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新冠病毒病初始反应对智障人士长期护理的影响:事件报告的中断时间序列分析

Impact of the initial response to COVID-19 on long-term care for people with intellectual disability: an interrupted time series analysis of incident reports.

作者信息

Schuengel C, Tummers J, Embregts P J C M, Leusink G L

机构信息

Department of Educational and Family Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Department of Information Technology, Wageningen University & Research, Wageningen, The Netherlands.

出版信息

J Intellect Disabil Res. 2020 Nov;64(11):817-824. doi: 10.1111/jir.12778. Epub 2020 Sep 21.

Abstract

BACKGROUND

The lockdown-measures in response to COVID-19 taken by long-term care organisations might have impacted problem behaviour and behavioural functioning of people with intellectual disability. This study tested changes in reported incidents, in particular regarding aggression, unexplained absence and, for contrast, medication errors.

METHODS

Metadata on weekly incident and near-incident reports from 2016 to June 2020 involving over 14 000 clients with mild to serious intellectual disability of 's Heeren Loo, a long-term care organisation for people with intellectual disability, were subjected to interrupted time series analysis, comparing the COVID-19 with the pre-COVID-19 period.

RESULTS

The imposition of lockdown-measures coincided with a significant drop in incidents (total, P < .001; aggression, P = .008; unexplained absences, P = .008; and medication errors, P < .001). Incidents in total (P = .001) and with aggression (P < .001) then climbed from this initial low level, while medication errors remained stably low (P = .94).

CONCLUSION

The rise in incidents involving aggression, against the background of generally lowered reporting, underlines the need for pandemic control measures that are suitable for people with intellectual disability in long-term care.

摘要

背景

长期护理机构针对新冠疫情采取的封锁措施可能对智障人士的问题行为和行为功能产生了影响。本研究测试了报告事件的变化情况,特别是关于攻击行为、无故缺勤的情况,以及作为对比的用药错误情况。

方法

对2016年至2020年6月期间来自一家为智障人士提供长期护理服务的机构——“赫伦洛”的涉及14000多名轻度至重度智障客户的每周事件及未遂事件报告的元数据进行中断时间序列分析,将新冠疫情期间与新冠疫情之前的时期进行比较。

结果

实施封锁措施的同时,事件数量显著下降(总数,P <.001;攻击行为,P =.008;无故缺勤,P =.008;用药错误,P <.001)。随后,事件总数(P =.001)和攻击行为事件(P <.001)从最初的低水平开始攀升,而用药错误则一直保持在较低水平(P =.94)。

结论

在总体报告数量下降的背景下,涉及攻击行为的事件有所增加,这凸显了需要采取适合长期护理机构中智障人士的疫情防控措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb7/7646647/f422e18c8477/JIR-64-817-g001.jpg

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