Department of Psychiatry,The Second Xianga Hospital,Central South University;China National Clinical Research Center on Mental Health Disorders (Xiangya);China National Technology Institute on Mental Disorders;Hunan Technology Institute of Psychiatry;Hunan Key Laboratory of Psychiatry and Mental Health;Mental Health Institute of Central South University,Changsha,Hunan,China.
Private Practice in Neuropsychology,Waterloo,Canada.
Int Psychogeriatr. 2018 Oct;30(10):1549-1555. doi: 10.1017/S104161021800025X. Epub 2018 Apr 4.
ABSTRACTBackground:The stress associated with care of patients with dementia has led to high nursing staff turnover. This study aims to explore patient factors that are related to nursing burden.
The present study examined nursing care burden related to 55 institutionalized dementia patients using the Modified Nursing Care Assessment Scale (M-NCAS). Cognition was assessed with the Severe Impairment Battery (SIB), activities of daily living (ADLs) were measured with the Alzheimer's Disease Functional Assessment of Change Scale (ADFACS), aggression was measured with the Aggressive Behavior Scale (ABS), and the Charlson Comorbidity Index (CCI) was used to assess medical comorbidity. Finally, the Dementia Cognitive Fluctuation Scale (DCFS) was used to assess the presence and severity of cognitive fluctuations (CFs). Linear regression models were used to assess their relationships with nursing care burden.
The mean age of the patients was 90.41 years (SD=2.84) and 89.10% were males. ADFACS total score (B = 0.36, β = 0.42, p = 0.002) and ABS score (B = 2.933, β = 0.37, p = 0.002) significantly predicted the M-NCAS Attitude score. ABS score was the only significant predictor of M-NCAS Strain score (B = 2.57, β = 0.35, p = 0.009).
In the long-term care setting, aggressive behavior plays an important role in both subjective and objective nursing burden, while impaired ADLs increase the objective burden for nursing staff.
本研究旨在探讨与护理负担相关的患者因素。
本研究使用改良护理负担评估量表（M-NCAS）评估了 55 例机构内痴呆患者的护理负担。使用严重损伤量表（SIB）评估认知功能，使用阿尔茨海默病功能评估变化量表（ADFACS）评估日常生活活动能力（ADL），使用攻击行为量表（ABS）评估攻击性，使用 Charlson 合并症指数（CCI）评估医疗合并症。最后，使用痴呆认知波动量表（DCFS）评估认知波动（CFs）的存在和严重程度。使用线性回归模型评估它们与护理负担的关系。
患者的平均年龄为 90.41 岁（SD=2.84），89.10%为男性。ADFACS 总分（B=0.36，β=0.42，p=0.002）和 ABS 评分（B=2.933，β=0.37，p=0.002）显著预测了 M-NCAS 态度评分。ABS 评分是 M-NCAS 紧张评分的唯一显著预测因子（B=2.57，β=0.35，p=0.009）。
在长期护理环境中，攻击性行为在主观和客观护理负担中都起着重要作用，而受损的 ADL 则增加了护理人员的客观负担。
