Dementia screening for elderly in-patients and its association with nursing care satisfaction-an observational study

Abstract

Inappropriate care for patients with cognitive dysfunction in the hospital could worsen quality of care and medical service satisfaction. All elderly participants were recruited from acute wards of 5 departments in an university hospital. They were administered the Chinese version of Ascertain Dementia 8 (AD8) at admission and the Nursing Service Satisfaction Questionnaire before discharge. A total of 345 participants completed the study. There were 91 (26.4%) participants with AD8 ≥ 2, the cut-off value of high risk of dementia. The prevalence was much higher than prior community-based reports. The Nursing Service Satisfaction Score was significantly lower in AD8 ≥ 2 than in AD8 < 2 (56.99 ± 0.94 vs 60.55 ± 0.48, P < .01). Using AD8 in hospital-based screening might be more efficient than in the community in terms of cost-effectiveness due to higher positive rate and easier approach to diagnostic facilities. AD8 ≥ 2 is also an indicator to identify care dissatisfaction among inpatients. By identifying patients with cognitive dysfunction, such as its related communication barriers, care systems could be tailored for more friendly services.

There exists high ratio of, and significant overlap between, suspected dementia and suspected depression among elderly outpatients

“…As shown in Table 1, there was a high AD8-positive rate (28.2%, suspected dementia) in our study, compatible with the previous reports of using AD8 in the hospital 22,23 but much higher than the AD8 screening results in the non-hospital settings 24,25 . There are some possible explanations for the high positive rate of AD8 in our study.…”

Assessing mental health of elderly outpatients, to screen only dementia or depression will have a strong bias

“…In Table 1, there was a high AD8-positive rate (28.2%, suspected dementia) in our study, compatible with the previous reports of using AD8 in the hospital [21,22] but much higher than the AD8 screening results in the non-hospital settings [23,24]. There are some possible explanations for the high positive rate of AD8 in our study.…”

“…Second, among hospital-based screening programs with AD8, only those ≥ 65 years were recruited in our study making the mean age (77.2 years) much older than the previous investigations with the median and the mean age to be 66 and 69.9 years separately [21,22]. And age is one of the established risk factors for dementia.…”

Assessment of patients’ satisfaction level with nursing care in the department of neurology

“…A study conducted by Huang et al investigated such a relationship and found that cognitive impairment (memory impairment) was associated with lower satisfaction with nursing care. The study additionally emphasized the need to identify cognitively impaired patients with communication difficulties in order to better adapt care to their needs [17]. In comparison, in a study by Szőcs et al, patients in severe condition as a result of stroke experienced lower satisfaction with care [18].…”