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Mental Status and Self-Medication Ability in the Hospitalized Elderly

Published online by Cambridge University Press:  29 November 2010

Louise Patrick
Affiliation:
SCO Hospital, Ottawa
Katharine Howell
Affiliation:
University of Waterloo

Abstract

This study investigated the relationships among several aspects of cognitive functioning and the outcome of self-medication training in hospitalized elderly patients. Data from 53 geriatric patients who received rehabilitation treatment at the SCO Hospital in Ottawa, Canada between 1992 and 1997 were collected, on an archival basis. Patients began a graduated self-medication program after undergoing a neuropsychological evaluation. Performance scores from five different aspects of cognition were regressed on the self-medication training outcome measures. Findings revealed that aspects of cognitive functioning were significantly related to the outcome of self-medication training. Thus, psychometric measures of cognition can be useful in predicting which patients are most likely to benefit from a self-medication program, or alternatively, those who would require a modified program to be able to learn. The clinical implications of these results are discussed.

Résumé

Cette étude examinait le lien entre plusieurs aspects du fonctionnement cognitif et le résultat d'un entraînement en automédication chez les patients âgés hospitalisés. Les données ont été tirées des dossiers de 53 patients gériatriques ayant reçu un traitement de réadaptation à l'Hôpital SCO, entre 1992 et 1997. Les patients ont tous commencé graduellement un programme d'automédication après avoir subi une évaluation neuropsychologique. L'impact du programme d'automédication sur cinq dimensions du fonctionnement cognitif a été mesuré à partir d'une analyse de régression. Les résultats ont révélé que certains aspects du fonctionnement cognitif étaient significativement liés aux résultats de l'entraînement en automédication. Par conséquent, les mesures psychométriques de la cognition peuvent être utiles pour prédire quels patients ont le plus de chance de bénéficier du programme d'automédication et ceux qui auront besoin d'un programme modifié pour pouvoir apprendre un nouveau schéma posologique. L'article traite des conséquences cliniques de ces résultats.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1998

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References

Brink, T.L., Yesavage, J.A., Rose, T.L., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening instrument. Journal of Psychiatric Research, 17, 3749.Google Scholar
Cervantez, Thompson T., & Ellenberg, M. (1987). A self-medication program in a rehabilitation setting. Rehabilitation Nursing, 12, 316319.Google Scholar
Cohen, C., & Cohen, P. (1983). Applied multiple regression analysis for the behavioral sciences. London: Lawrence Erlbaum Associates, Publishers.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioural sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-Mental State: a practical guide for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Harris, R.E., O'Hara, P.A., & Harper, D.W. (1995). Functional status of geriatric rehabilitation patients: a one year follow-up study. Journal of the American Geriatrics Society, 40, 5155.CrossRefGoogle Scholar
Hartke, R.J. (Ed.). (1991). Psychological aspects of geriatric rehabilitation, (pp. 18). Gaithersburg, MD: Aspen Publishers, Inc.Google Scholar
Kemp, B., Brummel-Smith, K., & Ramsdell, J.W. (Eds.). (1990). Geriatric rehabilitation (pp. 4246). Boston: College-Hill Press.Google Scholar
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.Google Scholar
Litchtenberg, P.A., & Christensen, B. (1992) Extended Normative Data for the Logical Memory subest of the WMS-R: Resposes from a sample of cognitively intact elderly medical patients. Psychological Reports, 71, 745746.Google Scholar
Mattis, S. (1988). Dementia rating scale. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Montgomery, K., & Costa, L. (1983) Neuropsychological test performance of a normal elderly sample. In Spreen, O. & Strauss, E., A compendium of neuropsychological tests (1991). New York: Oxford University Press.Google Scholar
Nadler, J.D., Richardson, E.D., Malloy, P.F., Marran, M.E., & Hostetier, Brinson M.E. (1993). The ability of the dementia rating scale to predict everyday functioning. Archives of Clinical Neuropsychology, 8, 449460.CrossRefGoogle ScholarPubMed
Northern California Neurobehavioural Group. (1983). Manual for the Neurobehavioural Cognitive Status Examination. Fairfax, CA.Google Scholar
Pajurkova, E.M., & Wilkins, A.J. (June, 1983). Prospective remembering inpatients with unilateral temporal or frontal lobectomies. Paper presented at the Annual Meeting of the International Neuropsychological Society, Lisbon, Portugal.Google Scholar
Palmer, H.M., & Dobson, K.S. (1994). Self-medication and memory in an elderly Canadian sample. The Gerontologist, 34, 658664.CrossRefGoogle Scholar
Patrick, L. (1996). Neuropsychology and physiotherapy: Partners in geriatric rehabilitation. Canadian Association of Physiotherapy (Gerontology Division) Newsletter, 39, 35.Google Scholar
Patrick, L., Leber, M., & Johnston, S. (1996). Aspects of cognitive status as predictors of mobility following geriatric rehabilitation. Aging, Clinical and Experimental Research, 8, 328333.Google ScholarPubMed
Pereles, L., Romonko, L., Murzyn, T., Hogan, D., Silvius, J., Stokes, E., Long, S., & Fung, T. (1996). Evaluation of a self-medication program. Journal of the American Geriatrics Society, 44, 161165.CrossRefGoogle ScholarPubMed
Resnick, B., Slocum, D., Ra, L., & Moffett, P. (1996). Geriatric rehabilitation: nursing interventions and outcomes focusing on urinary function and knowledge of medications. Rehabilitation Nursing, 21, 142147.CrossRefGoogle ScholarPubMed
Richardson, E.D., Nadler, J.D., & Malloy, P.F. (1995). Neuropsychologie prediction of performance measures of daily living skills in geriatric patients. Journal of Neuropsychology, 9, 565572.CrossRefGoogle Scholar
Rogers, J.C. (1990). Improving the ability to perform daily tasks. In Kemp, B., Brummel-Smith, K., & Ramsdell, J.W. (Eds.), Geriatric rehabilitation (pp. 137155). Boston: College-Hill Press.Google Scholar
Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests: Administration, norms, and commentary. New York: Oxford University Press.Google Scholar
Taira, F. (1991). Teaching independently living older adults about managing their medications. Rehabilitation Nursing, 16, 322326.Google ScholarPubMed
Weber, D.C., Fleming, K.C., & Evans, J.M. (1995). Rehabilitation of geriatric patients. Mayo Clinic Proceedings, 70, 11981204.CrossRefGoogle ScholarPubMed
Wechsler, D. (1987). Wechsler Memory Scale-Revised. New York: The Psychological Corporation.Google Scholar