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The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is associated with informant stress
- Authors:
- NYGAARD Harald A., NAIK Mala, GEITUNG John T.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(11), November 2009, pp.1085-1191.
- Publisher:
- Wiley
This study aimed to assess the association between informant stress and appraisal of patients’ cognitive functioning as reported by the IQCODE, which is designed to measure cognitive changes over time as perceived by an informant. Routinely collected data from a geriatric outpatient department during the period 1995 to 1998 were analysed, and the relationship between IQCODE and categorised Relative Stress Scale (RSS), an instrument to detect stress in caregivers, and informant groups and patient age was studied. The study concluded that IQCODE is associated with informant stress and that categorisation of RSS score into groups of low, intermediate and high risk or psychiatric morbidity can be a valuable contribution to a more meaningful application of RSS in general practice.
Are nursing home patients with dementia diagnosis at increased risk for inadequate pain treatment?
- Authors:
- NYGAARD Harald A., JARLAND Marit
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(8), August 2005, pp.730-737.
- Publisher:
- Wiley
Mentally impaired and demented nursing home patients are at increased risk of under-treatment for pain. This study examines pain assessment and complaints and pain treatment of nursing home patients according to mental state, and with special regard to treatment of patients with dementia diagnosis and cognitively impaired patients who did not have a dementia diagnosis. Cross sectional study from three nursing homes in Bergen, Norway including 125 persons (median age 84 years), living permanently in a nursing home was carried out. Diagnoses and prescribed and administered analgesic drugs were recorded. An experienced nurse interviewed nurses in charge and patients regarding presence of pain during the last week. Patients who were able to answer whether they had experienced pain during the last week were categorised as communicative. Cognitive function was assessed by means of the Abbreviated Mental Test. Seventeen percent of the patients were cognitively intact, 30% cognitively impaired and 54% had a dementia diagnosis. Forty-seven percent of communicative patients complained of pain, nurses reported pain in 67% patients. Twenty-nine percent of the patients had received scheduled analgesics during the last week, cognitively intact patients 38%, cognitively impaired 30%, demented 25%. Twenty percent were given analgesics PRN: cognitively intact patients 33%, cognitively impaired 27%, demented 12%. Logistic regression analyses revealed that patients with dementia diagnosis were less likely to receive PRN medication compared to mentally impaired patients. Regarding scheduled medication there was no difference between the groups. Nurses' opinion of pain was a significant factor for receiving analgesic drugs. The study concludes that a label of dementia may bias the interpretation of pain cues of demented patients, while complaints from cognitively impaired patients may be taken for granted. This may contribute to lower use of PRN medication in demented patients compared to cognitively impaired patients.