Skip to main content

24.06.2016 | Originalien

Interventionsstudien zur Unterstützung häuslicher Pflege

Empfehlungen zu Endpunkten und Assessment-Instrumenten bei kognitiv eingeschränkten Pflegebedürftigen

verfasst von: D. Albrecht, M.A., A. Pendergrass, C. Becker, M. Hautzinger, K. Pfeiffer

Erschienen in: Zeitschrift für Gerontologie und Geriatrie

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Alexopoulos GS, Abrams RC, Young RC et al (1988) Cornell scale for depression in dementia. Biol Psychiatry 23:271–284CrossRefPubMed Alexopoulos GS, Abrams RC, Young RC et al (1988) Cornell scale for depression in dementia. Biol Psychiatry 23:271–284CrossRefPubMed
2.
Zurück zum Zitat Bourgeois MS, Schulz R, Burgio L (1996) Interventions for caregivers of patients with alzheimer’s disease: A review and analysis of content, process, and outcomes. Int J Aging Hum Dev 43:35–92CrossRefPubMed Bourgeois MS, Schulz R, Burgio L (1996) Interventions for caregivers of patients with alzheimer’s disease: A review and analysis of content, process, and outcomes. Int J Aging Hum Dev 43:35–92CrossRefPubMed
3.
Zurück zum Zitat Brod M, Stewart AL, Sands L et al (1999) Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). Gerontologist 39:25–35CrossRefPubMed Brod M, Stewart AL, Sands L et al (1999) Conceptualization and measurement of quality of life in dementia: The dementia quality of life instrument (DQoL). Gerontologist 39:25–35CrossRefPubMed
4.
Zurück zum Zitat Cummings JL, Mega M, Gray K et al (1994) The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314CrossRefPubMed Cummings JL, Mega M, Gray K et al (1994) The neuropsychiatric inventory: Comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314CrossRefPubMed
5.
Zurück zum Zitat Debruyne H, Van Buggenhout M, Le Bastard N et al (2009) Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? Int J Geriatr Psychiatry 24:556–562CrossRefPubMed Debruyne H, Van Buggenhout M, Le Bastard N et al (2009) Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? Int J Geriatr Psychiatry 24:556–562CrossRefPubMed
6.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) „Mini-mental state“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) „Mini-mental state“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed
7.
Zurück zum Zitat Galasko D, Bennett D, Sano M et al (1997) An inventory to assess activities of daily living for clinical trials in alzheimer’s disease. The alzheimer’s disease cooperative study. Alzheimer Dis Assoc Disord 11:S33–39CrossRefPubMed Galasko D, Bennett D, Sano M et al (1997) An inventory to assess activities of daily living for clinical trials in alzheimer’s disease. The alzheimer’s disease cooperative study. Alzheimer Dis Assoc Disord 11:S33–39CrossRefPubMed
8.
Zurück zum Zitat Gauggel S, Birkner B (1998) Diagnostik depressiver Störungen bei älteren Menschen: Eine Übersicht über Entwicklung und Evaluation der „Geriatric Depression Scale“ (GDS). Z Gerontopsychol Psychiatry 11:159–171 Gauggel S, Birkner B (1998) Diagnostik depressiver Störungen bei älteren Menschen: Eine Übersicht über Entwicklung und Evaluation der „Geriatric Depression Scale“ (GDS). Z Gerontopsychol Psychiatry 11:159–171
9.
Zurück zum Zitat Gélinas I, Gauthier L, McIntyre MC et al (1999) Development of a functional measure for persons with alzheimer disease: The disability assessment for dementia. Am J Occup Ther 53:471–481CrossRefPubMed Gélinas I, Gauthier L, McIntyre MC et al (1999) Development of a functional measure for persons with alzheimer disease: The disability assessment for dementia. Am J Occup Ther 53:471–481CrossRefPubMed
10.
Zurück zum Zitat Grässel E (1998) Home care of demented and non-demented patients. II: Health and burden of caregivers. Z Gerontol Geriatr 31:57–62CrossRefPubMed Grässel E (1998) Home care of demented and non-demented patients. II: Health and burden of caregivers. Z Gerontol Geriatr 31:57–62CrossRefPubMed
11.
Zurück zum Zitat Hindmarch I, Lehfeld H, de Jongh P et al (1998) The Bayer activities of daily living scale (B-ADL). Dement Geriatr Cogn Dis 9:20–26CrossRef Hindmarch I, Lehfeld H, de Jongh P et al (1998) The Bayer activities of daily living scale (B-ADL). Dement Geriatr Cogn Dis 9:20–26CrossRef
13.
Zurück zum Zitat Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefPubMed
14.
Zurück zum Zitat Kaufer DI, Cummings JL, Ketchel P et al (2000) Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci 12:233–239CrossRefPubMed Kaufer DI, Cummings JL, Ketchel P et al (2000) Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci 12:233–239CrossRefPubMed
15.
