 10.1186/1471-2318-11-61.
People with dementia admitted to the acute hospital often receive poor quality care particularly with regards to management of behavioural and psychiatric symptoms of dementia (BPSD) and of pain. There have been no UK studies on the prevalence and type of pain or BPSD in people with dementia in this setting, or on how these may impact on patients, carers, staff and costs of care.
METHODS/DESIGN: We shall recruit older people with dementia who have unplanned acute medical admissions and measure the prevalence of BPSD using the Behave-AD (Behaviour in Alzheimer's Disease) and the CMAI (Cohen Mansfield Agitation Inventory). Pain prevalence and severity will be assessed by the PAINAD (Pain Assessment in Advanced Dementia) and the FACES pain scale. We will then analyse how these impact on a variety of outcomes and test the hypothesis that poor management of pain is associated with worsening of BPSD.
By demonstrating the costs of BPSD to individuals with dementia and the health service this study will provide important evidence to drive improvements in care. We can then develop effective training for acute hospital staff and alternative treatment strategies for BPSD in this setting.
入住急性医院的痴呆症患者往往接受的护理质量较差,特别是在痴呆症患者的行为和精神症状(BPSD)以及疼痛管理方面。在英国,针对这一环境中痴呆症患者的疼痛或 BPSD 的患病率和类型,或这些因素如何影响患者、护理人员、员工以及护理成本,尚无研究。
方法/设计:我们将招募有计划外急性医疗入院的老年痴呆症患者,并使用 Behave-AD(阿尔茨海默病行为)和 CMAI(科恩·曼斯菲尔德激惹量表)来衡量 BPSD 的患病率。疼痛的患病率和严重程度将通过 PAINAD(晚期痴呆症疼痛评估)和 FACES 疼痛量表进行评估。然后,我们将分析这些因素如何影响各种结果,并检验假设,即疼痛管理不善与 BPSD 的恶化有关。
通过证明痴呆症患者个人和医疗服务成本的 BPSD,本研究将为改善护理提供重要证据。然后,我们可以为急性医院工作人员开发有效的培训,并为这一环境中的 BPSD 开发替代治疗策略。