University of Alberta, 5-30 University Terrace, 8303-112 St, Edmonton, AB, Canada, T6G 1K4.
BMC Public Health. 2012 May 25;12:379. doi: 10.1186/1471-2458-12-379.
The study was set up to identify the extent and nature of difficulty with activities of daily living (disabilities) among elderly village residents of Bangladesh, to describe help currently given and to identify possible interventions. It was carried out at Gonoshasthaya Kendra (GK), a community development organization responsible for the health care of 600 villages with a population of some 1.5 million.
A survey card was designed and piloted using 12 questions on disability, elaborated from the Washington Group Disability questions, together with a checklist of health problems. A survey was carried out in 2010 in 535 villages under the care of GK since 2005, with village paramedics interviewing residents believed to be age 60 years or older. Respondents were matched where possible to data from the 2005 GK household census, giving data on education, occupation, socioeconomic group and smoking habit.
Survey cards were completed for 43417 residents of which 17346 were matched to residents recorded in the GK census as born ≤ 1945. The proportion reporting 'much difficulty' on one or more functional capacities increased steadily with age, reaching 55% (1796/3620) among those ≥ 85 years. Difficulties most frequently reported were lifting and carrying, vision and going outside the home. At all ages women were more likely to report 'much difficulty' than men (OR = 1.43 (1.35 to 1.48)), with widows and the illiterate at greater risk. Health problems, particularly hemiplegia, resting tremor, urinary incontinence and depression were strongly related to the 12 disabilities assessed. Help came almost entirely from family members; of 11211 villagers with 'much difficult' on at least one functional capacity, only 15 reported getting help outside the family.
Disabled elderly residents were dependent on the family for help but, with family cohesiveness under threat from migration to the city, there is a pressing need for the development and critical evaluation of community-based interventions designed specifically for the elderly in poor rural societies. New approaches to training and practice will be needed to integrate such disability management into primary care.
本研究旨在确定孟加拉国农村老年居民日常生活活动（残疾）的程度和性质，描述当前提供的帮助，并确定可能的干预措施。该研究在 Gonoshasthaya Kendra（GK）进行，这是一个负责 600 个村庄约 150 万人口医疗保健的社区发展组织。
设计了一张调查卡，使用了从华盛顿小组残疾问题中详细阐述的 12 个关于残疾的问题，以及一份健康问题清单。2010 年，在 GK 自 2005 年以来负责的 535 个村庄中进行了一项调查，由乡村医务人员采访据信年龄在 60 岁或以上的居民。在可能的情况下，受访者与 GK 2005 年家庭普查的数据相匹配，提供了教育、职业、社会经济群体和吸烟习惯的数据。
为 43417 名居民填写了调查卡，其中 17346 名与 GK 普查中记录的出生于 1945 年或以前的居民相匹配。报告在一项或多项功能能力上存在“严重困难”的比例随着年龄的增长而稳步上升，在 85 岁及以上的人群中达到 55%（1796/3620）。报告最多的困难是举重和搬运、视力和外出。在所有年龄段，女性报告“严重困难”的可能性都高于男性（OR=1.43（1.35 至 1.48）），寡妇和文盲的风险更高。健康问题，特别是偏瘫、静止性震颤、尿失禁和抑郁症与评估的 12 种残疾密切相关。帮助几乎完全来自家庭成员；在 11211 名至少在一项功能能力上存在“严重困难”的村民中，只有 15 名报告得到了家庭以外的帮助。
残疾老年居民依赖家庭获得帮助，但随着向城市迁移对家庭凝聚力的威胁，迫切需要为贫困农村社会中的老年人开发和严格评估专门的社区干预措施。需要新的培训和实践方法将这种残疾管理纳入初级保健。
