Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan.
Arch Gerontol Geriatr. 2011 Mar-Apr;52(2):127-32. doi: 10.1016/j.archger.2010.02.016. Epub 2010 Mar 25.
The aim of the study was to examine the effect of informal care levels on overall discontinuation of living at home, all-cause death, hospital admission, and long-term care placement for community-dwelling older people using various community-based services during a 3-year period. Prospective cohort study of 1582 community-dwelling disabled elderly and paired informal caregivers was conducted. Baseline data included the recipients and caregivers' demographic characteristics, comorbidities, informal care levels (sufficient, moderate, and insufficient care), which were evaluated by trained visiting nurses, and the level of formal community-based service use. Among 1582 participants, 97 died at home, 692 were admitted to hospitals, 318 died during their hospital stay, and 117 were institutionalized in long-term care facilities during 3 years of follow-up. A multivariate Cox hazard model demonstrated that when compared with a sufficient informal care level, an insufficient informal care level was associated with overall discontinuation of living at home, all-cause mortality, hospitalization, and institutionalization during 3 years of follow-up (hazard ratio: 1.65, 95% confidence interval: 1.15-2.36; 1.98, 1.17-3.34; 1.56, 1.04-2.35; 2.93, 1.25-6.86, respectively). The results suggested that informal caregiving is an important factor in the prevention of overall discontinuation of living at home in a population of disabled older people.
本研究旨在探讨在 3 年内使用各种基于社区的服务期间,非正规护理水平对居住在家的总体中断、全因死亡、住院和长期护理安置的影响。对 1582 名居住在社区的残疾老年人及其配对的非正规护理者进行了前瞻性队列研究。基线数据包括接受者和护理者的人口统计学特征、共病、非正规护理水平(充足、适度和不足护理),由经过培训的家访护士进行评估,以及正式基于社区的服务使用水平。在 1582 名参与者中,有 97 人在家中死亡,692 人住院,318 人在住院期间死亡,117 人在 3 年随访期间被安置在长期护理机构。多变量 Cox 风险模型表明,与充足的非正规护理水平相比,不足的非正规护理水平与 3 年内居住在家的总体中断、全因死亡率、住院和机构化相关(风险比:1.65,95%置信区间:1.15-2.36;1.98,1.17-3.34;1.56,1.04-2.35;2.93,1.25-6.86)。结果表明,在残疾老年人人群中,非正规护理是预防总体居住在家中断的一个重要因素。