Falter Laura-Beth, Gignac Monique A M, Cott Cheryl
The Arthritis Community Research and Evaluation Unit, The University Health Network, Toronto, Ontario, Canada.
Disabil Rehabil. 2003 Jul 22;25(14):795-806. doi: 10.1080/0963828031000093495.
This study extends understanding of the relationship between disability and independence in older adults with COPD.
An interviewer-administered questionnaire was used to examine disability, adaptation, perceptions of independence, and self-efficacy in a sample of 50 community-dwelling older adults. Odds ratios were used to investigate relationships between variables.
Participants used a wide range of behavioural strategies to adapt to their disability including: limiting activities, optimizing performance (e.g. taking rests), compensating for lost function (e.g. using equipment), and obtaining help from others. The relative use of these adaptations varied across five domains of activity: personal care, in-home mobility, household activities, community mobility, and valued activities. Most participants felt very or extremely independent in all domains. In personal care, those who reported greater disability (O.R. = 0.26), more frequent attempts to optimize performance (O.R. = 0.57), or greater reliance on help from others (O.R. = 0.79) were significantly (p < 0.05) less likely to feel very or extremely independent.
The relationship between disability and perceptions of independence depends on the nature of the activity and is influenced by factors that are amenable to study and intervention. In particular, the vast array of behavioural strategies available to older adults with COPD enables them to feel highly independent despite disability.
本研究拓展了对慢性阻塞性肺疾病（COPD）老年患者残疾与独立性之间关系的理解。
采用由访谈员实施的问卷，对50名社区居住的老年样本进行残疾、适应、独立性认知和自我效能的调查。使用比值比来研究变量之间的关系。
参与者采用了多种行为策略来适应他们的残疾，包括：限制活动、优化表现（如休息）、补偿功能丧失（如使用设备）以及从他人那里获得帮助。这些适应方式的相对使用情况在活动的五个领域有所不同：个人护理、居家移动、家务活动、社区移动和有价值的活动。大多数参与者在所有领域都感觉非常或极其独立。在个人护理方面，报告残疾程度更高（比值比 = 0.26）、更频繁尝试优化表现（比值比 = 0.57）或更依赖他人帮助（比值比 = 0.79）的参与者，感觉非常或极其独立的可能性显著更低（p < 0.05）。
残疾与独立性认知之间的关系取决于活动的性质，并受到适合研究和干预的因素影响。特别是，COPD老年患者可采用的大量行为策略使他们尽管有残疾仍能感觉高度独立。
