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Interventionsstudien zur Unterstützung häuslicher Pflege

Empfehlungen zu Endpunkten und Assessment-Instrumenten bei kognitiv eingeschränkten Pflegebedürftigen

Caregiver intervention studies

Recommendations on endpoints and outcome measures for cognitively impaired care recipients

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Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Bei der Evaluation von Interventionsstudien zur Unterstützung der häuslichen Pflege kognitiv eingeschränkter Personen ist neben der Wirksamkeitsprüfung auf der Ebene der Pflegenden auch die Wirkung der Intervention auf den Pflegebedürftigen von Interesse. Bislang berichten nur wenige Studien über diese Endpunkte. Die große Varianz der erfassten Dimensionen und verwendeten Assessment-Instrumente erschwert einen Vergleich von Studien.

Ziel der Arbeit

Der vorliegende Beitrag soll eine Übersicht sowie eine Empfehlung von Endpunkten und Assessment-Instrumenten aufseiten kognitiv eingeschränkter Pflegebedürftiger geben.

Material und Methode

Es erfolgte eine schriftliche Delphi-Befragung zu 16 Assessments aus 5 Dimensionen mit 14 Experten verschiedener Disziplinen, die in Forschungs- und Versorgungseinrichtungen in Deutschland arbeiteten.

Ergebnisse

Die wichtigsten Endpunkte und am besten bewerteten Assessments waren 1) herausforderndes Verhalten: Revised Memory and Behavior Problem Checklist, Neuro-Psychiatric Inventory Q; 2) depressive Symptomatik: Geriatrische Depressionsskala; 3) Lebensqualität: Quality of Life in Alzheimer’s Disease; 4) Kognition: Mini Mental State Examination; 5) ADL/IADL: Katz Activities of Daily Living und Lawton Instrumental Activities of Daily Living.

Schlussfolgerung

Die Experten, die sehr unterschiedliche Vorerfahrungen mit den einzelnen Assessments hatten, beurteilten die Instrumente teilweise sehr heterogen. Insgesamt konnten bisherige internationale Empfehlungen weitgehend bestätigt werden. In den Bereichen herausforderndes Verhalten und Lebensqualität besteht besonderer Bedarf an deutschsprachigen Validierungsstudien zu international gebräuchlichen Instrumenten.

Abstract

Background

Even though the intervention effects on cognitively impaired care recipients are of interest, the evaluation in dementia caregiver studies on caregiver outcomes is often limited. Furthermore, the comparison of studies and interventions is difficult because of the large variance of endpoints and assessments used in this field.

Objective

The aim of this study was to give an overview on the most prevalent outcomes for cognitively impaired care recipients and expert based recommendations for assessment.

Material and methods

A written Delphi survey was carried out on 16 assessments from 5 dimensions with 14 experts working in different disciplines in German healthcare and research institutes.

Results

The most important outcomes and best rated assessments were 1) for problem behavior: revised memory and behavior problem checklist and neuropsychiatric inventory Q, 2) for depressive symptoms: geriatric depression scale, 3) for quality of life: quality of life in Alzheimer’s disease, 4) for cognition: mini mental state examination and 5) for ADL/IADL: Katz activities of daily living and Lawton instrumental activities of daily living.

Conclusion

Due to the varying experiences of the experts with particular assessments, the ratings were in some cases relatively heterogeneous. Overall previous international recommendations could be confirmed. There is particular need of German validation studies on internationally used instruments within the dimensions of problem behavior and quality of life.

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Danksagung

Ein herzlicher Dank gilt allen Experten, die an der Studie teilgenommen haben: Prof. Sabine Bartholomeyczik, Universität Witten/Herdecke; Prof. Elmar Brähler, Universitätsklinikum Leipzig; Prof. Andreas Büscher, Hochschule Osnabrück; Prof. Gerhard Eschweiler, Geriatrisches Zentrum Tübingen; Prof. Elmar Gräßel, Psychiatrische Universitätsklinik Erlangen; Prof. Thomas Heidenreich, Hochschule Esslingen; Dr. Annett Horn, Universität Bielefeld; Dr. Petra Koczy, Robert-Bosch-Krankenhaus, Stuttgart; Prof. Monika Reichert, TU Dortmund; Prof. Martina Schäufele, Hochschule Mannheim; Günther Schwarz, Evangelische Gesellschaft, Stuttgart; Daniel Tucman, Deutsches Institut für angewandte Pflegeforschung e. V., Köln; Prof. Gabriele Wilz, Universität Jena. Die Studie wurde durch das Bundesministerium für Gesundheit gefördert (FKZ: IAA5-2513-ZPK-634).

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Authors and Affiliations

  1. Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Deutschland

    D. Albrecht M.A., C. Becker & K. Pfeiffer

  2. Klinische Psychologie und Psychotherapie, Fachbereich Psychologie, Eberhard Karls Universität, Tübingen, Deutschland

    D. Albrecht M.A. & M. Hautzinger

  3. Zentrum für Medizinische Versorgungsforschung, Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland

    A. Pendergrass

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  1. D. Albrecht M.A.
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  2. A. Pendergrass
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  3. C. Becker
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  4. M. Hautzinger
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  5. K. Pfeiffer
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Correspondence to D. Albrecht M.A..

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Interessenkonflikt

D. Albrecht, A. Pendergrass, C. Becker, M. Hautzinger und K. Pfeiffer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Albrecht, D., Pendergrass, A., Becker, C. et al. Interventionsstudien zur Unterstützung häuslicher Pflege. Z Gerontol Geriat 51, 642–649 (2018). https://doi.org/10.1007/s00391-016-1094-1

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  • DOI: https://doi.org/10.1007/s00391-016-1094-1

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