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社区安老,提升老年人的生活质量:改善功能和健康相关生活质量的生物-行为-环境干预措施,适用于残疾老年人。

Community aging in place, advancing better living for elders: a bio-behavioral-environmental intervention to improve function and health-related quality of life in disabled older adults.

机构信息

Department of Health Systems and Outcomes, School of Nursing, Johns Hopkins University, Baltimore, Maryland 21205, USA.

出版信息

J Am Geriatr Soc. 2011 Dec;59(12):2314-20. doi: 10.1111/j.1532-5415.2011.03698.x. Epub 2011 Oct 21.

Abstract

OBJECTIVES

To determine effect size and acceptability of a multicomponent behavior and home repair intervention for low-income disabled older adults.

DESIGN

Prospective randomized controlled pilot trial.

SETTING

Participants' homes.

PARTICIPANTS

Forty low-income older adults with difficulties in one or more activities of daily living (ADLs) or two or more instrumental activities of daily living (IADLs).

INTERVENTION

The Community Aging in Place, Advancing Better Living for Elders (CAPABLE), coordinated occupational therapy, nursing, and handyman visits, was compared with attention-control visits. The intervention consisted of up to six visits with an occupational therapist, up to four visits with a nurse, and an average of $1,300 in handyman repairs and modifications. Each intervention participant received all components of the intervention clinically individualized to risk profile and goals. Each attention-control participant received the same number of visits as the intervention participants, involving sedentary activities of their choice.

PRIMARY OUTCOME

difficulty in performing ADLs and IADLs.

SECONDARY OUTCOMES

health-related quality of life and falls efficacy.

RESULTS

Thirty-five of 40 adults (87%) completed the 6-month trial, and 93% and 100% of the control and intervention group, respectively, stated that the study benefited them. The intervention group improved on all outcomes. When comparing mean change in the intervention group with mean change in the control group from baseline to follow-up, the CAPABLE intervention had effect sizes of 0.63 for reducing difficulty in ADLs, 0.62 for reducing difficulty in IADLs, 0.89 for quality of life, and 0.55 for falls efficacy.

CONCLUSION

The CAPABLE intervention was acceptable to participants and feasible to provide and showed promising results, suggesting that this multicomponent intervention to reduce disability should be evaluated in a larger trial.

摘要

目的

确定针对低收入残疾老年人的多组分行为和家庭维修干预措施的效果大小和可接受性。

设计

前瞻性随机对照试点试验。

设置

参与者的家庭。

参与者

40 名日常生活活动(ADL)或两项或更多项工具性日常生活活动(IADL)有困难的低收入老年患者。

干预措施

社区适应老龄化,提升老年人更好的生活(CAPABLE),协调职业治疗、护理和工匠访问,与注意力控制访问进行比较。干预措施包括最多六次职业治疗师访问、最多四次护士访问以及平均 1300 美元的工匠维修和改造费用。每位干预参与者都接受了根据风险概况和目标进行个体化的干预的所有组成部分。每位注意力控制参与者接受了与干预参与者相同数量的访问,涉及他们选择的久坐活动。

主要结果

ADL 和 IADL 的活动困难程度。

次要结果

健康相关的生活质量和跌倒效能。

结果

40 名成年人中有 35 名(87%)完成了 6 个月的试验,分别有 93%和 100%的对照组和干预组表示研究对他们有益。干预组在所有结果上都有所改善。将干预组从基线到随访的平均变化与对照组的平均变化进行比较,CAPABLE 干预对降低 ADL 活动困难的效果大小为 0.63,对降低 IADL 活动困难的效果大小为 0.62,对生活质量的效果大小为 0.89,对跌倒效能的效果大小为 0.55。

结论

CAPABLE 干预措施对参与者是可接受的,并且可行的提供方式,并且显示出有希望的结果,这表明这种多组分干预措施可以减少残疾,应该在更大的试验中进行评估。

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