遇险识别工具的开发与可行性测试

IF 0.8 Q4 GERONTOLOGY Quality in Ageing and Older Adults Pub Date : 2019-12-06 DOI:10.1108/qaoa-06-2019-0030
G. Crowther, C. Brennan, K. Hall, Abbie Flinders, M. Bennett
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引用次数: 1

摘要

住院的痴呆症患者容易出现精神错乱、疼痛和心理症状。这些诊断与较差的患者预后相关,但往往未得到充分诊断和治疗。在经历谵妄、疼痛和心理症状的人群中,痛苦很常见。因此,对痛苦的筛查可能是识别未满足需求的一种敏感方式。本文的目的是描述遇险识别工具(DRT)的开发和可行性测试。DRT是一个纳入现有医院系统的单一问题筛选工具。它鼓励医疗保健专业人员定期寻找痛苦,并在确定痛苦时向他们指示相关资源。作者测试了在两个综合医院病房收治的痴呆症患者中使用DRT的可行性。使用混合方法来评估吸收和潜在的影响机制,包括使用频率、观察病房过程和与主要利益相关者的半结构化访谈。在52天的时间里,在32名参与者的日常护理中使用DRT;总共346个床日。DRT完成312次;平均每个参与者每天0.9次。如果参与者有一个明确的照顾者,83%的人在入院期间至少参与了一次评估。对利益相关者访谈的专题分析和观察数据表明,DRT快速、简单地完成,提高了病房对痛苦的认识,并有可能改善对住院痴呆症患者的护理。这是第一个在任何情况下例行检测痴呆症患者痛苦的简短筛查工具。它的吸收是积极的,如果有效,它可以改善痴呆症患者的护理和结果,但这超出了研究测试的范围。
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The development and feasibility testing of the Distress Recognition Tool
People with dementia in hospital are susceptible to delirium, pain and psychological symptoms. These diagnoses are associated with worse patient outcomes, yet are often underdiagnosed and undertreated. Distress is common in people experiencing delirium, pain and psychological symptoms. Screening for distress may therefore be a sensitive way of recognising unmet needs. The purpose of this paper is to describe the development and feasibility testing of the Distress Recognition Tool (DRT). The DRT is a single question screening tool that is incorporated into existing hospital systems. It encourages healthcare professionals to regularly look for distress and signposts them to relevant resources when distress is identified.,The authors tested the feasibility of using the DRT in people with dementia admitted on two general hospital wards. Mixed methods were used to assess uptake and potential mechanisms of impact, including frequency of use, observation of ward processes and semi-structured interviews with primary stakeholders.,Over a 52-day period, the DRT was used during routine care of 32 participants; a total of 346 bed days. The DRT was completed 312 times; an average of 0.9 times per participant per day. Where participants had an identified carer, 83 per cent contributed to the assessment at least once during the admission. Thematic analysis of stakeholder interviews, and observational data suggested that the DRT was quick and simple to complete, improved ward awareness of distress and had the potential to improve care for people with dementia admitted to hospital.,This is the first short screening tool for routinely detecting distress in dementia in any setting. Its uptake was positive, and if effective it could improve care and outcomes for people with dementia, however it was beyond the scope of the study test this.
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CiteScore
2.30
自引率
6.70%
发文量
17
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