Research Article
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Uzun Süreli Kurumsal Bakım Alan Yaşlılarda Ajitasyon Davranışlarının ve Etkileyen Faktörlerin Belirlenmesi

Year 2019, Volume: 27 Issue: 2, 173 - 187, 01.06.2019

Abstract

DOI: 10.26650/FNJN18075


Amaç: Ajitasyon kurumsal bakım alan
yaşlılarda yaygındır. Özellikle demanslı hastalar için önemli bir problemdir.
Bu kapsamda çalışmanın amacı bir ilde uzun süreli kurumsal bakım alan
yaşlıların ajitasyon davranışlarının ve etkileyen faktörlerle ilişkisinin
belirlenmesidir.



Yöntem: Araştırma tanımlayıcı ve analitik
türdedir. Araştırmanın evrenini, İl Aile ve Sosyal Politikalar Müdürlüğüne
bağlı üç kurumsal bakım merkezinde yaşayan yaşlı bireyler oluşturmuştur.
Araştırmada örneklem yöntemine gidilmeyip, örneklem grubuna 60 yaş ve üzeri,
kendisi ve yakını tarafından çalışmaya katılmasına olur verilen 178 yaşlı birey
alınmıştır. Araştırmanın verileri Eylül-Kasım 2018 tarihleri arasında
toplanmıştır. Verilerin toplanmasında sosyo-demografik soru formu,
Cohen-Mansfield Ajitasyon Envanteri (CMAE), Mini-Cog Kısa Bilişsel
Değerlendirme Formu, Barthel Günlük Yaşam Aktiviteleri İndeksi (BGYA),
Lawton&Brody Enstrümantal Günlük Yaşam Aktiviteleri Ölçeği (EGYA)
kullanılmıştır.



Bulgular: Çalışmaya katılan yaşlıların yaş
ortalaması 75.58±8.77 olup %56.7’si erkektir. Bulundukları kurumda bakım alma
süresi 23.48±24.46 aydır. Yaşlıların %50.6’sının psikiyatrik tanısı
bulunmaktadır. Demanslı yaşlıların CMAE puan ortalaması 46.26±15.10 olup
demansı olmayanlara göre anlamlı düzeyde yüksektir (Z=-2.132, p=0.033).
Mini-Cog puan değerlendirmesine göre bilişsel bozulma olasılığı yüksek olarak
belirlenen yaşlıların CMAE puan ortalaması 46.04±15.77 olup düşük bilişsel
bozulma olasılığı olanlara göre anlamlı düzeyde yüksektir (Z=-4.137, p=0.000).



Sonuç: Çalışmanın sonuçları demanslı
hastalarda ajitasyonun yüksek olduğunu, demansla birlikte seyreden bilişsel
bozulmanın ajitasyon üzerinde önemli bir etki gösterdiğini ortaya koymuştur. 

Cite this article as: Bayram, S., Usta, E., Altınbaş-Akkaş, Ö. ve Şık, T. (2019). The
determination of agitation behaviors among the elderly people receiving
long-term ınstitutional care and the ınfluencing factors. FNJN Florence
Nightingale Journal of Nursing, 27(2): 173-187.

