Abstract
BackgroundPatients hospitalized on acute psychogeriatric wards are a heterogeneous population. Cluster analysis is a useful statistical method for partitioning a sample of patients into well separated groups of patients who present common characteristics. Several patient profile studies exist, but they are not adapted to acutely hospitalized psychogeriatric patients with cognitive impairment. The present study aims to partition patients hospitalized due to behavioral and psychological symptoms of dementia into profiles based on a global evaluation of mental health using cluster analysis.MethodsUsing nine of the 13 items from the Health of the Nation Outcome Scales for elderly people (HoNOS65+), data were collected from a sample of 542 inpatients with dementia who were hospitalized between 2011 and 2014 in acute psychogeriatric wards of a Swiss university hospital. An optimal clustering solution was generated to represent various profiles, by using a mixed approach combining hierarchical and non-hierarchical (k-means) cluster analyses associated with a split-sample cross-validation. The quality of the clustering solution was evaluated based on a cross-validation, on a k-means method with 100 random initial seeds, on validation indexes, and on clinical interpretation.ResultsThe final solution consisted of four clinically distinct and homogeneous profiles labeled (1) BPSD-affective, (2) BPSD-functional, (3) BPSD-somatic and (4) BPSD-psychotic according to their predominant clinical features. The four profiles differed in cognitive status, length of hospital stay, and legal admission status.ConclusionIn the present study, clustering methods allowed us to identify four profiles with distinctive characteristics. This clustering solution may be developed into a classification system that may allow clinicians to differentiate patient needs in order to promptly identify tailored interventions and promote better allocation of available resources.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0966-7) contains supplementary material, which is available to authorized users.
Highlights
Patients hospitalized on acute psychogeriatric wards are a heterogeneous population
It is commonly considered that psychogeriatric inpatients with dementia constitute a heterogeneous population and some research has already focused on Behavioral and psychological symptoms of dementia (BPSD) profiles in dementia [17,18,19,20]
This study describes the development of four stable, valid, and reliable cluster profiles useful for distinguishing profiles of psychogeriatric patients hospitalized due to BPSD
Summary
Patients hospitalized on acute psychogeriatric wards are a heterogeneous population. Several patient profile studies exist, but they are not adapted to acutely hospitalized psychogeriatric patients with cognitive impairment. The present study aims to partition patients hospitalized due to behavioral and psychological symptoms of dementia into profiles based on a global evaluation of mental health using cluster analysis. It is commonly considered that psychogeriatric inpatients with dementia constitute a heterogeneous population and some research has already focused on BPSD profiles in dementia [17,18,19,20]. To date, the different patient profile studies combining somatic and psychiatric problems with socio-relational information, clinical evolution and care management are poorly described. Better knowledge regarding patients’ profiles in this type of setting is needed to better inform future health policy decisions regarding dementia care [21]
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