Aronson M K, Post D C, Guastadisegni P
Albert Einstein College of Medicine, Bronx, NY.
J Am Geriatr Soc. 1993 May;41(5):507-12. doi: 10.1111/j.1532-5415.1993.tb01886.x.
To examine the behavioral and functional problems of the cognitively impaired.
A survey of a cohort of residents from six nursing homes.
Subjects were randomly selected based on a minimum age of 70 years and a Resource Utilization Group (RUG) classification of the Physical or Behavioral type. Of those eligible, 44% (n = 366) agreed to participate. The participants and non-participants had similar demographics except for a higher incidence of mental illness in the non-participant group, which did not have a significant impact on agitation.
Six nursing homes in New York City, three voluntary non-profit and three proprietary.
The study used chart review, assessment of residents' cognitive and functional abilities, nursing assistants' ratings of residents' functional abilities, behavioral problems, and the amount of effort required in care, and time-motion observations of staff-resident interactions.
Residents' level of cognitive impairment had a significant impact on problem behaviors during ADL tasks, along with supervision required in patient care (P < 0.05). These results were validated by time-motion analysis. Regression analysis revealed that for non-demented subjects, the best indicator of care needs was health status, while for demented residents the best indicator was cognitive status (P < 0.0001).
The care needs of residents with dementia are better estimated by a mental status test for cognitive impairment then by ADL assessment alone. Greater agitation is associated with increasing cognitive impairment. Further, agitation and behavioral problems associated with care result in a need for increased staff supervision.
研究认知障碍者的行为和功能问题。
对六家养老院的一组居民进行调查。
根据最低年龄70岁和资源利用组（RUG）身体或行为类型分类随机选取受试者。符合条件者中，44%（n = 366）同意参与。参与者和非参与者的人口统计学特征相似，只是非参与者组精神疾病发病率较高，但这对躁动没有显著影响。
纽约市的六家养老院，三家志愿非营利性和三家营利性。
该研究采用病历审查、居民认知和功能能力评估、护理助理对居民功能能力、行为问题以及护理所需工作量的评分，以及对工作人员与居民互动的时间 - 动作观察。
居民的认知障碍程度对日常生活活动（ADL）任务中的问题行为有显著影响，同时对患者护理所需的监督也有影响（P < 0.05）。这些结果通过时间 - 动作分析得到验证。回归分析显示，对于非痴呆受试者，护理需求的最佳指标是健康状况，而对于痴呆居民，最佳指标是认知状况（P < 0.0001）。
通过认知障碍的精神状态测试比仅通过ADL评估能更好地估计痴呆居民的护理需求。躁动加剧与认知障碍加重相关。此外，与护理相关的躁动和行为问题导致需要增加工作人员监督。
