Goldstein Judah, Travers Andrew, Hubbard Ruth, Moorhouse Paige, Andrew Melissa K, Rockwood Kenneth
CJEM. 2014 Sep;16(5):370-7.
The Comprehensive Geriatric Assessment (CGA) is used in geriatric medicine as a means to manage the health care needs of older adults and to grade frailty. We modified the CGA so that it could be completed independently by care partners (usually family) and be used to grade frailty. Our objective was to examine the feasibility of a care partner completing the CGA at the time of the first prehospital encounter.
A prospective, observational study was conducted with a convenience sample of patients ≥ 70 years accompanied by a knowledgeable care partner. Feasibility was measured by the time required and percent completeness of items on the form based on completion by the care partner and by paramedic perception of utility.
Subjects (N = 104) were enrolled with three postenrolment exclusions due to ineligibility. Most participants were older women living in their own home. The mean time to complete the questionnaire was 18.7 minutes (SD 11.3; median 15 minutes; interquartile range 12-20 minutes). Only 64% of the care partners recorded the time it took. Nineteen percent of paramedics completed a follow-up survey, and all felt screening for frailty was worthwhile and most (> 70%) thought that the CP-CGA may be a useful approach. The study was limited by recruitment bias of potentially eligible patients, a high level of missingness in the outcome measures of interest, and low paramedic participation rates.
We observed a high rate of item completeness of questionnaires with a mean time to complete of 18.7 minutes in a convenience sample of older patients. A small sample of paramedics universally endorsed the utility of screening for frailty in the prehospital setting, and many thought the CP-CGA was a helpful tool.
综合老年医学评估（CGA）在老年医学中用于满足老年人的医疗保健需求并对衰弱程度进行分级。我们对CGA进行了修改，使其能够由照护伙伴（通常是家人）独立完成，并用于对衰弱程度进行分级。我们的目的是检验照护伙伴在首次院前接诊时完成CGA的可行性。
采用前瞻性观察性研究，以方便抽样的方式选取年龄≥70岁且有知识丰富的照护伙伴陪同的患者。可行性通过照护伙伴完成表格所需的时间和表格项目的完成百分比以及护理人员对实用性的看法来衡量。
共纳入104名受试者，3名受试者因不符合资格在入组后被排除。大多数参与者是居住在自己家中的老年女性。完成问卷的平均时间为18.7分钟（标准差11.3；中位数15分钟；四分位间距12 - 20分钟）。只有64%的照护伙伴记录了完成问卷所用的时间。19%的护理人员完成了后续调查，所有人都认为对衰弱进行筛查是值得的，并且大多数人（>70%）认为照护伙伴完成的CGA可能是一种有用的方法。该研究受到潜在合格患者的招募偏差、感兴趣的结局指标中高水平的缺失数据以及护理人员低参与率的限制。
在一个方便抽样的老年患者样本中，我们观察到问卷项目的完成率很高，完成问卷的平均时间为18.7分钟。一小部分护理人员一致认可在院前环境中对衰弱进行筛查的实用性，并且许多人认为照护伙伴完成的CGA是一个有用的工具。
