对老年患者具有 (不明原因) 持续性体征症状的生物心理社会措施的潜形状分析
Pauline Bos1, Rei Monden2, Carolien Benraad3
1Lentis Psychiatric Institute, Center for Old Age Psychiatry and Somatic Care, E61, 9471 KE Zuidlaren, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, Groningen, 9700 RB, the Netherlands.
Comprehensive psychiatry
|August 29, 2024
概括
持久性体征症状 (PSS) 的老年患者从综合护理中受益,而不仅仅是医学解释 (MES) 或无法解释 (MUS) 的区别. 数据驱动的个人资料揭示了脆弱的子组,需要针对性支持以获得更好的健康结果.
科学领域:
- 老年学是一门学科.
- 精神病体医学是一种精神病体医学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年人的持续性体征症状 (PSS) 通常通过基于症状解释 (医学解释 - MES,或医学无法解释 - MUS) 的单独的体征或精神病治疗途径进行管理.
- 这种传统的分离可能会忽视临床细微差别,并导致对特定患者亚组的治疗不够优.
- 在较老的PSS患者队伍中,对数据驱动的子组识别存在有限的研究.
研究的目的:
- 用数据驱动方法在PSS老年患者中确定临床相关的,均的子组.
- 超越传统的医学解释 (MES) 与医学无法解释 (MUS) 症状区分.
- 为经历PSS的老年人提供更综合和个性化的护理策略.
主要方法:
- 隐形形状分析 (LPA) 用于从病例控制研究中获得的数据.
- 进行了两次LPA:一个是体质健康测量 (N=272) 和另一个是心理社会测量 (N=272) 在60岁以上的参与者中.
- 参与者包括来自不同医疗机构的MUS (N=118) 和MES (N=154) 个体.
主要成果:
- 两种不同的体质健康状况出现了:"强"和"脆弱".
- 他们发现了四种不同的心理健康特征:"强烈"",脆弱"",孤独"和"不接受".
- 身体健康和精神健康概况之间没有明显的重叠 (κ = 0.019),脆弱的概况会对与健康有关的生活质量产生负面影响.
结论:
- 医学解释 (MES) 和医学无法解释 (MUS) 症状之间的区别可能无法充分捕捉老年人PSS的异质性.
- 通过体质和心理社会因素识别的脆弱子组,如果护理保持孤立,就有可能受到治疗不足的风险.
- 建议对PSS老年患者采取综合护理方法,无论症状来源如何,以满足所有脆弱个体的需求.
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