Introduction: Given the aging population and the high prevalence of cognitive impairment in older hospitalized patients, it is essential to provide good fundamental care to these vulnerable patients, who easily might be affected by poor outcomes as delirium. Risk factors for delirium are, for example, cognitive impairment, old age, pain, and sleep deprivation. Different symptoms are often unidentified in hospitals, and associated with poor well-being, but this is rarely studied in older patients with cognitive impairment. The study aim was to examine symptoms and sense of well-being in older hospitalized patients with cognitive impairment, as self-reported and reported in patient records. Methods: Exploratory quantitative subgroup (n = 25) analysis of a point-prevalence study (n = 210). Inclusion criteria were age ≥65, and cognitive impairment. Data were collected through structured interviews, validated instruments, and patient records. Associations between well-being and symptoms, and concordance between the occurrence of self-reported symptoms and symptoms reported in patient records were analyzed. Results: The patients reported severe and distressing symptoms that were sparsely reported (14%) in their records. As well were cognitive impairment, and the patients’ own descriptions of their well-being. Some symptoms and the total symptom burden were associated with poor well-being. Discussion/Conclusion: To our knowledge, this hypothesis-generating study is one of few studies that describe both symptoms and well-being as self-reported and reported in patient records, in vulnerable patients due to old age, cognitive impairment, and hospitalization. Despite the limited sample size, the results indicate that symptoms were more insufficient alleviated in these patients compared to patients with normal cognitive function in other studies. To our knowledge, this has not been shown previously. Additionally, patients’ own experiences were sparsely reported in their records. A larger sample size and longitudinal design has the potential to determine if symptom alleviation differs between patients with and without cognitive impairment, and if a total symptom burden increases the risk of poor outcomes as delirium in vulnerable patients.
Dement Geriatr Cogn Disord Extra 2021;11:71–77

中文翻译：

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认知障碍老年住院患者的症状和幸福感，如患者记录中的自我报告和报告：定量探索性亚组分析

简介：鉴于人口老龄化和老年住院患者认知障碍的高患病率，为这些易受谵妄等不良结果影响的弱势患者提供良好的基础护理至关重要。谵妄的危险因素包括认知障碍、年老、疼痛和睡眠不足。不同的症状在医院通常无法识别，并且与健康状况不佳有关，但这很少在老年认知障碍患者中进行研究。该研究旨在检查患有认知障碍的老年住院患者的症状和幸福感，这些患者自我报告并在患者记录中报告。方法：探索性定量亚组（ n= 25) 点患病率研究分析 ( n = 210)。纳入标准为年龄≥65 岁和认知障碍。通过结构化访谈、经过验证的工具和患者记录收集数据。分析了幸福感与症状之间的关联，以及自我报告症状的发生与患者记录中报告的症状之间的一致性。结果：患者报告了在他们的记录中很少报告的严重和令人痛苦的症状（14%）。认知障碍以及患者对自己健康状况的描述也是如此。一些症状和总症状负担与健康状况不佳有关。讨论/结论：据我们所知，这项产生假设的研究是少数几项将症状和幸福感描述为自我报告并在患者记录中报告的研究之一，这些研究涉及因年老、认知障碍和住院而导致的脆弱患者。尽管样本量有限，但结果表明，与其他研究中认知功能正常的患者相比，这些患者的症状缓解不足。据我们所知，这在以前没有展示过。此外，患者自己的经历很少在他们的记录中报告。更大的样本量和纵向设计有可能确定有和没有认知障碍的患者的症状缓解是否不同，以及总体症状负担是否会增加易受伤害患者谵妄的不良结局风险。
Dement Geriatr Cogn Disord Extra 2021；11:71–77