Eichler Tilly, Thyrian Jochen René, Hertel Johannes, Richter Steffen, Wucherer Diana, Michalowsky Bernhard, Teipel Stefan, Kilimann Ingo, Dreier Adina, Hoffmann Wolfgang
German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
J Alzheimers Dis. 2016;51(3):847-55. doi: 10.3233/JAD-150935.
To provide an optimal care for persons with dementia (PWD), their individual unmet needs have to be identified and comprehensively addressed.
Present analyses aim to describe the number and types of unmet needs of German primary care patients screened positive for dementia and factors associated with the number of unmet needs.
DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized controlled intervention trial. Analyses are based on the baseline data of 227 PWD (≥70 years, living at home) of the intervention group who had screened positive for dementia (DemTect<9) and received a standardized computer-assisted needs assessment.
PWD had on average 8.77±5.04 unmet needs (Range = 0-31). More than 90% of the PWD had three or more unmet needs. Unmet needs were identified across all predefined 26 subcategories. The majority of unmet needs occurred in the domains "nursing treatment and care" (38%), "social counseling and legal support" (20%), and "pharmacological treatment and care" (15%). More impairment in the activities of daily living was the only factor that was significantly associated with a higher number of unmet needs, independent of age, gender, living situation, presence of an informal caregiver, cognitive impairment, and depression.
Present results demonstrate that community-dwelling PWD had a broad range of varying unmet needs. These findings emphasize the importance of a comprehensive needs assessment that allows the identification of individual needs as the basis for a tailored intervention- such as Dementia Care Management- that can address these needs.
为了为痴呆症患者（PWD）提供最佳护理，必须识别并全面满足他们各自未得到满足的需求。
目前的分析旨在描述德国初级护理中痴呆筛查呈阳性患者未满足需求的数量和类型，以及与未满足需求数量相关的因素。
DelpHi-MV（痴呆症：梅克伦堡-前波美拉尼亚以生活和个人为中心的帮助）是一项基于全科医生的整群随机对照干预试验。分析基于干预组227名痴呆筛查呈阳性（DemTect<9）且接受标准化计算机辅助需求评估的PWD（≥70岁，居家生活）的基线数据。
PWD平均有8.77±5.04项未满足需求（范围=0-31）。超过90%的PWD有三项或更多未满足需求。在所有预先定义的26个子类别中均发现了未满足需求。大多数未满足需求出现在“护理治疗与照料”（38%）、“社会咨询与法律支持”（20%）以及“药物治疗与照料”（15%）领域。日常生活活动能力受损程度更高是与未满足需求数量较多显著相关的唯一因素，与年龄、性别、生活状况、是否有非正式照料者、认知障碍和抑郁无关。
目前的结果表明，社区居住的PWD存在广泛多样的未满足需求。这些发现强调了进行全面需求评估的重要性，这种评估能够识别个体需求，作为量身定制干预措施（如痴呆症护理管理）的基础，以满足这些需求。