References

  • Aile ve Sosyal Politikalar Bakanlığı. (2018). Engelli ve yaşlı bireylere ilişkin istatistiki bilgiler. İstatistik Bülteni. Erişim adresi: https://eyh.aile.gov.tr/uploads/pages/engelli-ve-yasli-bireylere-iliskin-istatistiki-bilgiler/2018-yili-nisan-ayi-bultenini-bu-baglantiyi-kullanarak-indirebilirsiniz.pdf Altunöz, U., Özel-Kızıl, E., Kırıcı, S., Baştuğ, G., Biçer-Kanat, B., Sakarya, A., et al. (2015). Dimensions of agitation based on the Cohen-Mansfield Agitation Inventory in patients with dementia. Turk Psikiyatri Derg. 26(2), 116-122. Bahar, G., Bahar, A., Savaş, H. A. (2009). Yaşlılık ve yaşlılara sunulan sosyal hizmetler. Fırat Sağlık Hizmetleri Dergisi, 4(12), 85-98. Borson, S., Scanlan, J., Brush, M., Vitaliano, P., Dokmak, A. (2000). The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 15(11), 1021-1027. Bruen, P., McGeown, W., Shanks, M., Venneri, A. (2008). Neuroanatomical correlates of neuropsychiatric symptoms in alzheimer’s disease. Brain, 131(9), 2455-2463. Chemerinski, E., Petracca, G., Tesón, A., Sabe, L., Leiguarda, R., Starkstein, S.E. (1998). Prevalence and correlates of aggressive behavior in alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 10(4), 421-425. Choy, C. N. P., Lam, L. C. W., Chan, W. C., Li, S. W., Chiu, H. F. K. (2001). Agitation in Chinese elderly: validation of the Chinese version of the Cohen-Mansfield Agitation Inventory. Int Psychogeriatr. 13(3), 325-335. Citrome, L. (2002). Atypical antipsychotics for acute agitation. New intramuscular options offer advantages. Postgrad Med. 112(6), 85-96. Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly, II. Preliminary results in the cognitively deteriorated. J Am Geriatr Soc. 34(10), 722-727. Cohen-Mansfield, J. (2008). Agitated behavior in persons with dementia: The relationship between type of behavior, its frequency, and its disruptiveness. J Psychiatr Res. 43(1), 64-69.
  • Cohen-Mansfield, J., Marx, M., Rosenthal, A. (1989). A description of agitation in a nursing home. J Gerontol. 44(3), 77-84. Cohen-Mansfield, J., Marx, M. S., Rosenthal, A. S. (1990). Dementia and agitation in nursing home residents: how are they related?. Psychol Aging. 5(1), 3-8. Demircioğlu-Özal, M. (2014). Alzheimer hastalarında Cohen-Mansfield Ajitasyon Envanteri’nin (Cohen-Mansfield Agitation Inventory-CMAI) Türkçe uyarlaması, geçerlik ve güvenirliği. (Yüksek Lisans Tezi). İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. Dewing, J. (2010). Responding agitation in people with dementia. Nurs Older People. 22(6), 18-25. Forstl, H., Burns, A., Levy, R., Cairns, N. (1994). Neuropathological correlates of psychotic phenomena in confirmed Alzheimer’s disease. Br J Psychiatry. 165(1), 53-59. Hamel, M., Gold, D. P., Andres, D., Reis, M., Dastoor, D., Grauer, H., et al. (1990). Predictors and consequences of aggressive behavior by community-based dementia patients. Gerontologist. 30(2), 206-211. Haupt, M., Kurz, A., Janner, M. (2000). A two-year follow-up of behavioural and psychological symptoms in Alzheimer’s disease. Dement Geriatr Cogn Disord. 11(3), 147-152. Hodge, M. (2012). The agitated & violent patient. In L. Hans & Y. Mawji (Eds.), The ABC’s of emergency medicine (pp. 104). Canada: University of Toronto. Kılıç, D. (2009). Yaşlı sağlığı. B. Erci (Ed.), Halk sağlığı hemşireliği içinde (s.133-155). Amasya: Fırat Matbaacılık. Küçükdeveci, A. A., Yavuzer, G., Tennant, A., Süldür, N., Sonel, B., Arasil, T. (2000). Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 32(2), 87-92. Lawton, M. P., Broody, E. M. (1969). Assessment of older people: Self maintaining and instrumental activities of daily living. Gerontologist. 9(3), 179-186. Livingston, G., Barber, J., Marston, L., Rapaport, P., Livingston, D., Cousins, S., et al. (2017). Prevalence of and associations with agitation in residents with dementia living in care homes: MARQUE cross-sectional study. BJPsych Open. 3(4), 171-178. Mahoney, F. I., Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Md State Med J. 14: 61-65. Majić, T., Pluta, J. P., Mell, T., Treusch, Y., Gutzmann, H., Rapp, M. A. (2012). Correlates of agitation and depression in nursing home residents with dementia. Int Psychogeriatr. 24(11), 1779-1789. Malone, M. L., Thompson, L., Goodwin, J. S. (1993). Agressive behaviors among the institutionalized elderly. J Am Geriatr Soc. 41(8), 853-856. Özel-Kızıl, E. T., Baştuğ, G., Erdoğan, S., Sakarya, D., Durmaz, N. (2012). Psychometric properties of the Turkish version of Cohen-Mansfield agitation inventory in patients with dementia. Turkish Journal of Geriatrics, 15(1), 24-29. Schreiner, A. S., Yamamoto, E., Shiotani, H. (2000). Agitated behavior in elderly nursing home residents with dementia in Japan. J Gerontol B Psychol Sci Soc Sci. 55(3), 180-186. Tractenberg, R. E, Weiner, M. F., Thal, L. J. (2002). Estimating the prevalence of agitation in community-dwelling persons with alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 14(1), 11-18. Türkiye İstatistik Kurumu-TÜİK. (2015). İstatistiklerle yaşlılar, 2014. Sayı: 18620. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=18620 Türkiye İstatistik Kurumu-TÜİK. (2016). İstatistiklerle yaşlılar, 2015. Sayı:21520. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=21520 World Health Organization-WHO. (2012). Dementia: a public health priority. Switzerland: WHO Press. Zuidema, S. U., de Jonghe, J. F., Verhey, F. R., Koopmans, R. T. (2007). Agitation in Dutch institutionalized patients with dementia: factor analysis of the Dutch version of the Cohen-Mansfield Agitation Inventory. Dement Geriatr Cogn Disord. 23(1), 35-41.

