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德国初级保健中有效协作式痴呆症护理管理计划的任务和活动。

Tasks and Activities of an Effective Collaborative Dementia Care Management Program in German Primary Care.

机构信息

German Center for Neurodegenerative Diseases (DZNE) Rostock/ Greifswald, Greifswald, Germany.

Institute for Community Medicine, University Medicine, University of Greifswald, Greifswald, Germany.

出版信息

J Alzheimers Dis. 2022;87(4):1615-1625. doi: 10.3233/JAD-215656.

Abstract

BACKGROUND

Recent studies have demonstrated the efficiency of collaborative dementia care, which aims to improve post-diagnostic support. However, tasks carried out of such models are currently unknown, hindering its implementation.

OBJECTIVE

To describe tasks of a collaborative model of dementia care, analyze the association between specific task subgroups and number of tasks with patients' and caregivers' characteristics and the impact of specific tasks on health-related quality of life (HRQoL).

METHODS

The analysis was based on 183 persons with dementia (PwD) who received dementia care management conducted by dementia-specific qualified nurses. A standardized, computer-assisted assessment was used to identify patients' and caregivers' unmet needs. Tasks carried out to address unmet needs were documented, categorized, and descriptively analyzed. We used multivariate regression models to identify socio-demographic and clinical factors associated with a specific subgroup of tasks or a higher number of tasks.

RESULTS

On average, 20.5 tasks were carried out per dyad (PwD and caregiver). 41% of tasks were categorized to cooperation with other healthcare providers, 39% to nursing care, and 19% to social support. Lower HRQoL and higher age, cognitive impairment, deficits in daily living activities, and depressive symptoms were significantly associated with a higher number of tasks. A higher number of cooperation tasks were associated with a higher gain in HRQoL.

CONCLUSION

Patients' characteristics and HRQoL significantly determine the intensity of collaborative care interventions. Variability of the intensity should be considered in developing future studies and in the implementation into routine care.

CLINICALTRIALS

gov Identifier: NCT01401582.

摘要

背景

最近的研究表明,协作性痴呆护理模式具有提高诊断后支持的效率。然而,目前尚不清楚这种模式所执行的任务,这阻碍了其实施。

目的

描述协作性痴呆护理模式的任务,分析特定任务亚组与患者和护理人员特征之间的关联,以及特定任务对健康相关生活质量(HRQoL)的影响。

方法

分析基于接受痴呆特定合格护士进行的痴呆护理管理的 183 名痴呆患者(PwD)。使用标准化的计算机辅助评估来确定患者和护理人员的未满足需求。记录、分类并描述性分析解决未满足需求所执行的任务。我们使用多变量回归模型来确定与特定任务亚组或更多任务相关的社会人口统计学和临床因素。

结果

平均每个患者-护理人员对(PwD 和护理人员)执行 20.5 项任务。41%的任务被归类为与其他医疗保健提供者合作,39%的任务是护理,19%的任务是社会支持。较低的 HRQoL 以及更高的年龄、认知障碍、日常生活活动缺陷和抑郁症状与更多的任务显著相关。更多的合作任务与更高的 HRQoL 增益相关。

结论

患者的特征和 HRQoL 显著决定了协作性护理干预的强度。在未来的研究和常规护理实施中,应考虑强度的可变性。

临床试验

gov 标识符:NCT01401582。

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本文引用的文献

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[Socioeconomic differences in health and need for care among the elderly].[老年人健康状况及护理需求的社会经济差异]
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