Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas.
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, Texas.
J Am Geriatr Soc. 2019 Aug;67(8):1604-1609. doi: 10.1111/jgs.15882. Epub 2019 Apr 19.
This study assessed frequency of caregiver identification and needs of a sample of persons with dementia (PWDs) and their caregivers to determine whether needs were addressed and whether documentation increased with growing levels of self-reported relationship problems and burden.
Cross-sectional design using data from electronic medical record (EMR) review and baseline research assessments (Burden Interview and Mutuality Scale). Items from a caregiver assessment tool were used to identify documentation of important factors in clinical guidelines.
Michael E. Debakey VA Medical Center, Houston, TX.
A total of 211 PWDs from a randomized controlled trial testing a psychosocial intervention for preventing aggression in PWDs.
EMRs for 12 months before participation in the original study were abstracted, using a tool created by the authors to assess documentation of information deemed important to caregiver assessment in clinical guidelines (eg, caregiver needs, caregiver well-being, and caregiving context). The first two authors reviewed the EMRs, adjusting the tool, based on questions that arose.
Of 211 EMRs of PWDs reviewed, 177 (89%) identified caregivers. Of these, 88% identified the caregiver by name or relation to the PWD, 28% assessed caregiver well-being, and 41% assessed caregiver needs. All EMRs assessing caregiver needs showed provision of caregiver support (including psychoeducation, skills training, or referrals for additional aid). Levels of self-reported caregiver burden were not associated with documentation of assessment; however, higher levels of self-reported relationship problems were positively associated with increased caregiver contact documentation and negatively associated with caregiver need documentation and Alzheimer Association referrals.
Healthcare providers identified caregivers in most of the sample, but less than 50% assessed their well-being and needs. J Am Geriatr Soc 67:1604-1609, 2019.
本研究评估了痴呆症患者（PWDs）及其照料者样本中照料者识别的频率和需求，以确定需求是否得到满足，以及随着自我报告的关系问题和负担程度的增加，文档记录是否增加。
使用电子病历（EMR）审查和基线研究评估（负担访谈和相互性量表）的数据进行的横断面设计。照料者评估工具的项目用于确定临床指南中重要因素的文档记录。
德克萨斯州休斯顿迈克尔·E·德贝基退伍军人事务医疗中心。
共有 211 名来自随机对照试验的 PWDs 参加了该试验，该试验测试了一种用于预防 PWDs 攻击的心理社会干预措施。
在参加原始研究之前的 12 个月内，使用作者创建的工具提取 EMR，以评估在临床指南中被认为对照料者评估重要的信息的文档记录（例如，照料者需求、照料者福祉和照料背景）。前两位作者审查了 EMR 记录，并根据出现的问题调整了工具。
在审查的 211 份 PWDs 的 EMR 中，有 177 份（89%）确定了照料者。在这些 EMR 中，88%通过姓名或与 PWD 的关系来识别照料者，28%评估了照料者的福祉，41%评估了照料者的需求。所有评估照料者需求的 EMR 都显示提供了照料者支持（包括心理教育、技能培训或转介以获得额外帮助）。自我报告的照料者负担水平与评估文件记录无关；然而，较高的自我报告的关系问题与增加的照料者联系文件记录呈正相关，与照料者需求文件记录和阿尔茨海默协会转介呈负相关。
医疗保健提供者在大多数样本中识别了照料者，但只有不到 50%评估了他们的福祉和需求。美国老年医学会 67：1604-1609，2019 年。
