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Poor Mental Status in Older Hospital Patients: Prevalence and Correlates

Published online by Cambridge University Press:  29 November 2010

Bill Eaton ,
M.J. Stones  and
Ken Rockwood
Bill Eaton
Affiliation:
Memorial University of Newfoundland
M.J. Stones
Affiliation:
Memorial University of Newfoundland
Ken Rockwood
Affiliation:
Memorial University of Newfoundland
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Abstract

Some older patients on treatment wards suffer from poor mental status in addition to a primary illness condition. This research 1) compared the relative prevalence of cognitive dysfunction when indexed by a mental status questionnaire (MSQ), physician reports, and nurse ratings, respectively, and 2) examined relationships of the MSQ to other variables. The sample was the entire inpatient population on medical and surgical wards at two general hospitals during a one-week period. Data were obtained from the patients (i.e., the MSQ), case notes by physicians (i.e., diagnoses or symptoms indicative of cognitive dysfunction), and ward nuses (i.e., ratings on several variables). The findings were that prevalence of cognitive dysfunction was greater by the MSQ than by physician reports, than by nurse ratings. Against the criterion of MSQ classification, both physicial reports and nurse ratings exhibited false positive and false negative errors; however, false negative errors were more frequent. The strong correlates of MSQ included capacity for independent living, use of geriatric chair, and physician evaluation. Other signs of normalcy or dysfunction were specific to only one MSQ category: tube feeding, restraint, and basic function capability.

Résumé

Certains malades âgés présentent outre leur maladie principale un bilan de santé mentale déficient. Dans la présente recherche, nous avons 1) comparé la prévalence relative des dysfonctions cognitives révélée respectivement par un questionnaire (Bilan des fonctions mentales, les déclarations du médecin, et l'évaluation des infirmières, et 2) nous avons examiné les rapports du Bilan aux autres variables. Notre échantillonnage comprend l'entière population des services médicaux et chirurgicaux de deux hôpitaux généraux au cours d'une semaine. Les données proviennent des malades eux-mêmes (Bilan), des notes des médecins (diagnostics et symptômes indiquant la présence de dysfonctions cognitives), et des infirmières (évaluation en fonction de plusieurs variables). D'après les résultats obtenus, la prévalence des dysfonctions cognitives se présente dans un ordre décroîssant selon qu'elle provient des réponse au questionnaire, des rapports des médecins, et des évaluations des infirmières. Comparativement au critère du Bilan, les rapports des médecins et les évaluations des infirmières comportent des jugements positifs erronés et des jugements négatifs erronés, toutefois la fréquence des jugements négatifs erronés est plus élevée. Parmi les corrélats marqués du Bilan, il faut signaler la conservation de l'autonomie, l'utilisation d'un fauleuil gériatrique, et l'évaluation du praticien. D'autres signes de fonctionnement normal ou anormal se rattachent à une catégorie particulière du Bilan, soit l'alimentation forcées, la restriction des mouvements et la capacité fonctionnelle fondamentale.

Keywords

elderlyagedphysiciansnursesdementiaconfusiondiagnosisscreening.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 5 , Issue 4 , Winter/L'hiver 1986 , pp. 231 - 239
Copyright
Copyright © Canadian Association on Gerontology 1986

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References

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