Passos Joaquim, Sequeira Carlos, Fernandes Lia
Health Sciences, School of Health of Viana do Castelo, 4900-314 Viana do Castelo, Portugal.
Int J Alzheimers Dis. 2012;2012:638267. doi: 10.1155/2012/638267. Epub 2012 Oct 24.
The problems and needs of older people are often associated with mental illness, characterized by a set of clinical manifestations, which constitute important domains for investigation and clinical practice. This paper presents the results of a pilot study whose main purpose was to identify met and unmet needs and to analyze the relationship between those needs, psychopathology and functionality in older people with mental health problems. A sample of 75 patients aged 65 or over, of both sexes, diagnosed with mental illness using ICD-9. The main diagnoses were depression (36%) and dementia (29.3%). Most patients had cognitive impairment (MMSE, 52%; CDT, 66.7%), depression (GDS, 61.3%), anxiety (ZAS, 81.3%), and moderate dependence (BI, 49.3% and LI, 77.3%). The main unmet needs found were daytime activities (40%), social benefits (13.3%), company (10.7%), psychological distress (9.3%), and continence (8%). The majority of these unmet needs occur with dementia patients. The majority of the carers of these patients had global needs (met and unmet) in terms of psychological distress. Findings also reveal that a low level of functionality is associated with dementia diagnoses. The association analyses suggest that dementia is an important determinant of the functional status and needs.
老年人的问题和需求往往与精神疾病相关,其具有一系列临床表现,这些临床表现构成了调查和临床实践的重要领域。本文介绍了一项试点研究的结果,该研究的主要目的是确定已满足和未满足的需求,并分析患有心理健康问题的老年人的这些需求、精神病理学和功能之间的关系。选取了75名65岁及以上的患者作为样本,男女皆有,使用国际疾病分类第九版(ICD - 9)诊断为患有精神疾病。主要诊断为抑郁症(36%)和痴呆症(29.3%)。大多数患者有认知障碍(简易精神状态检查表,52%;认知功能测试,66.7%)、抑郁症(老年抑郁量表,61.3%)、焦虑症(焦虑自评量表,81.3%)以及中度依赖(巴氏指数,49.3%;日常生活能力量表,77.3%)。发现的主要未满足需求包括日间活动(40%)、社会福利(13.3%)、陪伴(10.7%)、心理困扰(9.3%)和大小便失禁(8%)。这些未满足需求大多出现在痴呆症患者中。这些患者的大多数照料者在心理困扰方面存在整体需求(已满足和未满足)。研究结果还表明,功能水平低与痴呆症诊断相关。关联分析表明,痴呆症是功能状态和需求的一个重要决定因素。