急诊老年期痴呆患者的主要家庭照顾者对老年期痴呆安全的认知调查

Survey on Awareness State of Dementia Security in Family Caregivers of Elderly Dementia in Emergency Department

目的探讨急诊老年期痴呆患者的主要家庭照顾者对老年期痴呆安全的认知情况,并提出相应的解决措施。方法选取2011年1月—2013年6月来我院急诊科就诊的老年期痴呆患者84例及其主要家庭照顾者84例。分析患者急诊就诊原因,并采用自行设计的调查问卷对主要照顾者就老年期痴呆安全的认知情况进行调查。结果 84例老年期痴呆患者急诊就诊原因:跌倒与坠床22例(26.2%),误吸和误食14例(16.7%),自伤自杀9例(10.7%),烧烫伤4例(4.8%),其他疾病35例(41.6%)。主要家庭照顾者对家中物品放置〔条目1和条目2回答正确率分别为97.6%(82/84)和94.0%(79/84)〕、病情观察〔条目11回答正确率为90.5%(76/84)〕、物理约束〔条目15回答正确率为89.3%(75/84)〕的认知率高;而对于外出〔条目3的回答正确率为27.4%(23/84)〕、水温〔条目7的回答正确率为23.8%(20/84)〕、痴呆患者疼痛感受〔条目9的回答正确率为21.4%(18/84)〕的认知率低;而条目12仅有11.9%(10/84)的家庭照顾者回答正确。大专及以上文化程度的家庭照顾者对老年期痴呆安全保障方面的照顾性行为得分均高于其他文化程度者,高中及中专、大专及以上文化程度者总分均高于小学及以下文化程度者,且大专及以上文化程度者总分高于初中文化程度者(P<0.05)。照顾时间>10年的家庭照顾者对老年期痴呆安全保障方面的照顾性行为得分及总分均高于其他照顾时间者,照顾时间<1年者协助康复得分均低于其他照顾时间者,照顾时间1~5年者协助康复得分及总分均高于照顾时间<1年者及>5~10年者(P<0.05)。结论急诊老年期痴呆患者的主要家庭照顾者对老年期痴呆的安全认知水平较低,故应加强其老年专科知识培训和高危行为的风险知识教育。主要家庭照顾者的文化程度及照顾时间与其对老年期痴呆的安全认知水平有关。

Objective To analyze the awareness state of dementia security in family caregivers of elderly dementia in Emergency Department in order to propose solutions. Methods 84 dementia elderly admitted to the Emergency Department in our hospital from January 2011 to June 2013 and their family caregivers were selected. The reasons for the visit were analyzed and self - made questionnaires were used to survey the awareness state of dementia security of the family caregivers. Results The reasons for visit among the 84 patients： falling down or falling out of bed （22 cases, 26. 2% ）, aspiration or ingestion （14 cases, 16. 7% ） , self- injury or suicide （9 cases, 10. 7% ） , burns （4 cases, 4. 8% ） and other diseases （35 cases, 41.6% ） . As concerns the family caregivers, the awareness rate was high on items placement at home [ with a correct answer rate of 97.6% （82/84） and 94.0% （79/84） for item 1 and item 2） , disease observation [with a correct answer rate of 90. 5% （76/84） for item 11] and physical constraint [with a correct answer rate of 89. 3% （75/84） for item 15] . But the awareness rate was low on going out [ with a correct answer rate of 27.4% （ 23/84 ） for item 3 ], water temperature [with a correct answer rate of 23.8% （20/84） for item 73 and pain feeling of dementia patients （with a correct answer rate of 21.4% （18/84） for item 9]. The correct answer rate for item 12 was only 11.9% （10/84） . The security awareness scores of ＂ university and above＂ educated family caregivers were the highest, and the scores of ＂ high school and college＂ educated caregivers were higher than ＂ primary school or below＂ educated caregivers, and the scores of college educated caregivers were also higher than junior middle school educated caregivers （P 〈0. 05） . Family caregivers who have taken care of the dementia patients for more than ten years had the highest security awareness scores, while care^ivers who have taken care of the dementia oatients for less than one year had the lowest. Caregivers who had taken care of the patients one to five years had higher scores than those who less than one year and those who five to ten years （ P 〈 0. 05 ） . Conclusion The dementia security awareness state of dementia family caregivers is still low. Education on elderly dementia knowledge and high - risk behavior knowledge should be carried out. Education background and the attending time are related to the security awareness.