Duan Yinfei, Shippee Tetyana P, Ng Weiwen, Akosionu Odichinma, Woodhouse Mark, Chu Haitao, Ahluwalia Jasjit S, Gaugler Joseph E, Virnig Beth A, Bowblis John R
University of Minnesota School of Nursing, Minneapolis, MN, USA.
Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
J Am Med Dir Assoc. 2020 Nov;21(11):1712-1717. doi: 10.1016/j.jamda.2020.06.033. Epub 2020 Jul 29.
The Preferences Assessment Tool (PAT) in the Minimum Data Set (MDS) 3.0 assesses 16 resident preferences for daily routines and activities. Although integrating important preferences into care planning is essential to provide person-centered care in nursing homes (NHs), preferences rated as important but unmet or unimportant may not receive much attention. This study aims to (1) identify the prevalence of unmet preferences and unimportant preferences, and (2) examine their associations with resident and facility-level characteristics.
This is a longitudinal study of residents in NHs.
We used data from 2012-2017 MDS assessments of long-stay residents aged 65 or older in 295 Minnesota NHs. In total, 51,859 assessments from 25,668 residents were included.
Generalized linear mixed models were used to analyze resident and facility-level characteristics associated with having any unmet preferences, and with the number of unimportant preferences.
Across all years for both daily routine preferences and activity preferences, 3.3% to 5.1% of residents reported that at least 1 or more preference was important but unmet, and 10.0% to 16.6% reported that 4 or more out of the 8 preferences were unimportant. Residents with higher depressive symptoms, and poorer physical and sensory function were more likely to report unmet preferences. Residents with poorer physical and sensory function, and living in rural facilities and facilities having fewer activity staff hours per resident day were more likely to report unimportant preferences.
Residents with functional and sensory limitations and living in underresourced NHs are more likely to report that preferences are unimportant, or that they are important but unmet. It is important for staff to elicit preferences that truly matter for residents, and to enable residents to meet their preferences.
《最低数据集》（MDS）3.0中的偏好评估工具（PAT）评估居民在日常活动和事务方面的16项偏好。尽管将重要偏好纳入护理计划对于在养老院提供以患者为中心的护理至关重要，但被评为重要但未得到满足或不重要的偏好可能未受到太多关注。本研究旨在（1）确定未得到满足的偏好和不重要的偏好的发生率，以及（2）研究它们与居民及机构层面特征之间的关联。
这是一项针对养老院居民的纵向研究。
我们使用了2012年至2017年明尼苏达州295家养老院中65岁及以上长期居住居民的MDS评估数据。总共纳入了来自25,668名居民的51,859份评估。
使用广义线性混合模型分析与存在任何未得到满足的偏好以及与不重要偏好数量相关的居民和机构层面特征。
在所有年份中，无论是日常活动偏好还是活动偏好，3.3%至5.1%的居民报告至少有1项或更多偏好被评为重要但未得到满足，10.0%至16.6%的居民报告8项偏好中有4项或更多被评为不重要。抑郁症状较重、身体和感官功能较差的居民更有可能报告未得到满足的偏好。身体和感官功能较差、居住在农村养老院以及每位居民每天活动工作人员工时较少的养老院中的居民更有可能报告不重要的偏好。
功能和感官存在限制且居住在资源不足的养老院中的居民更有可能报告偏好不重要，或者偏好虽重要但未得到满足。工作人员了解对居民真正重要的偏好并使居民能够实现其偏好非常重要。
