Takahashi Kyo, Kato Atsushi, Igari Tomoyuki, Sase Eriko, Shibanuma Akira, Kikuchi Kimiyo, Nanishi Keiko, Jimba Masamine, Yasuoka Junko
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Social Rehabilitation, Research Institute, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.
Geriatr Gerontol Int. 2015 Jul;15(7):910-7. doi: 10.1111/ggi.12353. Epub 2014 Sep 26.
Being homebound is regarded as a negative condition for social participation in Japan. However, little is known about the possibility of psychological resilience to prevent being homebound among older adults with urinary incontinence. The present study aimed to examine the association between sense of coherence as a measure of psychological resilience and being homebound among older adults with urinary incontinence.
A cross-sectional study was carried out in Chiba, Japan. We trained 95 care managers as interviewers, and they collected the data from 411 community-dwelling frail older adults using a pretested structured questionnaire. Logistic regression analysis was run to identify factors associated with being homebound among the participants with urinary incontinence.
Of the participants, 158 (38.4%) had urinary incontinence. Among the participants with urinary incontinence, 52 (32.9%) were homebound. As a result of logistic regression analysis adjusting for age, sex, living status, hobby, types of prevalent diseases, walking ability, perceived social support and subjective social capital, lower meaningfulness in their lives, which is a component of a sense of coherence, remained positively associated with being homebound (adjusted odds ratio 0.79, 95% confidence interval 0.65-0.96).
Being homebound is less prevalent among those who feel challenges, or worthy of investment or engagement in daily life. By improving a sense of meaningfulness, homebound status might be improved among older adults with urinary incontinence. To encourage active social participation of the target population, their psychological resilience (particularly meaningfulness) should be addressed more.
在日本，居家不出被视为社会参与的一种消极状态。然而，对于尿失禁老年人群体中预防居家不出的心理复原力的可能性，人们知之甚少。本研究旨在探讨作为心理复原力指标的连贯感与尿失禁老年人群体居家不出之间的关联。
在日本千叶县开展了一项横断面研究。我们培训了95名护理经理作为访谈员，他们使用经过预测试的结构化问卷从411名居住在社区的体弱老年人那里收集数据。进行逻辑回归分析以确定尿失禁参与者中与居家不出相关的因素。
参与者中，158人（38.4%）患有尿失禁。在尿失禁参与者中，52人（32.9%）居家不出。经过对年龄、性别、生活状况、爱好、常见疾病类型、行走能力、感知到的社会支持和主观社会资本进行调整的逻辑回归分析后，生活意义感较低（连贯感的一个组成部分）仍然与居家不出呈正相关（调整后的优势比为0.79，95%置信区间为0.65 - 0.96）。
在那些感到生活有挑战、值得投入或参与日常生活的人群中，居家不出的情况不太普遍。通过提高生活意义感，尿失禁老年人的居家不出状况可能会得到改善。为了鼓励目标人群积极参与社会，应更多地关注他们的心理复原力（尤其是生活意义感）。
