Yoshimura Atsuko, Lebowitz Adam, Bun Shogyoku, Aiba Miyuki, Ikejima Chiaki, Asada Takashi
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Yashio Central General Hospital, Tokyo, Japan.
Psychogeriatrics. 2016 Jan;16(1):34-45. doi: 10.1111/psyg.12117. Epub 2015 Apr 27.
In Japan, the number of dementia patients admitted to hospitals and other care facilities has been increasing and their hospital stays prolonged. Until now, there has been no study examining the differences between patients in psychiatric hospitals and other care facilities. Here we attempt a comparative analysis of characteristics of dementia patients in psychiatric hospitals and other types of facilities based on a nationwide survey.
A nationwide, cross-sectional survey was conducted in 2009-2011. Questionnaires were sent to randomly selected facilities and asked about each facility's status as of September 2009 and about individuals with dementia residing in each facility during the 2008 fiscal year. The portion about individuals consisted of items to assess eligibility for the Long-Term Care Insurance programme. Based on data from 6121 patients residing in seven different types of facilities, features of dementia patients in psychiatric hospitals and differences among facilities were analyzed.
There was a significant difference in average age, activities of daily living level, and dementia severity level among the seven types of facilities. The average age in all types of facilities, except for psychiatric hospitals, was higher than the national average life expectancy of 82.59 years. The results of the study revealed that in psychiatric hospitals the proportion of men, those aged <75 years, demented patients with severe behavioural and psychological symptoms of dementia, and those with frontotemporal dementia was significantly greater than in other types of facilities. In other Long-Term Care Insurance care facilities, dementia patients >80 years and women accounted for 80% of all patients.
Result showed that dementia patients in psychiatric hospitals had a higher proportion of men, younger age groups, and severe dementia than other types of facilities. These features contrast markedly with status of dementia patients in other Long-Term Care Insurance care facilities. In order to facilitate dementia patients' early discharge from psychiatric hospitals to other care facilities or to home, further fulfillment care services corresponding to severe dementia and early-onset dementia may be needed.
在日本，入住医院及其他护理机构的痴呆症患者数量不断增加，住院时间也越来越长。到目前为止，尚无研究探讨精神病医院患者与其他护理机构患者之间的差异。在此，我们基于一项全国性调查，尝试对精神病医院和其他类型机构中痴呆症患者的特征进行比较分析。
在2009年至2011年进行了一项全国性横断面调查。问卷被发送至随机选取的机构，询问各机构截至2009年9月的状况以及2008财年居住在各机构的痴呆症患者情况。关于个人的部分包括评估长期护理保险计划资格的项目。基于居住在七种不同类型机构的6121名患者的数据，分析了精神病医院中痴呆症患者的特征以及各机构之间的差异。
七种类型的机构在平均年龄、日常生活活动水平和痴呆严重程度方面存在显著差异。除精神病医院外，所有类型机构的平均年龄均高于全国平均预期寿命82.59岁。研究结果显示，在精神病医院中，男性、年龄<75岁者、患有严重痴呆行为和心理症状的痴呆症患者以及额颞叶痴呆患者的比例显著高于其他类型机构。在其他长期护理保险护理机构中，80岁以上的痴呆症患者和女性占所有患者的80%。
结果表明，与其他类型机构相比，精神病医院中的痴呆症患者男性比例更高、年龄组更年轻且痴呆程度更严重。这些特征与其他长期护理保险护理机构中痴呆症患者的状况形成鲜明对比。为了促进痴呆症患者从精神病医院尽早出院到其他护理机构或家中，可能需要进一步完善针对重度痴呆和早发性痴呆的护理服务。
