评估和管理痴呆症疼痛:从跨学科文本信息通信的见解
Ashley Woods1, Matthew Farmer1, Mihail Popescu2
1Sinclair School of Nursing, School of Nursing, University of Missouri, Columbia, MO.
概括
对于患有阿尔茨海默氏症和相关痴呆症 (ADRD) 和黑人居民的养老院沟通中,疼痛的代表性不足. 这突显了疼痛评估和管理方面的差异,需要改进沟通策略.
科学领域:
- 老年学是一门学科.
- 医疗信息学 医疗信息学
- 疼痛管理 疼痛管理
背景情况:
- 养老院居民,特别是那些患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的人,经历了复杂的疼痛管理需求.
- 跨学科医疗团队之间的有效沟通对于最佳的患者护理至关重要,特别是在医院转移期间.
研究的目的:
- 为了比较疼痛评估和管理在跨学科短信 (TMs) 中的表现,在医院转移之前,对于有或没有ADRD的养老院居民.
- 在医疗保健专业人员之间交换的TM中与疼痛提及相关的因素.
主要方法:
- 对21000个跨学科的TM进行了回顾性分析,并从转移到医院的养老院居民那里调查数据 (2016-2020).
- 使用自然语言处理 (NLP) 来识别疼痛评估,管理和药物的提及.
- 统计分析,包括独立的t测试和通用线性模型,用于评估与疼痛提及和ADRD状态相关的差异和预测因素.
主要成果:
- 分析包括694次转移,涉及414名居民;39%的人患有ADRD.
- 与没有ADRD的居民相比,患有ADRD的居民在TM中提到疼痛的次数显著减少 (t = 2.38,p = .02).
- 年龄,种族和并发症是与疼痛相关的TM提及的重要预测因素,而痴呆阶段和可避免的转移并非如此.
结论:
- 对于黑人居民和ADRD患者来说,疼痛在沟通中表现不佳,这表明在护理方面存在潜在的差异.
- 需要更公平的疼痛管理实践,包括增强的评估工具和改进的沟通协议,特别是通过医疗机构的TM.
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