- 期刊
Using the Minimum Data Set to Determine Predictors of Terminal Restlessness among Nursing Home Residents
用MDS測定美國護理之家住民臨終躁動不安之預測因子
摘要
本研究之目的在測定自長者健康評估工具(Minimum Data Set, MDS)中所選取的四個變項(疼痛、憂鬱情緒、問題狀況及藥物使用)是否為護理之家住民臨終躁動不安之預測因子。本研究乃採橫斷、描述性設計，回溯居住於美國西北部某一護理之家在西元2000及2001年過世住民的最後一次MDS紀錄。以臨終躁動不安做為依變項，疼痛、憂鬱情緒、問題狀況及藥物使用四個變項為自變項，運用徑路分析統計方法探討此四變項是否可預測住民臨終躁動不安的情形。結果共有84位住民紀錄納入本研究，徑路分析顯示：(1)住民的問題狀況(β=.557)及疼痛(β=.193)可預測住民憂鬱情緒變異量的44.6%；(2)疼痛(β=.370)及憂鬱情緒(β=.313)可預測住民臨終躁動不安變異量的34%。本研究發現具有重要之臨床意義，尤其許多年老住民在臨終時無法以口語溝通，審慎地評估住民臨終時疼痛狀況及情緒變化是必要的，藉以提供合適且立即性的措施。
並列摘要
The aim of this study was to determine predictive variables of terminal restlessness that were selected from the Minimum Data Set (MDS) among nursing home residents. A descriptive, cross-sectional design was used to retrospectively review decedents' Minimum Data Set records. Four independent variables from the MDS (distressed mood, problem conditions, pain, and medications) were examined as to whether they were predictive variables of terminal restlessness by utilizing path analysis statistical method. Residents from a nursing home located in the northwestern United States who died during 2000 and 2001, had at least one MDS record and no comatose in their MDS cognitive patterns were selected. A total of 84 decedents’ records were consequently recruited for use in this study. A path analysis result showed (a) 44.6% of the variance in distressed mood is predicted by two variables: problem conditions (β=.557) and pain (β=.193) and (b) 34% of the variance in terminal restlessness is predicted by two variables: pain (β=.370) and distressed mood (β=.313). Results indicate that residents who (a) had more problem conditions and more pain are more likely to have distressed moods and (b) experienced more pain and had more distressed moods have a higher incidence of terminal restlessness. These findings provide important and valuable clinical implications. A careful evaluation of pain is necessary, especially as many elders are not able to communicate well during the terminal phase of their lives. How to access residents' moods and provide appropriate and immediate interventions, comfort, and even just being there for them are imperative for nursing home care providers.
參考文獻
延伸閱讀
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