Canterbury Hospital, Sydney Local Health District, New South Wales, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia.
Geriatr Nurs. 2013 Sep-Oct;34(5):355-60. doi: 10.1016/j.gerinurse.2013.05.004. Epub 2013 Jun 14.
A linguistically diverse cohort of 126 medical inpatients 65 y and over was recruited to determine rates of delirium after admission, associated outcomes, and staff detection of delirium. A clinical interview and cognitive and functional questionnaires were completed with the patient and their carer, and files were reviewed. The incidence of delirium at comprehensive assessment early after admission was 10.3% and the overall incidence 19.1% over the whole admission. Cognitive impairment was common (n = 80, 63.5%), including 61 patients (48.4%) who had dementia. Most patients (83%) with delirium had dementia. Staff recognized less than 21% of patients with delirium, 33% of patients with dementia, and 36% of cognitively impaired patients. There was no difference in outcomes between English and non-English speaking patients. Given the high prevalence and poor recognition of cognitive disorders in older people, routine cognitive screening should occur. Staff education should focus upon improving delirium detection and addressing the needs of cognitively impaired older inpatients.
研究招募了 126 名年龄在 65 岁及以上的语言多样化的住院内科患者，以确定入院后谵妄的发生率、相关结局以及医护人员对谵妄的识别情况。通过对患者及其照顾者进行临床访谈、认知和功能问卷评估，并查阅病历资料来完成评估。在入院早期的全面评估中，谵妄的发生率为 10.3%，整个住院期间的总发生率为 19.1%。认知障碍很常见（n=80，63.5%），包括 61 名（48.4%）痴呆患者。谵妄患者中，超过 80%（83%）有痴呆。医护人员识别出的谵妄患者、痴呆患者和认知障碍患者分别不到 21%、33%和 36%。英语和非英语患者的结局无差异。鉴于老年人认知障碍的高患病率和识别率低，应常规进行认知筛查。医护人员应重点接受培训，以提高对谵妄的识别能力，并满足认知障碍老年住院患者的需求。
