Physical Therapy Department, University of Applied Sciences Western Switzerland, Geneva, Switzerland.
Swiss Med Wkly. 2011 Apr 29;141:w13183. doi: 10.4414/smw.2011.13183. eCollection 2011.
The aim of this paper was to establish gender-specific associations between the characteristics of residents recently admitted to Swiss nursing homes (NH) and their activities of daily living (ADL) performance.
A sample of 17'331 NH residents living in 90 Swiss NHs received a Resident Assessment Instrument Minimum Data Set (RAI-MDS) shortly after NH entry, in the period from 1997 to 2007. ADL performance was assessed using the MDS-ADL long-form scale that measures self-performance in the seven following tasks: bed mobility, transfer, locomotion, dressing, eating, toilet use and personal hygiene. Associations between ADL performance and health and personal characteristics of the residents were then investigated using bivariate and multivariate analyses.
A total of 40% of the residents recently admitted to Swiss NHs were completely dependent for ADL. Absence of physical activity and having been admitted to a NH before 2003 were gender-specific variables associated with poorer ADL. Incontinence, poor balance, impaired cognition and vision as well as low BMI were important factors associated with poorer ADL performance in both genders.
The general scheme of ADL impairment was quite similar for both genders, but females tended to do slightly but significantly better than males. Overall, strategies improving balance, continence, cognition and sensory function including treatment of vision impairment, promoting healthy nutrition as well as physical activity--particularly among elderly women with musculoskeletal conditions--may facilitate care in recently admitted residents and/or delay NH admission.
本研究旨在确定瑞士养老院（NH）近期入住居民的特征与日常生活活动（ADL）表现之间的性别特异性关联。
1997 年至 2007 年间，90 家瑞士 NH 中的 17331 名 NH 居民在入住 NH 后不久接受了居民评估工具最低数据集（RAI-MDS）的评估。ADL 表现使用 MDS-ADL 长表进行评估，该表测量以下七个任务中的自我表现：床移动、转移、移动、穿衣、进食、使用厕所和个人卫生。然后使用双变量和多变量分析调查 ADL 表现与居民健康和个人特征之间的关联。
最近入住瑞士 NH 的居民中，40%完全依赖 ADL。缺乏身体活动和 2003 年前入住 NH 是与 ADL 较差相关的性别特异性变量。尿失禁、平衡不良、认知和视力受损以及 BMI 较低是两性 ADL 表现较差的重要因素。
ADL 损害的总体模式在两性中非常相似，但女性的表现略好于男性。总体而言，改善平衡、尿失禁、认知和感官功能的策略，包括治疗视力障碍、促进健康营养以及身体活动——特别是针对有肌肉骨骼疾病的老年女性——可能有助于最近入住的居民的护理和/或延迟 NH 入住。
