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养老院居民中的痴呆症与癌症共病:一项横断面研究的二次分析

Comorbid Dementia and Cancer in Residents of Nursing Homes: Secondary Analyses of a Cross-Sectional Study.

作者信息

Blytt Kjersti Marie, Selbæk Geir, Drageset Jorunn, Natvig Gerd Karin, Husebo Bettina S

机构信息

Author Affiliations: Department of Global Public Health and Primary Care (Ms Blytt and Drs Drageset, Natvig, and Husebo) and Centre for Elderly and Nursing Home Medicine (Ms Blytt and Dr Husebo), University of Bergen; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen (Ms Blytt); Faculty of Medicine, University of Oslo; Ageing and Health, Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tonsberg; and Centre for Old Age Psychiatry Research, Innlandet Hospital Trust, Ottestad (Dr Selbæk); Faculty for Health and Social Sciences, Bergen University College (Dr Drageset); and the Municipality of Bergen (Dr Husebo), Norway.

出版信息

Cancer Nurs. 2018 Mar/Apr;41(2):E13-E20. doi: 10.1097/NCC.0000000000000478.

Abstract

BACKGROUND

Life expectancy is increasing continuously, which increases the likelihood of developing dementia or cancer. Both dementia and cancer are serious conditions that give manifold symptoms. The interaction of these conditions is however complex and less explored.

OBJECTIVES

The aim of this study was to identify the prevalence of cancer and differences regarding neuropsychiatric symptoms (NPS) and medication among nursing home (NH) patients with and without dementia and cancer.

METHODS

This is a cross-sectional study of Norwegian NH patients (N = 1825). Participants were categorized according to degree of dementia (Clinical Dementia Rating > 1) and cancer diagnoses. Differences in NPS and other symptoms, as well as the use of medication, were explored.

RESULTS

Eighty-four percent of NH patients had dementia, and 5.5% had comorbid dementia and cancer. Patients with comorbid dementia and cancer received significantly more analgesics compared with patients without cancer but with dementia (P < .05). Compared with patients without dementia but with cancer, patients with comorbid dementia and cancer had significantly more NPS, including sleep disturbances and agitation.

CONCLUSIONS

Patients with comorbid dementia and cancer receive more analgesics than patients with dementia but still display more agitation and sleep disturbances than patients with cancer and patients with neither dementia nor cancer, suggesting that symptoms may not be treated adequately.

IMPLICATIONS FOR PRACTICE

The results indicate a considerable strain for patients with comorbid dementia and cancer and highlight essential challenges for the clinician who is responsible for treatment and care. Nurses should pay attention to agitation and sleep disturbances among patients with comorbid dementia and cancer.

摘要

背景

预期寿命在持续增加,这增加了患痴呆症或癌症的可能性。痴呆症和癌症都是会引发多种症状的严重疾病。然而,这些疾病之间的相互作用很复杂,且较少被研究。

目的

本研究的目的是确定患有和未患有痴呆症及癌症的养老院患者中癌症的患病率以及神经精神症状(NPS)和用药情况的差异。

方法

这是一项对挪威养老院患者(N = 1825)的横断面研究。参与者根据痴呆程度(临床痴呆评定量表>1)和癌症诊断进行分类。探讨了NPS和其他症状以及用药情况的差异。

结果

84%的养老院患者患有痴呆症,5.5%患有痴呆症和癌症的合并症。与没有癌症但患有痴呆症的患者相比,患有痴呆症和癌症合并症的患者服用的镇痛药明显更多(P <.05)。与没有痴呆症但患有癌症的患者相比,患有痴呆症和癌症合并症的患者的NPS明显更多,包括睡眠障碍和躁动。

结论

患有痴呆症和癌症合并症的患者比患有痴呆症的患者服用更多的镇痛药,但与患有癌症以及既没有痴呆症也没有癌症的患者相比,仍表现出更多的躁动和睡眠障碍,这表明症状可能没有得到充分治疗。

对实践的启示

结果表明患有痴呆症和癌症合并症的患者承受着相当大的压力,并凸显了负责治疗和护理的临床医生面临的重大挑战。护士应关注患有痴呆症和癌症合并症患者的躁动和睡眠障碍。

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