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痴呆患者护理者咨询的益处:一项回顾性观察研究。

Benefits of Caregiver Counseling in Patients with Dementia: A Retrospective Observational Study.

作者信息

Chen Po-Chih, Lee Hsun-Hua, Chan Lung, Hu Chaur-Jong

机构信息

Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan,

Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan,

出版信息

Dement Geriatr Cogn Disord. 2022;51(6):460-466. doi: 10.1159/000527245. Epub 2023 Jan 23.

Abstract

INTRODUCTION

Patients with dementia have a 1.42 times higher risk of hospitalization than those without. Preparing and educating caregivers by counseling may attenuate the frequency of hospitalization and the financial burden on the health-care system. We conducted a retrospective observational study to verify whether caregiver counseling would benefit patients with mild cognitive impairment (MCI) or dementia.

METHODS

The primary caregivers of patients with MCI or dementia at our Dementia Center from January 2017 to December 2018 were included in this study. Of the 532 caregivers who received counseling on caregiving for patients with dementia, 350 with complete data were included. The incidences of the patients' emergency department visits, hospitalizations, and durations of hospitalizations in 2 years prior to and after their caregivers received counseling were compared. A paired t test was used to test the frequency of patients' hospitalizations and emergency visits before and after counseling, and a p value of less than 0.05 was considered significant.

RESULTS

The incidence of emergency visits (before counseling: 0.67 times/year, standard deviation [SD] = 0.823; after counseling: 0.25 times/year, SD = 0.549; p < 0.001) and hospitalizations (before counseling: 1.104 times/year, SD = 0.882; after counseling: 0.719 times/year, SD = 0.642; p < 0.001) decreased significantly after caregivers received counseling. The durations of hospitalization before and after counseling were 9.74 (SD = 6.940) days and 9.23 (SD = 6.908) days, respectively (p = 0.136).

CONCLUSION

Counseling for caregivers of patients with MCI or dementia can significantly decrease the incidences of patients' emergency visits and hospitalizations but not durations of hospitalization. In multifaceted disease like dementia, counseling for caregivers is beneficial and reduces the burden on the health-care system. Further large-scale studies are warranted to verify this finding.

摘要

引言

痴呆症患者住院风险比非痴呆症患者高1.42倍。通过咨询对护理人员进行培训和教育,可能会减少住院频率,并减轻医疗保健系统的经济负担。我们进行了一项回顾性观察研究,以验证对护理人员的咨询是否会使轻度认知障碍(MCI)或痴呆症患者受益。

方法

本研究纳入了2017年1月至2018年12月在我们痴呆症中心的MCI或痴呆症患者的主要护理人员。在532名接受痴呆症患者护理咨询的护理人员中,350名数据完整的人员被纳入研究。比较了护理人员接受咨询前后两年内患者的急诊就诊、住院发生率及住院时长。采用配对t检验来检验咨询前后患者的住院和急诊就诊频率,p值小于0.05被认为具有统计学意义。

结果

护理人员接受咨询后,急诊就诊发生率(咨询前:每年0.67次,标准差[SD]=0.823;咨询后:每年0.25次,SD=0.549;p<0.001)和住院发生率(咨询前:每年1.104次,SD=0.882;咨询后:每年0.719次,SD=0.642;p<0.001)显著降低。咨询前后的住院时长分别为9.74(SD=6.940)天和9.23(SD=6.908)天(p=0.136)。

结论

对MCI或痴呆症患者的护理人员进行咨询可显著降低患者的急诊就诊和住院发生率,但不能缩短住院时长。在痴呆症这种多方面问题的疾病中,对护理人员进行咨询是有益的,并可减轻医疗保健系统的负担。有必要进行进一步的大规模研究来验证这一发现。

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