在患有充血性心力衰竭的老年人中解决普遍认知评估的需求
Myrna K Serna1, Shilpa Rajagopal2, Sunil K Sahai1
1Department of Internal Medicine-Division of General Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus
|July 22, 2024
概括
在患有充血性心力衰竭 (CHF) 的老年人中,认知障碍 (CI) 通常不会被识别,导致住院病例增加. 早期查和4Ms框架可以改善对这些复杂患者的护理.
科学领域:
- 老年病的医生 老年病的医生
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 在老年人中,充血性心力衰竭 (CHF) 和认知障碍 (CI) 很普遍.
- 同时出现的CHF和CI往往导致CI的诊断不足,导致住院治疗,发病率和死亡率增加.
- 解决这些问题需要采用综合方法,考虑健康的社会决定因素.
研究的目的:
- 强调认知障碍在患有充血性心力衰竭的患者中识别和管理认知障碍的重要性.
- 引入卫生保健改进研究所 (IHI) 的4Ms框架,作为综合护理的工具.
- 强调早期的严重疾病对话和社会工作咨询.
主要方法:
- 使用IHI 4Ms框架 (重要的是什么,药物,心理,移动性) 进行整体的患者评估.
- 建议在CHF患者中进行认知障碍的普遍查.
- 倡导有效的认知评估工具 (例如,Mini-Cog,FAQ) 和ADL/IADL评估.
- 促进早期的严重疾病对话和社会工作咨询.
主要成果:
- 在CHF患者中早期识别CI可以减轻不良结果.
- 4Ms框架提供了一种结构化的方法,以解决医疗,认知和功能领域的患者需求.
- 将健康的社会决定因素纳入护理规划,对于管理复杂的患者需求至关重要.
结论:
- 对CI的普遍查和早期采用4Ms框架对于优化患有心血管衰竭的老年人护理至关重要.
- 与心力衰竭一起认知状态的积极管理改善了患者的结果.
- 与社会工作的合作对于导航资源和支持患者退院后至关重要.
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