Wilkie Ross, Peat George, Thomas Elaine, Croft Peter
Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK.
Qual Life Res. 2007 Sep;16(7):1147-56. doi: 10.1007/s11136-007-9221-5. Epub 2007 May 26.
In the World Health Organization's International Classification of Functioning, Disability and Health, participation restriction--the social and personal consequences of health conditions and their environment--is an important component of the concept of disability. The cross-sectional associations between perceived participation restriction and health, demographic and socio-economic factors were examined in 7,878 community-dwelling adults aged 50 years and over in North Staffordshire, UK who responded to a postal survey. All health conditions, impairments, activity limitations, demographic and socio-economic factors were associated with participation restriction, after adjusting for age and gender in a logistic regression analysis. Health and disability factors most strongly and independently associated with participation restriction in a multivariate analysis were the number of peripheral joint pains, the number of health conditions, cognitive impairment, anxiety, depression, and activity limitation. Perceived adequacy of income, employment status and occupational class were also significantly associated with participation restriction after adjusting for health and disability factors. In conclusion, perceived participation restriction is associated with a range of health and socio-economic factors. Although further prospective research is needed to identify the direction of causal association, these factors represent potential targets for intervention to prevent or reduce participation restriction in older adults in the community.
在世界卫生组织的《国际功能、残疾和健康分类》中,参与受限——健康状况及其环境所产生的社会和个人后果——是残疾概念的一个重要组成部分。在英国北斯塔福德郡,对7878名年龄在50岁及以上的社区居住成年人进行了一项邮寄调查,以研究感知到的参与受限与健康、人口统计学和社会经济因素之间的横断面关联。在逻辑回归分析中对年龄和性别进行调整后,所有健康状况、损伤、活动受限、人口统计学和社会经济因素均与参与受限相关。在多变量分析中,与参与受限最强烈且独立相关的健康和残疾因素是外周关节疼痛的数量、健康状况的数量、认知障碍、焦虑、抑郁以及活动受限。在对健康和残疾因素进行调整后,感知到的收入充足程度、就业状况和职业阶层也与参与受限显著相关。总之,感知到的参与受限与一系列健康和社会经济因素相关。尽管需要进一步的前瞻性研究来确定因果关联的方向,但这些因素是预防或减少社区老年人参与受限的潜在干预目标。