Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Institute of Nursing Science, Medical University of Graz, Graz, Austria.
Eur Geriatr Med. 2020 Jun;11(3):393-402. doi: 10.1007/s41999-020-00304-3. Epub 2020 Mar 13.
Even though dehydration is a big problem among nursing home residents, a universally agreed method to diagnose dehydration among nursing home residents is missing. Therefore, this study aimed to establish consensus on a method to diagnose dehydration in this population.
Using an international Delphi study, 53 experts (physicians and advanced nurse practitioners) were asked to judge various methods to diagnose dehydration on relevance and feasibility in the nursing home. Based on the methods that gained consensus in the first and second round (≥ 75% consensus), a step-by-step diagnostic strategy was developed which was presented to, and judged by, the experts in round three.
After the first and second round, consensus was reached on nine anamnestic items, eight physical symptoms and three blood tests. In the third round, 24 experts agreed with the developed step-by-step diagnostic strategy as a standard to diagnose dehydration in nursing home residents.
This is the first study reaching international consensus on a strategy to diagnose dehydration in the nursing home. This strategy comprehends a presumption phase, where anamnestic items and physical symptoms are examined, followed by a confirmation phase with blood tests to confirm the diagnosis of dehydration. Using this strategy, it is important to take the individual characteristics (e.g. co-morbidity) of the resident and its care environment (e.g. ambient temperature) into account.
尽管脱水是养老院居民面临的一个严重问题，但目前仍缺乏一种普遍认可的方法来诊断养老院居民的脱水情况。因此，本研究旨在就诊断该人群脱水的方法达成共识。
本研究采用国际德尔菲研究，邀请 53 名专家（医生和高级护师）对各种诊断养老院居民脱水的方法的相关性和可行性进行判断。根据在第一轮和第二轮中达成共识的方法（≥75%的共识），制定了一个逐步诊断策略，并在第三轮中提交给专家进行判断。
在第一轮和第二轮之后，就九项病史项目、八项身体症状和三项血液检查达成了共识。在第三轮中，24 名专家同意将制定的逐步诊断策略作为诊断养老院居民脱水的标准。
这是第一项就诊断养老院居民脱水的策略达成国际共识的研究。该策略包括一个假设阶段，在此阶段检查病史项目和身体症状，然后进入一个确认阶段，通过血液检查来确认脱水的诊断。使用该策略时，需要考虑居民的个体特征（例如合并症）及其护理环境（例如环境温度）。
