接受公共护理与非正式护理相结合的老年人与仅接受公共护理的老年人的功能能力和健康问题。

Functional ability and health complaints among older people with a combination of public and informal care vs. public care only.

作者信息

Karlsson Staffan, Edberg Anna-Karin, Westergren Albert, Hallberg Ingalill Rahm

机构信息

Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

出版信息

Scand J Caring Sci. 2008 Mar;22(1):136-48. doi: 10.1111/j.1471-6712.2007.00549.x.

Abstract

The aim of the study was to investigate functional ability and health complaints of people, 65+, living in special accommodation (equivalent to nursing home) and their counterparts who live at home and receive municipal care or a combination of municipal and informal care. Persons (n = 1958) receiving municipal care were assessed in terms of functional ability, health complaints, and level of informal and municipal care and services. The results showed that more home care, services and help with Instrumental Activities of Daily Living (IADL) were provided to those receiving only municipal care at home, while more home care and services associated with Personal Activities of Daily Living (PADL) as well as nursing care were provided to those receiving informal care in addition to formal care. Cohabitation was a predictor of a combination of municipal and informal care in the home (OR: 5.935), while assistance with IADL provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883) and PADL (OR: 2.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. The distribution of municipal care divided older people into three distinct groups. The most frail and elderly people who had no cohabitants received care in special accommodation, determined by their level of physical and cognitive dependency. The frailest individuals living at home were cohabiting and received a combination of municipal and informal care, while those who were less dependent mainly had help with IADL from municipal care only. The results indicate that there is a shift from the substitution to the complementary model and highlights that attention to the family carers is needed.

摘要

该研究的目的是调查65岁及以上居住在特殊住所(相当于养老院)的人群以及居家接受市政护理或市政与非正式护理相结合的人群的功能能力和健康问题。对接受市政护理的1958人进行了功能能力、健康问题以及非正式和市政护理与服务水平的评估。结果显示,仅在家接受市政护理的人群获得了更多的居家护理、服务以及日常生活工具性活动(IADL)方面的帮助,而除了正式护理外还接受非正式护理的人群则获得了更多与日常生活个人活动(PADL)相关的居家护理和服务以及护理照顾。同居是在家接受市政和非正式护理相结合的一个预测因素(比值比:5.935),而市政居家护理和服务提供的IADL方面的帮助仅预测市政护理(比值比:0.344)。以仅接受市政护理为参照,高龄(比值比:1.051)、IADL依赖(比值比:19.883)和PADL依赖(比值比:2.695)以及认知能力受损(比值比:3.849)是居住在特殊住所接受护理的预测因素。以在家接受非正式和市政护理相结合为参照,独居(比值比:0.106)、IADL依赖(比值比:11.348)和PADL依赖(比值比:2.506)、认知能力受损(比值比:3.448)、视力受损或失明(比值比:1.812)以及不存在愈合缓慢的伤口(比值比:0.407)是居住在特殊住所的预测因素。市政护理的分配将老年人分为三个不同的群体。没有同居者的最体弱和年长者在特殊住所接受护理,这由他们的身体和认知依赖程度决定。居家的最体弱个体与他人同居,并接受市政和非正式护理相结合的服务,而依赖性较小的个体主要仅从市政护理中获得IADL方面的帮助。结果表明,存在从替代模式向互补模式的转变,并强调需要关注家庭照顾者。

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