Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Aging Ment Health. 2012;16(6):795-803. doi: 10.1080/13607863.2011.651436. Epub 2012 Feb 24.
We wanted to unveil associations between perceived health and physical health, function in activity of daily living, anxiety, depression and coping resources in terms of sense of coherence (SOC) in elderly (≥65 years) in-hospital patients without cognitive impairment.
In a cross-sectional study, we evaluated 217 hospitalized elderly patients with an age range 65-95 (mean 77.9) years. Perceived health was rated on a four-point scale. Physical health was measured with the Charlson index; functional status was rated using the Lawton and Brody's scale for self-maintaining and instrumental activities of daily living; and, anxiety and depression were rated using the Hospital Anxiety and Depression scale. Finally, the 13-item version of the SOC scale was used to assess coping, and cognitive state was assessed using the Mini-mental State Examination.
In all, 40% of the patients reported good perceived health. In an adjusted logistic regression analysis, the main outcome good perceived health was associated with increasing age: odds ratio (OR) 1.06 (95% CI 1.01-1.11); good physical health: OR 2.49 (95% CI 1.22-5.07); and, medium high and high SOC: OR 2.48 (95% CI 1.20-5.13), and OR 2.43 (95% CI 1.11-5.28), respectively. Explained variance was 22.2%.
Good coping resources and low severity of co-morbid disorders are the two most important factors that explain why elderly inpatients rate their health as good. Since coping may be equally important as poor physical health for perception of health, coping should be recognized and measured in clinical practice.
我们旨在揭示感知健康与身体健康、日常生活活动功能、焦虑、抑郁以及在无认知障碍的住院老年患者(≥65 岁)中,与应对资源(基于综合健康感知)之间的关联。
在一项横断面研究中,我们评估了 217 名年龄在 65-95 岁(平均 77.9 岁)之间的住院老年患者。感知健康的评估采用四点量表。身体健康采用 Charlson 指数进行测量;功能状态使用 Lawton 和 Brody 的自我维持和日常活动工具性活动量表进行评估;焦虑和抑郁采用医院焦虑和抑郁量表进行评估。最后,使用综合健康感知量表的 13 项版本评估应对,使用简易精神状态检查评估认知状态。
所有患者中,40%报告了良好的感知健康。在调整后的逻辑回归分析中,主要结局即良好的感知健康与年龄增长相关:比值比(OR)为 1.06(95%置信区间 1.01-1.11);良好的身体健康:OR 为 2.49(95%置信区间 1.22-5.07);以及,中等高和高 SOC:OR 分别为 2.48(95%置信区间 1.20-5.13)和 2.43(95%置信区间 1.11-5.28)。解释方差为 22.2%。
良好的应对资源和较低的合并症严重程度是解释为什么住院老年患者将其健康状况评估为良好的两个最重要因素。由于应对可能与身体健康一样重要,对健康感知的影响,因此在临床实践中应认识到并测量应对。