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一种用于定义痴呆症患者清醒期的德尔菲法。

A Delphi Approach to Define Lucid Episodes in People Living With Dementia.

作者信息

Bangerter Lauren R, Griffin Joan M, Kim Kyungmin, Finnie Dawn M, Lapid Maria I, Gaugler Joseph E, Biggar Virginia S, Frangiosa Theresa

机构信息

Health Economics and Aging Research Institute, MedStar Health Research Institute, Hyattsville, MD.

Division of Health Care Delivery Research and Kern Center for the Science of Healthcare Delivery.

出版信息

Alzheimer Dis Assoc Disord. 2024;38(2):147-151. doi: 10.1097/WAD.0000000000000621. Epub 2024 May 17.

Abstract

PURPOSE

Lucid episodes (LEs: unexpected episodes of spontaneous, meaningful, and relevant communication or behavior) in Alzheimer disease and related dementias are a new area of scientific inquiry that lacks clinical consensus and require more conceptual attention.

METHODS

We aimed to measure consensus from an expert group on: (1) potential medical or clinical explanations for LEs; (2) necessary medical and clinical context to LEs; and (3) interpretation of LEs.

PATIENTS

We convened 13 experts from different disciplines (neurology, psychiatry, psychology, pharmacy, palliative care, hospice, nursing, social work, primary care, geriatrics, and professional home caregivers) to identify elements of LEs.

RESULTS

Experts provided a range of opinions on medical and clinical explanations and questions to understand LEs. Consensus on LEs when presented with clinical vignettes was not reached. Panelists highlighted key medical and contextual factors needed to make a definitive judgement about LEs.

CONCLUSION

There is variability in how LEs are interpreted by clinical experts, which complicates the identification of LEs in Alzheimer disease and related dementias.

摘要

目的

阿尔茨海默病及相关痴呆症中的清醒期(LEs:意外出现的自发、有意义且相关的交流或行为发作)是一个新的科学研究领域,缺乏临床共识,需要更多的概念关注。

方法

我们旨在衡量一个专家小组在以下方面的共识:(1)LEs的潜在医学或临床解释;(2)LEs所需的医学和临床背景;(3)LEs的解读。

患者

我们召集了13位来自不同学科(神经病学、精神病学、心理学、药学、姑息治疗、临终关怀、护理、社会工作、初级保健、老年医学以及专业家庭护理人员)的专家来确定LEs的要素。

结果

专家们对LEs的医学和临床解释以及理解LEs的问题提出了一系列意见。在展示临床案例时,未就LEs达成共识。小组成员强调了对LEs做出明确判断所需的关键医学和背景因素。

结论

临床专家对LEs的解读存在差异,这使得在阿尔茨海默病及相关痴呆症中识别LEs变得复杂。

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