Sherrell K, Anderson R, Buckwalter K
Buehler Center on Aging, Northwestern University, Chicago, IL 60611, USA.
Arch Psychiatr Nurs. 1998 Jun;12(3):131-9. doi: 10.1016/s0883-9417(98)80014-9.
This article presents results from a retrospective study of psychological assessments of elderly persons with chronic mental illness residing in nursing homes. All residents (N = 570) received this assessment as part of federally mandated screening for mentally ill persons residing in long-term care. The process, the Preadmission Screening and Resident Review, was mandated by the Omnibus Budget Reconciliation Act (OBRA 87). These assessments were the first stage in a process to determine if the nursing home was the most appropriate placement for each resident. If nursing home care was deemed appropriate, then a psychological treatment program was to be established within the nursing home setting. The sample ranged in age from 50 to 104 (mean of 70). The majority had a diagnosis of schizophrenia and a history of psychiatric hospitalization occurring early in their life. The assessments did not include any quantifiable data on activities of daily living, cognitive functioning, or level of psychiatric impairment. Therefore, the researchers coded the narrative data so that it could be interpreted. The majority functioned within the none-to-mild range of cognitive impairment, and very few were completely dependent in the need for physical care. The most recorded symptom was social withdrawal. Neuroleptic medications were administered to 64% of elderly persons with chronic mental illness. Importantly, there was no relationship between demographic or clinical information and treatment recommendations. Implications of these findings for psychiatric nurses are discussed.
本文介绍了一项针对居住在养老院的患有慢性精神疾病的老年人进行心理评估的回顾性研究结果。所有居民（N = 570）都接受了这项评估，作为联邦政府对居住在长期护理机构中的精神疾病患者进行强制筛查的一部分。这个过程，即入院前筛查和居民评估，是由《综合预算协调法案》（OBRA 87）规定的。这些评估是确定养老院是否是每位居民最合适安置场所的过程的第一阶段。如果认为养老院护理合适，那么就要在养老院环境中建立一个心理治疗项目。样本年龄从50岁到104岁不等（平均70岁）。大多数人被诊断患有精神分裂症，并且在其生命早期有过精神科住院史。这些评估不包括关于日常生活活动、认知功能或精神障碍程度的任何可量化数据。因此，研究人员对叙述性数据进行编码以便进行解读。大多数人的认知障碍处于无到轻度范围内，很少有人在身体护理需求方面完全依赖他人。记录最多的症状是社交退缩。64%患有慢性精神疾病的老年人服用了抗精神病药物。重要的是，人口统计学或临床信息与治疗建议之间没有关联。本文讨论了这些研究结果对精神科护士的启示。
