De Waalboog, 'Joachim en Anna', Center for Specialized Geriatric Care, Postbus 31071, 6503 CB, Nijmegen, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
Int J Nurs Stud. 2018 May;81:89-97. doi: 10.1016/j.ijnurstu.2018.02.008. Epub 2018 Feb 26.
Aging societies will bring an increase in the number of long-term care residents with mental-physical multimorbidity. To optimize care for these residents, it is important to study their care needs, since unmet needs lower quality of life. To date, knowledge about care needs of residents with mental-physical multimorbidity is limited. The aim of this study was to explore (un)met care needs of residents with mental-physical multimorbidity and determinants of unmet needs.
Cross-sectional cohort study among 141 residents with mental-physical multimorbidity without dementia living in 17 geronto-psychiatric nursing home units across the Netherlands. Data collection consisted of chart review, semi-structured interviews, (brief) neuropsychological testing, and self-report questionnaires. The Camberwell Assessment of Need for the Elderly (CANE) was used to rate (un)met care needs from residents' and nursing staff's perceptions. Descriptive and multivariate regression analyses were conducted.
Residents reported a mean number of 11.89 needs (SD 2.88) of which 24.2% (n = 2.88, SD 2.48) were unmet. Nursing staff indicated a mean number of 14.73 needs (SD 2.32) of which 10.8% (n = 1.59, SD 1.61) were unmet. According to the residents, most unmet needs were found in the social domain as opposed to the psychological domain as reported by the nursing staff. Different opinions between resident and nursing staff about unmet needs was most common in the areas accommodation, company, and daytime activities. Further, nearly half of the residents indicated 'no need' regarding behavior while the nursing staff supposed that the resident did require some kind of support. Depression, anxiety and less care dependency were the most important determinants of unmet needs.
Systematic assessment of care needs showed differences between the perspectives of resident and nursing staff. These should be the starting point of a dialogue between them about needs, wishes and expectations regarding care. This dialogue can subsequently lead to the most optimal individually tailored care plan. To achieve this, nurses with effective communication and negotiation skills, are indispensable.
老龄化社会将导致患有身心多种疾病的长期护理居民人数增加。为了优化对这些居民的护理，研究他们的护理需求很重要，因为未满足的需求会降低生活质量。迄今为止，关于患有身心多种疾病的居民护理需求的知识有限。本研究的目的是探讨患有身心多种疾病的居民的（未）满足的护理需求以及未满足需求的决定因素。
这是一项在荷兰 17 个老年精神病学护理院单元中，对 141 名患有身心多种疾病且无痴呆症的居民进行的横断面队列研究。数据收集包括病历回顾、半结构化访谈、（简短）神经心理测试和自我报告问卷。使用 Camberwell 老年需求评估量表（CANE）从居民和护理人员的角度评估（未）满足的护理需求。进行了描述性和多元回归分析。
居民报告了 11.89 项需求（SD 2.88），其中 24.2%（n=2.88，SD 2.48）未得到满足。护理人员表示有 14.73 项需求（SD 2.32），其中 10.8%（n=1.59，SD 1.61）未得到满足。根据居民的说法，与护理人员报告的心理领域相比，大多数未满足的需求出现在社会领域。居民和护理人员对未满足需求的看法存在最大差异的领域是住宿、陪伴和日间活动。此外，近一半的居民表示对自己的行为“没有需求”，而护理人员则认为居民确实需要某种支持。抑郁、焦虑和较少的护理依赖是未满足需求的最重要决定因素。
对护理需求的系统评估显示了居民和护理人员观点之间的差异。这些应该是他们就护理需求、愿望和期望进行对话的起点。这种对话可以随后导致最优化的个性化护理计划。为此，具有有效沟通和谈判技巧的护士是不可或缺的。
