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Behavioral and Psychological Symptoms: A Contribution for their Understanding Based on the Unmet Needs Model

Published online by Cambridge University Press:  23 March 2020

A.R. Ferreira ,
S. Martins ,
C. Dias ,
M.R. Simões  and
L. Fernandes
A.R. Ferreira
Affiliation:
PhD Program in Clinical and Health Services Research/PDICSS- Health Information and Decision Sciences Department, Faculty of Medicine, University of Porto, Porto, Portugal
S. Martins
Affiliation:
CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine- University of Porto, Porto, Portugal
C. Dias
Affiliation:
Health Information and Decision Sciences Department. Center for Health Technology and Services Research/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal
M.R. Simões
Affiliation:
Psychological Assessment Laboratory. CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
L. Fernandes
Affiliation:
Department of Clinical Neuroscience and Mental Health. CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal

Abstract

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Introduction

Behavioural and psychological symptoms (BPSD) are frequent in dementia and their contribution to poor health outcomes is well recognized. Four major frameworks attempt an explanation their aetiology: biological, behavioural, environmental vulnerability and unmet needs models. The latter states that BPSD are symptoms of needs that are not being met due to patients’ decreased ability to communicate/fulfil them. This model also implies that if needs were met, BPSD would improve.

Aims

To explore the relation between needs and BPSD, and describe which unmet needs were contributing to BPSD in an elderly sample.

Methods

A cross-sectional study was conducted in three Portuguese nursing homes. All residents were considered eligible. However, those unwilling or unable to participate were excluded. For each elderly patient, needs were assessed with camberwell assessment of need for the elderly/cane and BPSD with European Portuguese neuropsychiatric inventory/NPI.

Results

The final sample included 166 elderly with an average of 80.9(sd = 10.2) years. Significant correlations between NPI and unmet and global needs were found (rs = 0.181,P = 0.020; rs = 0.254,P = 0.001, respectively). Additionally, the unmet needs of daytime activities (P = 0.019), company (P = 0.028) and behaviour (P = 0.001), presented significant correlations with NPI.

Conclusion

In this sample, a high number of unmet needs were found. The absence of daytime activities, company and behaviour contributed to the identified BPSD, which is in line with other studies also highlighting the importance of these needs in nursing homes. This not only provides a framework for understanding BPSD, but also points to the identification of unmet needs as pivotal in prevention and treatment of these symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Old age psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S657
Copyright
Copyright © European Psychiatric Association 2017
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