The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors

Year 2019, Volume: 27 Issue: 2, 173 - 187, 01.06.2019

Abstract

DOI: 10.26650/FNJN18075


Aim: Agitation is common among elderly
people staying at nursing homes. It is a significant problem particularly for
patients with dementia. This study aims to determine the agitation behaviors of
elderly people receiving long-term institutional care in a city and influencing
factors.

Method: The population of this descriptive
and analytical study consisted of elderly individuals in three institutional
care centers. 178 elderly individuals aged 60 and above were taken into the
sample group. Approval was taken from them and their relatives. The study data
were collected between September–November 2018 using the socio-demographic
question form, the Cohen-Mansfield Agitation Inventory (CMAI), the Mini-Cog
Brief Cognitive Assessment Form, the Barthel Index for Activities of Daily
Living (ADL) and the Lawton&Brody Instrumental Activities of Daily Living
Scale (IADL).

Results: The mean age of the participants
was 75.58±8.77 and 56.7% were males. The duration of stay at the institution
was 23.48±24.46 months. Although 50.6% of the participants had psychiatric
diagnoses. The mean score for the CMAI for the patients with dementia was
46.26±15.10, which was significantly higher than those without dementia
(Z=-2.132, p=0.033).







Conclusions: The results show agitation is
high among patients with dementia and cognitive impairment affects agitation
significantly. 

Cite this article as: Bayram, S., Usta, E., Altınbaş-Akkaş, Ö. ve Şık, T. (2019). The
determination of agitation behaviors among the elderly people receiving
long-term ınstitutional care and the ınfluencing factors. FNJN Florence
Nightingale Journal of Nursing, 27(2): 173-187.

