College of Nursing, University of Utah, Salt Lake City, UT, USA.
Aging Ment Health. 2012;16(7):892-901. doi: 10.1080/13607863.2012.667785. Epub 2012 Apr 10.
We evaluated the use of the Cornell Scale for Depression in Dementia (CSDD) as a proxy measure. Study questions were: How do residents' self-reports on the CSDD compare with the nurse proxy CSDD ratings of the resident? How do characteristics of depression as rated by the resident CSDD and the nurse CSDD compare? To what extent are demographic and clinical variables associated with resident CSDD, nurse CSDD, and the discrepancy between resident and nurse CSDD scores?
Residents and nurse proxy pairs (n=395 pairs) from 28 nursing homes (NHs) participated. We calculated discrepancy scores for total and subscale CSDD scores, examined correlations between resident and nurse CSDD scores, and described rates of clinical depression using each of the scores. We conducted multivariate analyses to examine factors associated with resident and nurse CSDD and discrepancy scores.
On average, participants had mild cognitive impairment, were White, and female. Associations between resident and nurse CSDD were low (r=0.16). The mean discrepancy score was -2.03 (SD=5.28, p<0.001), indicating that nurses evaluated residents as less depressed than residents evaluated themselves. Discrepancy scores were not associated with residents' cognitive status, but were associated with a measure of self-report reliability. Regression analyses indicated that depression diagnosis accounted for a small but significant association with resident CSDD, but was not significantly associated with nurse CSDD.
These findings underscore the importance of obtaining resident input when assessing depression in NH residents with dementia, and educating NH nurses in the most effective ways to assess depression.
我们评估了使用康奈尔抑郁量表痴呆版（CSDD）作为替代指标。研究问题是：居民的自我报告与护理人员对居民的 CSDD 评分相比如何？居民和护理人员评定的抑郁特征有何不同？居民 CSDD、护理人员 CSDD 评分以及居民和护理人员 CSDD 评分之间的差异与哪些人口统计学和临床变量相关？
来自 28 家养老院（NH）的居民和护理人员代理对（n=395 对）参与了研究。我们计算了 CSDD 总分和各分量表的差值评分，考察了居民和护理人员 CSDD 评分之间的相关性，并使用每种评分描述了临床抑郁症的发生率。我们进行了多元分析，以考察与居民和护理人员 CSDD 以及居民和护理人员 CSDD 评分差异相关的因素。
平均而言，参与者患有轻度认知障碍，为白人，且为女性。居民和护理人员 CSDD 之间的相关性较低（r=0.16）。平均差值评分为-2.03（SD=5.28，p<0.001），表明护士对居民的评估比居民自我评估的抑郁程度要轻。差值评分与居民的认知状态无关，但与自我报告可靠性的衡量标准有关。回归分析表明，抑郁诊断与居民 CSDD 有一定的小但显著的关联，但与护理人员 CSDD 无显著关联。
这些发现强调了在评估患有痴呆症的 NH 居民的抑郁症状时，获取居民的意见以及对 NH 护士进行评估抑郁最有效的方法进行教育的重要性。
