入住急症医院的痴呆症患者的行为和精神症状：前瞻性队列研究。
Behavioural and psychiatric symptoms in people with dementia admitted to the acute hospital: prospective cohort study.
作者信息
Sampson Elizabeth L, White Nicola, Leurent Baptiste, Scott Sharon, Lord Kathryn, Round Jeff, Jones Louise
机构信息
Elizabeth L. Sampson, MD MRCPsych, Marie Curie Palliative Care Research Unit, Division of Psychiatry, University College Medical School and Barnet Enfield and Haringey Mental Health Trust-Liaison Psychiatry Team, North Middlesex University Hospital, London; Nicola White, BSc, MSc, Baptiste Leurent, MSc, Sharon Scott, RGN MSc, Kathryn Lord, BSc, Jeff Round, MA, Louise Jones, MB FRCP, Marie Curie Palliative Care Research Unit, Division of Psychiatry, University College Medical School, London, UK.
出版信息
Br J Psychiatry. 2014 Sep;205(3):189-96. doi: 10.1192/bjp.bp.113.130948. Epub 2014 Jul 24.
BACKGROUND
Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and psychiatric symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. AIMS To define the prevalence of BPSD and explore their clinical associations.
METHOD
Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4 (± 1) days until discharge. Other measures included length of stay, care quality indicators, adverse events and mortality.
RESULTS
Participants were very impaired; 46% at Functional Assessment Staging Scale (FAST) stage 6d or above (doubly incontinent), 75% had BPSD, and 43% had some BPSD that were moderately/severely troubling to staff. Most common were aggression (57%), activity disturbance (44%), sleep disturbance (42%) and anxiety (35%).
CONCLUSIONS
We found that BPSD are very common in older people admitted to an acute hospital. Patients and staff would benefit from more specialist psychiatric support.
背景
痴呆症在入住急症医院的老年人中很常见。人们担心他们所接受的护理质量。痴呆症的行为和精神症状（BPSD）似乎对医院工作人员特别具有挑战性。目的：确定BPSD的患病率并探讨其临床关联。
方法
对230名70岁以上因急性内科疾病入院的痴呆症患者进行纵向队列研究，入院时及出院前每4（±1）天评估一次BPSD。其他测量指标包括住院时间、护理质量指标、不良事件和死亡率。
结果
参与者功能严重受损；46%处于功能评估分期量表（FAST）6d期或以上（大小便失禁），75%有BPSD，43%有一些让工作人员感到中度/重度困扰的BPSD。最常见的是攻击行为（57%）、活动障碍（44%）、睡眠障碍（42%）和焦虑（35%）。
结论
我们发现BPSD在入住急症医院的老年人中非常常见。患者和工作人员将受益于更多的专科精神科支持。
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