Hoenig Helen, Landerman Lawrence R, Shipp Kathy M, George Linda
Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, North Carolina 27705, USA.
J Am Geriatr Soc. 2003 Sep;51(9):1244-51. doi: 10.1046/j.1532-5415.2003.51408.x.
To identify factors associated with activity restriction.
Cohort study.
Patients prescribed a new wheelchair at one of two teaching hospitals (one Veterans Affairs and one private hospital).
One hundred fifty-three consecutive, community-dwelling wheelchair users, who had a Short Portable Mental Status Score greater than 6 out of 10 and could be interviewed within 7 to 21 days of receiving the wheelchair.
Dependent variables were self-reported nonmedical visits and medical visits in the preceding week (any vs no visits and the number of visits). Independent variables were self-reported sociodemographic and health characteristics, mobility limitations, and environmental barriers.
Study subjects reported, on average, 1.79 mobility limitations, 11.17 hours out of bed, and 5.56 hours of personal assistance per day. Multivariate analyses show that higher income was the only significant sociodemographic factor; it was associated with more medical visits (beta=0.44, P<.01). Of health status characteristics, more comorbid conditions predicted fewer nonmedical visits (beta=-0.14, P<.10) and amputation was associated with fewer medical visits (beta-0.82, P<.05). Regarding mobility limitations, more mobility limitations was associated with lower odds of any nonmedical visit (odds ratio (OR)=0.71, P<.5) and fewer nonmedical visits (beta=-0.28, P<.05); more hours out of bed predicted more nonmedical visits (beta=0.05, P<.5) and lower odds any medical visit (OR=0.92, P<.05). More environmental barriers predicted fewer nonmedical (beta=-0.32, P<.01) or medical visits (beta=-0.21, P<.05).
Mobility limitations and environmental barriers were associated with restricted participation in diverse activities outside the home.
确定与活动受限相关的因素。
队列研究。
在两家教学医院（一家退伍军人事务医院和一家私立医院）之一开具新轮椅处方的患者。
153名连续的社区居家轮椅使用者，其简易便携式精神状态评分大于6分（满分10分），且在收到轮椅后的7至21天内可接受访谈。
因变量为前一周自我报告的非医疗就诊和医疗就诊情况（有就诊与无就诊以及就诊次数）。自变量为自我报告的社会人口学和健康特征、行动能力限制以及环境障碍。
研究对象平均报告有1.79项行动能力限制、每天卧床11.17小时以及接受5.56小时的个人协助。多变量分析表明，较高收入是唯一显著的社会人口学因素；它与更多的医疗就诊相关（β=0.44，P<0.01）。在健康状况特征方面，更多的合并症预示着非医疗就诊次数减少（β=-0.14，P<0.10），截肢与医疗就诊次数减少相关（β=-0.82，P<0.05）。关于行动能力限制，更多的行动能力限制与任何非医疗就诊的较低几率相关（优势比（OR）=0.71，P<0.5）以及非医疗就诊次数减少（β=-0.28，P<0.05）；更多的卧床小时数预示着更多的非医疗就诊（β=0.05，P<0.5）以及任何医疗就诊的较低几率（OR=0.92，P<0.05）。更多的环境障碍预示着非医疗就诊次数减少（β=-0.32，P<0.01）或医疗就诊次数减少（β=-0.21，P<0.05）。
行动能力限制和环境障碍与在家外参与各种活动受限相关。
