Institute on Aging, San Francisco, California 94118, USA.
Gerontologist. 2010 Aug;50(4):531-40. doi: 10.1093/geront/gnp172. Epub 2010 Jan 27.
The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life.
Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable community-dwelling older adults who did not attend an ADHC. Assessments were conducted at study enrollment, 6 and 12 months.
ADHC participants (n = 57) and comparison group subjects (n = 67) were similar at baseline in age, ethnic diversity, medical conditions, depression, cognition, immigration history, education, income, and marital status. Significantly more comparison group subjects lived alone (p = .002). One year after enrollment, the SF-36 domains role physical and role emotional improved significantly. Adjusted role physical scores for ADHC participants improved (23 vs. 36) but declined for the comparison group (38 vs. 26, time by group interaction p = .01), and role emotional scores improved for ADHC participants (62 vs.70) but declined for the comparison group (65 vs. 48, time by group interaction p = .02). Secondary analyses revealed that changes in daily physical functioning, depressed affect, or cognitive functioning did not explain the improvements found in role physical and role emotional scores for ADHC participants. No significant differences in trends for the 2 groups occurred for the SF-36 domains physical functioning, social functioning, and mental health.
ADHC participation may enhance older adults' quality of life. Quality of life may be a key measure to inform care planning, program improvement, and policy development of ADHC.
本研究旨在评估成人日间健康中心(ADHC)参与度与健康相关生活质量之间的关联。
采用病例对照前瞻性研究,利用医疗结局调查简表 36 项(SF-36)对 16 个 ADHC 项目中刚入组的新参与者与未参加 ADHC 的可比社区居住的老年成年人进行比较。评估在研究入组时、6 个月和 12 个月时进行。
ADHC 参与者(n=57)和对照组受试者(n=67)在年龄、种族多样性、医疗状况、抑郁、认知、移民史、教育、收入和婚姻状况方面基线相似。对照组受试者独居的比例明显更高(p=0.002)。入组 1 年后,SF-36 领域的躯体角色功能和情绪角色功能显著改善。ADHC 参与者的躯体角色功能调整后评分提高(23 分比 36 分),而对照组则下降(38 分比 26 分,时间与组间交互作用 p=0.01),情绪角色功能评分提高(62 分比 70 分),而对照组则下降(65 分比 48 分,时间与组间交互作用 p=0.02)。进一步的分析表明,ADHC 参与者躯体角色功能和情绪角色功能评分的改善与日常生活身体机能、抑郁情绪或认知功能的变化无关。两组 SF-36 领域的身体机能、社会功能和心理健康方面均未出现显著的趋势差异。
ADHC 参与度可能会提高老年人的生活质量。生活质量可能是为 ADHC 的护理计划、项目改进和政策制定提供信息的关键衡量标准。