Jhang Kai-Ming, Wang Wen-Fu, Cheng Yu-Ching, Tung Yu-Chun, Yen Shao-Wei, Wu Hsin-Hung
Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan.
Psychol Res Behav Manag. 2023 Jan 19;16:179-195. doi: 10.2147/PRBM.S388394. eCollection 2023.
The purpose of this study was to find care need combinations for dementia patients with multiple chronic diseases and their caregivers.
A cross-sectional study was conducted with 83 patients who had multiple chronic diseases. Variables from patients included age, gender, severity of clinical dementia rating, feeding, hypnotics, mobility, getting lost, mood symptoms, and behavioral and psychological symptoms. Moreover, 26 types of care needs were included in this study. The Apriori algorithm was employed to first identify care need combinations and then to find the relationships between care needs and variables from dementia patients with multiple chronic diseases.
Six rules were generated for care need combinations. Four care needs could be formed as a basic care need bundle. Moreover, two additional care needs could be added to provide a wider coverage for patients. In the second stage, 93 rules were found and categorized into three groups, including 2, 6, and 28 general rules with support of 30% but less than 40%, 20% but less than 30%, and 10% but less than 20%, respectively. When the support value is 10% but less than 20%, more variables from patients were found in rules which help the dementia collaborative care team members provide tailor-made care need bundles.
Four basic care needs were social resources referral and legal support (Care (1)), drug knowledge education (Care (3)), memory problem care (Care (5)), and fall prevention (Care (8)). Besides, disease knowledge education (Care (2)) and hypertension care (Care (16)) were frequent unmet needs in this specific population. Moreover, care for the mood of the caregiver (Care (11)) should be considered especially in dementia patients with preserved ambulatory function or with symptoms of hallucination. The collaborative care team should pay more attention to those care needs when assessing this specific population.
本研究旨在找出患有多种慢性病的痴呆患者及其照料者的护理需求组合。
对83名患有多种慢性病的患者进行了横断面研究。患者的变量包括年龄、性别、临床痴呆评定量表的严重程度、进食、催眠药物、活动能力、走失情况、情绪症状以及行为和心理症状。此外，本研究纳入了26种护理需求类型。采用Apriori算法首先识别护理需求组合，然后找出患有多种慢性病的痴呆患者的护理需求与变量之间的关系。
生成了六条护理需求组合规则。四项护理需求可构成一个基本护理需求包。此外，还可添加另外两项护理需求，以便为患者提供更广泛的覆盖范围。在第二阶段，发现了93条规则并分为三组，分别包括支持度为30%但小于40%、20%但小于30%以及10%但小于20%的2条、6条和28条一般规则。当支持度值为10%但小于20%时，在规则中发现了更多来自患者的变量，这有助于痴呆协作护理团队成员提供量身定制的护理需求包。
四项基本护理需求为社会资源转介与法律支持（护理需求（1））、药物知识教育（护理需求（3））、记忆问题护理（护理需求（5））以及预防跌倒（护理需求（8））。此外，疾病知识教育（护理需求（2））和高血压护理（护理需求（16））是这一特定人群中经常未得到满足的需求。此外，对于具有活动能力或有幻觉症状的痴呆患者，尤其应考虑照料者的情绪护理（护理需求（11））。协作护理团队在评估这一特定人群时应更加关注这些护理需求。