Zurück zum Zitat Kessler J, Calabrese P, Kalbe E et al (2000) DemTect: Ein neues Screening-Verfahren zur Unterstützung der Demenzdiagnostik. Psycho 26:343–347 Kessler J, Calabrese P, Kalbe E et al (2000) DemTect: Ein neues Screening-Verfahren zur Unterstützung der Demenzdiagnostik. Psycho 26:343–347
16.
Zurück zum Zitat Klein D, Pendergrass A, Becker C et al (2015) Dementia Caregiver interventions: A systematic review of care recipient outcome measures. Int J Emerg Ment Health 17:415–426 Klein D, Pendergrass A, Becker C et al (2015) Dementia Caregiver interventions: A systematic review of care recipient outcome measures. Int J Emerg Ment Health 17:415–426
17.
Zurück zum Zitat Lawton MP, Brody EM (1969) Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186CrossRefPubMed Lawton MP, Brody EM (1969) Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186CrossRefPubMed
18.
Zurück zum Zitat Logsdon RG, Gibbons LE, McCurry SM et al (1999) Quality of life in alzheimer’s disease: Patient and caregiver reports. J Ment Health Aging 5:21–32 Logsdon RG, Gibbons LE, McCurry SM et al (1999) Quality of life in alzheimer’s disease: Patient and caregiver reports. J Ment Health Aging 5:21–32
19.
Zurück zum Zitat Martín-Carrasco M, Ballesteros-Rodríguez J, Domínguez-Panchón AI et al (2014) Interventions for caregivers of patients with dementia. Actas Esp Psiquiatr 42:300–314PubMed Martín-Carrasco M, Ballesteros-Rodríguez J, Domínguez-Panchón AI et al (2014) Interventions for caregivers of patients with dementia. Actas Esp Psiquiatr 42:300–314PubMed
20.
Zurück zum Zitat Matthews JT, Lingler JH, Campbell GB et al (2015) Usability of a wearable camera system for dementia family caregivers. J Healthc Eng 6:213–238CrossRefPubMed Matthews JT, Lingler JH, Campbell GB et al (2015) Usability of a wearable camera system for dementia family caregivers. J Healthc Eng 6:213–238CrossRefPubMed
21.
Zurück zum Zitat Moise P, Schwarzinger M, Um M et al (2004) Dementia Care in 9 OECD Countries: A Comparative Analysis (OECD)CrossRef Moise P, Schwarzinger M, Um M et al (2004) Dementia Care in 9 OECD Countries: A Comparative Analysis (OECD)CrossRef
22.
Zurück zum Zitat Moniz-Cook E, Vernooij-Dassen M, Woods R et al (2008) A european consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 12:14–29CrossRefPubMed Moniz-Cook E, Vernooij-Dassen M, Woods R et al (2008) A european consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 12:14–29CrossRefPubMed
23.
Zurück zum Zitat Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389CrossRefPubMed Montgomery SA, Asberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134:382–389CrossRefPubMed
24.
Zurück zum Zitat Müller-Thomsen T, Arlt S, Mann U et al (2005) Detecting depression in alzheimer’s disease: Evaluation of four different scales. Arch Clin Neuropsychol 20:271–276CrossRefPubMed Müller-Thomsen T, Arlt S, Mann U et al (2005) Detecting depression in alzheimer’s disease: Evaluation of four different scales. Arch Clin Neuropsychol 20:271–276CrossRefPubMed
25.
Zurück zum Zitat Nasreddine ZS, Phillips NA, Bédirian V et al (2005) The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699CrossRefPubMed Nasreddine ZS, Phillips NA, Bédirian V et al (2005) The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699CrossRefPubMed
26.
Zurück zum Zitat Pendergrass A, Becker C, Hautzinger M et al (2015) Dementia Caregiver interventions: A systematic review of caregiver outcomes and instruments in randomized controlled trials. Int J Emerg Ment Health 17:459–468 Pendergrass A, Becker C, Hautzinger M et al (2015) Dementia Caregiver interventions: A systematic review of caregiver outcomes and instruments in randomized controlled trials. Int J Emerg Ment Health 17:459–468
27.
Zurück zum Zitat Pfeffer RI, Kurosaki TT, Harrah CH et al (1982) Measurement of functional activities in older adults in the community. J Gerontol 37:323–329CrossRefPubMed Pfeffer RI, Kurosaki TT, Harrah CH et al (1982) Measurement of functional activities in older adults in the community. J Gerontol 37:323–329CrossRefPubMed
28.
Zurück zum Zitat Pusey H, Richards D (2001) A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia. Aging Ment Health 5:107–119CrossRefPubMed Pusey H, Richards D (2001) A systematic review of the effectiveness of psychosocial interventions for carers of people with dementia. Aging Ment Health 5:107–119CrossRefPubMed
29.
Zurück zum Zitat Ramirez Diaz PS, Gregório PG, Ribera Casado JM et al (2005) The need for a consensus in the use of assessment tools for alzheimer’s disease: the feasibility study (assessment tools for dementia in alzheimer centres across europe), a european alzheimer’s disease consortium’s (EADC) survey. Int J Geriatr Psychiatry 20:744–748CrossRef Ramirez Diaz PS, Gregório PG, Ribera Casado JM et al (2005) The need for a consensus in the use of assessment tools for alzheimer’s disease: the feasibility study (assessment tools for dementia in alzheimer centres across europe), a european alzheimer’s disease consortium’s (EADC) survey. Int J Geriatr Psychiatry 20:744–748CrossRef
