痴呆症护理研究和心理社会因素
Zahra Rahemi1, Juanita-Dawne Bacsu2, Matthew Lee Smith3
1Clemson University, Greenville, SC, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 26, 2025
概括
黑人患有认知障碍的患者在生命结束时遵守预先护理计划 (ACP) 的可能性较小. 解决认知衰退和种族差异对于公平的终身护理至关重要.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 阿尔茨海默氏症和相关痴呆症 (ADRD) 带来了巨大的财务和死亡负担.
- 预先护理计划 (ACP) 完成率较低,特别是在面临医疗保健差异的黑人和西班牙裔人口中.
- 在理解终身护理与患者偏好保持一致方面存在关键差距,特别是在认知障碍患者中.
研究的目的:
- 调查在遵守生命终结指令方面的种族差异.
- 探索认知状态在遵守预先护理计划中的作用.
主要方法:
- 利用了来自健康和退休研究 (HRS) 出口文件 (1995-2016) 的数据.
- 通过记忆的代理报告评估认知状态 (糟糕与正常) 接近生命的终点.
- 根据代理受访者采访,评估了对书面生命终结指令的遵守情况.
主要成果:
- 26%的死者在临近死亡时的记忆评分很差.
- 在基于认知状态 (p=0.02) 的终身指令的遵守方面发现了显著的种族差异.
- 认知能力差的黑人参与者与认知能力正常的参与者相比,不遵守生命终结指令的可能性增加了2.2倍.
结论:
- 认知状态在终身指令的遵守方面显著影响了种族差异.
- 解决认知衰退和种族不平等问题对于改善患者偏好实施和终身护理结果至关重要.
- 调查结果强调了对文化敏感的方法的需要,以提升对不同人群的护理规划和终身护理.
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