References

  • Aile ve Sosyal Politikalar Bakanlığı. (2018). Engelli ve yaşlı bireylere ilişkin istatistiki bilgiler. İstatistik Bülteni. Erişim adresi: https://eyh.aile.gov.tr/uploads/pages/engelli-ve-yasli-bireylere-iliskin-istatistiki-bilgiler/2018-yili-nisan-ayi-bultenini-bu-baglantiyi-kullanarak-indirebilirsiniz.pdf Altunöz, U., Özel-Kızıl, E., Kırıcı, S., Baştuğ, G., Biçer-Kanat, B., Sakarya, A., et al. (2015). Dimensions of agitation based on the Cohen-Mansfield Agitation Inventory in patients with dementia. Turk Psikiyatri Derg. 26(2), 116-122. Bahar, G., Bahar, A., Savaş, H. A. (2009). Yaşlılık ve yaşlılara sunulan sosyal hizmetler. Fırat Sağlık Hizmetleri Dergisi, 4(12), 85-98. Borson, S., Scanlan, J., Brush, M., Vitaliano, P., Dokmak, A. (2000). The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 15(11), 1021-1027. Bruen, P., McGeown, W., Shanks, M., Venneri, A. (2008). Neuroanatomical correlates of neuropsychiatric symptoms in alzheimer’s disease. Brain, 131(9), 2455-2463. Chemerinski, E., Petracca, G., Tesón, A., Sabe, L., Leiguarda, R., Starkstein, S.E. (1998). Prevalence and correlates of aggressive behavior in alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 10(4), 421-425. Choy, C. N. P., Lam, L. C. W., Chan, W. C., Li, S. W., Chiu, H. F. K. (2001). Agitation in Chinese elderly: validation of the Chinese version of the Cohen-Mansfield Agitation Inventory. Int Psychogeriatr. 13(3), 325-335. Citrome, L. (2002). Atypical antipsychotics for acute agitation. New intramuscular options offer advantages. Postgrad Med. 112(6), 85-96. Cohen-Mansfield, J. (1986). Agitated behaviors in the elderly, II. Preliminary results in the cognitively deteriorated. J Am Geriatr Soc. 34(10), 722-727. Cohen-Mansfield, J. (2008). Agitated behavior in persons with dementia: The relationship between type of behavior, its frequency, and its disruptiveness. J Psychiatr Res. 43(1), 64-69.
  • Cohen-Mansfield, J., Marx, M., Rosenthal, A. (1989). A description of agitation in a nursing home. J Gerontol. 44(3), 77-84. Cohen-Mansfield, J., Marx, M. S., Rosenthal, A. S. (1990). Dementia and agitation in nursing home residents: how are they related?. Psychol Aging. 5(1), 3-8. Demircioğlu-Özal, M. (2014). Alzheimer hastalarında Cohen-Mansfield Ajitasyon Envanteri’nin (Cohen-Mansfield Agitation Inventory-CMAI) Türkçe uyarlaması, geçerlik ve güvenirliği. (Yüksek Lisans Tezi). İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. Dewing, J. (2010). Responding agitation in people with dementia. Nurs Older People. 22(6), 18-25. Forstl, H., Burns, A., Levy, R., Cairns, N. (1994). Neuropathological correlates of psychotic phenomena in confirmed Alzheimer’s disease. Br J Psychiatry. 165(1), 53-59. Hamel, M., Gold, D. P., Andres, D., Reis, M., Dastoor, D., Grauer, H., et al. (1990). Predictors and consequences of aggressive behavior by community-based dementia patients. Gerontologist. 30(2), 206-211. Haupt, M., Kurz, A., Janner, M. (2000). A two-year follow-up of behavioural and psychological symptoms in Alzheimer’s disease. Dement Geriatr Cogn Disord. 11(3), 147-152. Hodge, M. (2012). The agitated & violent patient. In L. Hans & Y. Mawji (Eds.), The ABC’s of emergency medicine (pp. 104). Canada: University of Toronto. Kılıç, D. (2009). Yaşlı sağlığı. B. Erci (Ed.), Halk sağlığı hemşireliği içinde (s.133-155). Amasya: Fırat Matbaacılık. Küçükdeveci, A. A., Yavuzer, G., Tennant, A., Süldür, N., Sonel, B., Arasil, T. (2000). Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 32(2), 87-92. Lawton, M. P., Broody, E. M. (1969). Assessment of older people: Self maintaining and instrumental activities of daily living. Gerontologist. 9(3), 179-186. Livingston, G., Barber, J., Marston, L., Rapaport, P., Livingston, D., Cousins, S., et al. (2017). Prevalence of and associations with agitation in residents with dementia living in care homes: MARQUE cross-sectional study. BJPsych Open. 3(4), 171-178. Mahoney, F. I., Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Md State Med J. 14: 61-65. Majić, T., Pluta, J. P., Mell, T., Treusch, Y., Gutzmann, H., Rapp, M. A. (2012). Correlates of agitation and depression in nursing home residents with dementia. Int Psychogeriatr. 24(11), 1779-1789. Malone, M. L., Thompson, L., Goodwin, J. S. (1993). Agressive behaviors among the institutionalized elderly. J Am Geriatr Soc. 41(8), 853-856. Özel-Kızıl, E. T., Baştuğ, G., Erdoğan, S., Sakarya, D., Durmaz, N. (2012). Psychometric properties of the Turkish version of Cohen-Mansfield agitation inventory in patients with dementia. Turkish Journal of Geriatrics, 15(1), 24-29. Schreiner, A. S., Yamamoto, E., Shiotani, H. (2000). Agitated behavior in elderly nursing home residents with dementia in Japan. J Gerontol B Psychol Sci Soc Sci. 55(3), 180-186. Tractenberg, R. E, Weiner, M. F., Thal, L. J. (2002). Estimating the prevalence of agitation in community-dwelling persons with alzheimer’s disease. J Neuropsychiatry Clin Neurosci. 14(1), 11-18. Türkiye İstatistik Kurumu-TÜİK. (2015). İstatistiklerle yaşlılar, 2014. Sayı: 18620. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=18620 Türkiye İstatistik Kurumu-TÜİK. (2016). İstatistiklerle yaşlılar, 2015. Sayı:21520. Erişim adresi: http://www.tuik.gov.tr/PreHaberBultenleri.do?id=21520 World Health Organization-WHO. (2012). Dementia: a public health priority. Switzerland: WHO Press. Zuidema, S. U., de Jonghe, J. F., Verhey, F. R., Koopmans, R. T. (2007). Agitation in Dutch institutionalized patients with dementia: factor analysis of the Dutch version of the Cohen-Mansfield Agitation Inventory. Dement Geriatr Cogn Disord. 23(1), 35-41.
There are 2 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Serap Bayram

