预防住院老年病人发生谵妄照护方案实施及效果评价

Implementation and effect evaluation of care plan for prevention of delirium in elderly patients

目的实施预防住院老年病人发生谵妄照护方案并评价其效果。方法建立谵妄预防照护团队,开展多中心、随机对照试验,纳入病例447例,其中对照组230例,试验组217例。对照组接受常规医疗和护理,试验组接受预防谵妄照护方案,观察时间均为2周。比较2组病人谵妄发生率及干预前后认知功能、自理能力。结果试验组谵妄发生率明显低于对照组(2.7%比7.3%,P<0.05)。干预2周后,试验组认知功能障碍改善优于对照组(P<0.05),其中轻、中度智力功能改善较为明显;试验组自理能力得分高于干预前(P<0.05),但2组间差异无统计学意义(P>0.05);试验组平均住院日少于对照组[(11.58±6.27)d比(13.21±8.36)d],差异有统计学意义(P<0.05)。结论预防住院老年病人发生谵妄照护方案能降低住院老年病人谵妄发生率,预防认知功能下降,缩短住院时间。

Objective To implement the care plan foRprevention of delirium in the hospitalized elderly patients and evaluate its effect.Methods A care team foRdelirium prevention was established.A total of 447 patients were enrolled in a multi-center,randomized controlled trial,with 230 cases in the control group and 217 cases in the experimental group.The control group received routine medical treatment and nursing,and the experimental group received care plan foRdelirium prevention on the basis of routine medical treatment and nursing.The observation time was 2 weeks.The delirium incidence,cognitive function and self-care ability of the two groups were compared before and afteRintervention.Results The incidence rate of delirium in the experimental group was significantly loweRthan that in the control group(2.7%vs 7.3%,P<0.05).AfteRtwo weeks of intervention,cognitive impairment in the experimental group was improved more than that in the control group(P<0.05),especially in the patients with mild and moderate cognitive impairment.The score of Barthel Index in the experimental group before the intervention was higheRthan that afteRthe intervention(P<0.05),but there was no signicant difference between the two groups.The hospitalization time of the experimental group was less than that of the control group(P<0.05).Conclusions Care plan to prevent delirium in hospitalized elderly patients can reduce the incidence of delirium and the loss of self-care ability and prevent cognitive decline.