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由经过培训的志愿者(医学和心理学专业学生)实施的针对谵妄风险因素的非药物干预措施,减少了急性内科病房老年患者对抗精神病药物的需求以及住院时间:一项试点研究。

Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study.

作者信息

Gorski Stanislaw, Piotrowicz Karolina, Rewiuk Krzysztof, Halicka Monika, Kalwak Weronika, Rybak Paulina, Grodzicki Tomasz

机构信息

Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland.

Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Biomed Res Int. 2017;2017:1297164. doi: 10.1155/2017/1297164. Epub 2017 Jan 10.

Abstract

. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. . Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards). Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization), received standard care. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. . 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. . Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

摘要

在波兰的一个内科病房,评估了由经过培训的志愿者(医学和心理学专业学生)提供的针对老年住院患者谵妄风险因素的非药物多组分预防措施的有效性。在内科病房,将参与者招募到干预组和对照组(纳入标准:年龄≥75岁、急性疾病、基本定向能力以及入院时逻辑思维能力正常;排除标准:预期寿命<24小时、外科住院治疗、因传染病隔离以及转至其他医疗病房)。每天,经过培训的志愿者对干预组实施针对院内并发症风险因素的多组分标准化干预措施。对照组采用回顾性个体匹配策略(年龄、性别和住院时间1∶1配比)选择,接受标准护理。通过医疗记录回顾性评估住院时间、死亡情况、跌倒、谵妄发作以及抗精神病药物处方。130名患者(男性占38.4%)参与了研究,干预组有65人。与对照组相比,干预组启动抗精神病药物治疗的频率较低。干预组有住院时间缩短的趋势,且死亡人数有非统计学意义的减少。针对谵妄风险因素的非药物多组分干预措施有效缩短了内科病房老年患者的住院时间,并减少了启动抗精神病治疗的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a399/5259647/c040f3976ff1/BMRI2017-1297164.001.jpg

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