关于长期护理中妄想风险的组织背景和促进相互作用:一项跨部门研究
Katharina Choroschun1, Carole A Estabrooks2, Yinfei Duan2
1School of Public Health, Bielefeld University, Bielefeld, Germany.
Journal of the American Medical Directors Association
|April 25, 2024
概括
组织背景和促进影响长期护理 (LTC) 的错觉. 需要针对性干预,考虑特定的单元因素,以有效提高痴呆症管理的质量.
科学领域:
- 老年学是一门学科.
- 医疗保健管理的管理
- 临床护理 临床护理
背景情况:
- 组织背景和促进对长期护理 (LTC) 的最佳实践至关重要,特别是在妄想管理方面.
- 了解这些因素之间的相互作用及其对妄的影响对于改善住院护理至关重要.
研究的目的:
- 评估组织背景的个人和互动关联,以及在LTC环境中与妄想患病率的促进.
- 确定可以针对质量改进举措来减少妄想的具体因素.
主要方法:
- 对加拿大的86个LTC设施的281个护理单位的8755名居民的二次数据进行了回顾性横截面分析.
- 使用居民评估仪器-最小数据集2.0 (RAI-MDS 2.0) 评估的狂妄症.
- 通过阿尔伯塔语境工具 (ACT) 测量的组织背景,人员数量和人员组合;促进包括经理感知的报告充足性和药剂师可用性.
主要成果:
- 在17.4%的居民中, Delirium 症状存在.
- 充分的RAI-MDS报告减少了妄想 (OR=0.63),而更长的护理时间 (OR=1.2) 和药剂师的可用性 (OR=1.5) 增加了它.
- 相互作用是显著的:增加经理OCB降低了低社会资本单位的妄想,增加的人员组合降低了高评估背景单位的妄想.
结论:
- 组织背景和促进之间的单位层面的相互作用会影响妄想率.
- 质量改进干预措施必须根据特定的上下文因素进行调整,以获得最佳的有效性来减少妄想.
- 对这些复杂相互作用的进一步研究可以指导有针对性的策略,以便在LTC中更好地治疗妄想症.
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