Kuzmik Ashley, Boltz Marie
Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA.
Clin Gerontol. 2024 Aug 5:1-12. doi: 10.1080/07317115.2024.2388144.
The purpose of this study was to explore the mediating roles of care receiver clinical factors on the relationship between care partner preparedness and care partner desire to seek long-term care admission for persons living with dementia at hospital discharge.
This study analyzed data from the Family centered Function-focused Care (Fam-FFC), which included 424 care receiver and care partner dyads. A multiple mediation model examined the indirect effects of care partner preparedness on the desire to seek long-term care through care receiver clinical factors (behavioral and psychological symptoms of dementia [BPSD], comorbidities, delirium severity, physical function, and cognition).
Delirium severity and physical function partially mediated the relationship between care partner preparedness and care partner desire to seek long-term care admission (B = -.011; 95% CI = -.019, -.003, and B = -.013; 95% CI = -.027, -.001, respectively).
Interventions should enhance care partner preparedness and address delirium severity and physical function in hospitalized persons with dementia to prevent unwanted nursing home placement at hospital discharge.
Integrating care partner preparedness and care receiver clinical factors (delirium severity and physical function) into discharge planning may minimize care partner desire to seek long-term care.
本研究旨在探讨受照护者临床因素在照护伙伴准备情况与照护伙伴希望为出院时的痴呆症患者寻求长期护理机构安置意愿之间关系中的中介作用。
本研究分析了以家庭为中心的功能聚焦护理（Fam-FFC）的数据，其中包括424对受照护者与照护伙伴。一个多重中介模型检验了照护伙伴准备情况通过受照护者临床因素（痴呆症的行为和心理症状[BPSD]、共病、谵妄严重程度、身体功能和认知）对寻求长期护理意愿的间接影响。
谵妄严重程度和身体功能部分中介了照护伙伴准备情况与照护伙伴寻求长期护理机构安置意愿之间的关系（B = -0.011；95%置信区间 = -0.019，-0.003；以及B = -0.013；95%置信区间 = -0.027，-0.001）。
干预措施应增强照护伙伴的准备情况，并解决住院痴呆症患者的谵妄严重程度和身体功能问题，以防止在出院时出现不必要的养老院安置情况。
将照护伙伴准备情况和受照护者临床因素（谵妄严重程度和身体功能）纳入出院计划，可能会降低照护伙伴寻求长期护理的意愿。
