Ramos Luiz Roberto, Andreoni Solange, Coelho-Filho João Macedo, Lima-Costa Maria Fernanda, Matos Divane Leite, Rebouças Monica, Veras Renato
Rev Saude Publica. 2013 Jun;47(3):506-13. doi: 10.1590/s0034-8910.2013047004325.
To analyze non-redundant questions on independence in activities of daily living in the elderly, representing the spectrum of dependency.
Multicenter project with a probabilistic population sample of 5,371 elderly residents in Sao Paulo, SP, Rio de Janeiro, RJ, Fortaleza, CE and Bambui, MG in 2008. A household survey was carried out and a questionnaire with 20 activities of daily living applied for the elderly to self-assess the difficulty/need for help in performing them. The responses were analyzed according to: the prevalence of some kind of difficulty/need for help for each activities of daily living, the frequency of non-response, and the grouping of activities in factor analysis.
The personal activities (e.g., dressing) have, on average, a low prevalence of difficulty or need for help, compared to instrumental activities (e.g., shopping), and have lower rates of non- response. In factor analysis it was possible to identify three factors grouping the activities of daily living: one relative to mobility (e.g., walking 100 m), another for personal needs (e.g., bathing) and one relative to what someone else can do for the elderly (e.g., washing clothes). The activities of daily living with the highest eigenvalues in each group were also analyzed in the light of the prevalence of reported need for help and the proportion of non response. Three activities of daily living were selected as representing the spectrum of dependency and being well understood by the elderly - getting out of bed, bathing and walking 100 m.
With only three activities of daily living we can have a simple and reliable screening instrument capable of identifying elderly in need of help in daily life. Estimating demand for care on a daily basis is an important indicator for planning and administration of health services within the paradigm of chronic diseases and population aging.
分析老年人日常生活活动中关于独立性的非冗余问题，以体现依赖程度范围。
2008年在圣保罗、里约热内卢、福塔莱萨和班布伊开展的多中心项目，对5371名老年居民进行概率抽样。进行了家庭调查，并向老年人发放了一份包含20项日常生活活动的问卷，让他们自我评估进行这些活动时的困难程度/是否需要帮助。根据以下方面对回答进行分析：每项日常生活活动中某种困难/需要帮助的发生率、无回答的频率，以及在因子分析中对活动进行分组。
与工具性活动（如购物）相比，个人活动（如穿衣）平均困难或需要帮助的发生率较低，且无回答率也较低。在因子分析中，可以识别出将日常生活活动分组的三个因子：一个与行动能力相关（如步行100米），另一个与个人需求相关（如洗澡），还有一个与他人能为老年人做的事情相关（如洗衣服）。还根据报告的需要帮助的发生率和无回答比例，对每组中特征值最高的日常生活活动进行了分析。选择了三项日常生活活动作为代表依赖程度范围且老年人易于理解的活动——起床、洗澡和步行100米。
仅通过三项日常生活活动，我们就能拥有一个简单可靠的筛查工具，能够识别出日常生活中需要帮助的老年人。在慢性病和人口老龄化的范式下，每日估算护理需求是卫生服务规划和管理的一项重要指标。