Esra Usta This is me

Özlem Altınbaş Akkaş This is me

Tuğçe Sık This is me

Publication Date June 1, 2019
Published in Issue Year 2019 Volume: 27 Issue: 2

Cite

APA Bayram, S., Usta, E., Altınbaş Akkaş, Ö., Sık, T. (2019). The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors. Florence Nightingale Journal of Nursing, 27(2), 173-187.
AMA Bayram S, Usta E, Altınbaş Akkaş Ö, Sık T. The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors. Florence Nightingale Journal of Nursing. June 2019;27(2):173-187.
Chicago Bayram, Serap, Esra Usta, Özlem Altınbaş Akkaş, and Tuğçe Sık. “The Determination of Agitation Behaviors Among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors”. Florence Nightingale Journal of Nursing 27, no. 2 (June 2019): 173-87.
EndNote Bayram S, Usta E, Altınbaş Akkaş Ö, Sık T (June 1, 2019) The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors. Florence Nightingale Journal of Nursing 27 2 173–187.
IEEE S. Bayram, E. Usta, Ö. Altınbaş Akkaş, and T. Sık, “The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors”, Florence Nightingale Journal of Nursing, vol. 27, no. 2, pp. 173–187, 2019.
ISNAD Bayram, Serap et al. “The Determination of Agitation Behaviors Among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors”. Florence Nightingale Journal of Nursing 27/2 (June 2019), 173-187.
JAMA Bayram S, Usta E, Altınbaş Akkaş Ö, Sık T. The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors. Florence Nightingale Journal of Nursing. 2019;27:173–187.
MLA Bayram, Serap et al. “The Determination of Agitation Behaviors Among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors”. Florence Nightingale Journal of Nursing, vol. 27, no. 2, 2019, pp. 173-87.
Vancouver Bayram S, Usta E, Altınbaş Akkaş Ö, Sık T. The Determination of Agitation Behaviors among the Elderly People Receiving Long-Term Institutional Care and the Influencing Factors. Florence Nightingale Journal of Nursing. 2019;27(2):173-87.