Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland,
Laboratory of Geriatrics, Department of Palliative Care, Poznan University of Medical Sciences, Poznan, Poland.
Clin Interv Aging. 2018 Nov 21;13:2389-2395. doi: 10.2147/CIA.S145937. eCollection 2018.
No comprehensive needs assessment is performed routinely in Poland.
The goal of the study was to investigate the patterns of needs in older individuals living in long-term care institutions (LTCIs) using the Camberwell Assessment of Need for the Elderly (CANE) questionnaire, based on a previously published study protocol.
The study included 306 LTCI residents (age: ≥75 years) with the a Mini-Mental State Examination (MMSE) score of at least 10 points. The dependence in basic activities of daily living was measured using the Barthel index (BI). A screening for depression was performed using the Geriatric Depression Scale (GDS) in subjects with an MMSE score of ≥15 points. Thereafter, CANE was used to analyze needs receiving adequate support (met needs) and those without appropriate interventions (unmet needs).
The mean age of studied individuals was 83.2±6.0 years. They had 10.4±3.2 met needs and 0.8±1.2 unmet needs. Unmet needs were reported most commonly in the following areas: company (15.9%), psychological distress (14.0%), intimate relationship (11.4%), eyesight/hearing/communication (11.4%), and daytime activities (11.0%). The OR of having a large number of met needs (ie, above the median) was almost eight times higher in residents with a BI score of 0-49 points versus those with ≥80 points. The group between (with 50-79 points) had this parameter almost four times higher. The OR of having a large number of unmet needs depended neither on BI nor on GDS and was more than four times higher in the group of 10-19 MMSE points (ie, with symptoms of moderate dementia) versus subjects with 24-30 MMSE points (ie, without symptoms of dementia).
We defined the target group with high probability of unmet needs and the areas in which resources and efforts should be concentrated. We believe that the results can be used to optimize care in LTCIs.
波兰没有进行全面的需求评估。
本研究的目的是使用坎伯韦尔老年人需求评估量表（CANE）调查问卷，根据之前发表的研究方案，调查长期护理机构（LTCIs）中老年人的需求模式。
该研究包括 306 名 LTCIs 居民（年龄：≥75 岁），其 Mini-Mental State Examination（MMSE）评分至少为 10 分。使用 Barthel 指数（BI）测量基本日常生活活动的依赖程度。对于 MMSE 评分≥15 分的受试者，使用老年抑郁量表（GDS）进行抑郁筛查。此后，使用 CANE 分析接受充分支持的需求（满足需求）和没有适当干预的需求（未满足需求）。
研究对象的平均年龄为 83.2±6.0 岁。他们有 10.4±3.2 项满足需求和 0.8±1.2 项未满足需求。未满足的需求最常见于以下领域：陪伴（15.9%）、心理困扰（14.0%）、亲密关系（11.4%）、视力/听力/沟通（11.4%）和日间活动（11.0%）。BI 评分为 0-49 分的居民比 BI 评分≥80 分的居民拥有大量满足需求（即高于中位数）的可能性高近 8 倍。BI 评分为 50-79 分的居民这一参数几乎高 4 倍。大量未满足需求的可能性既不依赖于 BI，也不依赖于 GDS，在 MMSE 评分为 10-19 分（即有中度痴呆症状）的组中，这一参数比 MMSE 评分为 24-30 分（即无痴呆症状）的受试者高 4 倍以上。
我们确定了未满足需求概率高的目标群体和应集中资源和精力的领域。我们相信，这些结果可用于优化长期护理机构的护理。