30.
Zurück zum Zitat Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for alzheimer’s disease. Am J Psychiatry 141:1356–1364CrossRefPubMed Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for alzheimer’s disease. Am J Psychiatry 141:1356–1364CrossRefPubMed
31.
Zurück zum Zitat Roth D, Gitlin LN, Coon DW et al (2003) Psychometric analysis of the revised memory and behavior problems checklist: Factor structure of occurrence and reaction ratings. Psychol Aging 18:906–915CrossRefPubMedPubMedCentral Roth D, Gitlin LN, Coon DW et al (2003) Psychometric analysis of the revised memory and behavior problems checklist: Factor structure of occurrence and reaction ratings. Psychol Aging 18:906–915CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Sheehan BD, Lall R, Stinton C et al (2012) Patient and proxy measurement of quality of life among general hospital in-patients with dementia. Aging Ment Health 16:603–607CrossRefPubMed Sheehan BD, Lall R, Stinton C et al (2012) Patient and proxy measurement of quality of life among general hospital in-patients with dementia. Aging Ment Health 16:603–607CrossRefPubMed
33.
Zurück zum Zitat Smith SC, Lamping DL, Banerjee S et al (2005) Measurement of health-related quality of life for people with dementia: Development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technol Assess 9:1–93PubMed Smith SC, Lamping DL, Banerjee S et al (2005) Measurement of health-related quality of life for people with dementia: Development of a new instrument (DEMQOL) and an evaluation of current methodology. Health Technol Assess 9:1–93PubMed
34.
Zurück zum Zitat Sutcliffe C, Cordingley L, Burns A et al (2000) A new version of the geriatric depression scale for nursing and residential home populations: The geriatric depression scale (residential) (GDS-12R). Int Psychogeriatr 12:173–181CrossRefPubMed Sutcliffe C, Cordingley L, Burns A et al (2000) A new version of the geriatric depression scale for nursing and residential home populations: The geriatric depression scale (residential) (GDS-12R). Int Psychogeriatr 12:173–181CrossRefPubMed
35.
Zurück zum Zitat Teri L, Truax P, Logsdon R et al (1992) Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychol Aging 7:622–631CrossRefPubMed Teri L, Truax P, Logsdon R et al (1992) Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychol Aging 7:622–631CrossRefPubMed
36.
Zurück zum Zitat Thorgrimsen L, Selwood A, Spector A et al (2003) Whose quality of life is it anyway? The validity and reliability of the quality of life-alzheimer’s disease (QoL-AD) scale. Alzheimer Dis Assoc Disord 17:201–208CrossRefPubMed Thorgrimsen L, Selwood A, Spector A et al (2003) Whose quality of life is it anyway? The validity and reliability of the quality of life-alzheimer’s disease (QoL-AD) scale. Alzheimer Dis Assoc Disord 17:201–208CrossRefPubMed
37.
Zurück zum Zitat Van Houtven CH, Voils CI, Weinberger M (2011) An organizing framework for informal caregiver interventions: Detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts. BMC Geriatr 11:77CrossRefPubMedPubMedCentral Van Houtven CH, Voils CI, Weinberger M (2011) An organizing framework for informal caregiver interventions: Detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts. BMC Geriatr 11:77CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Volicer L, Hurley A, Canberg L (1999) A model of psychological well-being in advanced dementia. J Ment Health Aging 5:83–94 Volicer L, Hurley A, Canberg L (1999) A model of psychological well-being in advanced dementia. J Ment Health Aging 5:83–94
39.
Zurück zum Zitat Yesavage JA, Brink TL, Rose TL et al (1982) Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 17:37–49CrossRefPubMed Yesavage JA, Brink TL, Rose TL et al (1982) Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 17:37–49CrossRefPubMed
40.
Zurück zum Zitat Zarit SH, Zarit JM (1983) The memory and behavior problems checklist. University Park: Pennsylvania State University Zarit SH, Zarit JM (1983) The memory and behavior problems checklist. University Park: Pennsylvania State University
Metadaten
Titel
Interventionsstudien zur Unterstützung häuslicher Pflege
Empfehlungen zu Endpunkten und Assessment-Instrumenten bei kognitiv eingeschränkten Pflegebedürftigen
verfasst von
D. Albrecht, M.A.
A. Pendergrass
C. Becker
M. Hautzinger
K. Pfeiffer
Publikationsdatum
24.06.2016
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-016-1094-1