Huang Li-Kai, Tsai Jui-Chen, Lee Hsun-Hua, Kuan Yi-Chun, Lee Yao-Tung, Lin Chia-Pei, Chao Shu-Ping, Hu Chaur-Jong
Department of Neurology and Dementia Center.
Graduate Institute of Humanities in Medicine.
Medicine (Baltimore). 2020 Jan;99(2):e18741. doi: 10.1097/MD.0000000000018741.
Inappropriate care for patients with cognitive dysfunction in the hospital could worsen quality of care and medical service satisfaction.All elderly participants were recruited from acute wards of 5 departments in an university hospital. They were administered the Chinese version of Ascertain Dementia 8 (AD8) at admission and the Nursing Service Satisfaction Questionnaire before discharge.A total of 345 participants completed the study. There were 91 (26.4%) participants with AD8 ≥ 2, the cut-off value of high risk of dementia. The prevalence was much higher than prior community-based reports. The Nursing Service Satisfaction Score was significantly lower in AD8 ≥ 2 than in AD8 < 2 (56.99 ± 0.94 vs 60.55 ± 0.48, P < .01).Using AD8 in hospital-based screening might be more efficient than in the community in terms of cost-effectiveness due to higher positive rate and easier approach to diagnostic facilities. AD8 ≥ 2 is also an indicator to identify care dissatisfaction among inpatients. By identifying patients with cognitive dysfunction, such as its related communication barriers, care systems could be tailored for more friendly services.
医院中对认知功能障碍患者的不恰当护理可能会降低护理质量和医疗服务满意度。所有老年参与者均来自一所大学医院5个科室的急性病房。他们在入院时接受中文版的简易痴呆筛查量表8(AD8)评估,并在出院前填写护理服务满意度问卷。共有345名参与者完成了研究。其中91名(26.4%)参与者的AD8评分≥2,这是痴呆高风险的临界值。该患病率远高于先前基于社区的报告。AD8评分≥2的参与者的护理服务满意度得分显著低于AD8评分<2的参与者(56.99±0.94 vs 60.55±0.48,P<0.01)。由于基于医院筛查的AD8阳性率更高且更容易获得诊断设施,因此从成本效益角度来看,在医院进行AD8筛查可能比在社区更有效。AD8≥2也是识别住院患者护理不满意的一个指标。通过识别认知功能障碍患者及其相关的沟通障碍等问题,可以调整护理系统,提供更友好的服务。