Gitlin Laura N, Winter Laraine, Stanley Ian H
1 Johns Hopkins University, Baltimore, MD, USA.
2 Philadelphia VA Medical Center, PA, USA.
J Appl Gerontol. 2017 Jun;36(6):647-666. doi: 10.1177/0733464815581479. Epub 2015 Apr 13.
We examine prevalence of four compensatory strategies (assistive devices, receiving help, changing frequency, or method of performance) and their immediate and long-term relationship to well-being. A total of 319 older adults (>70 years) with functional difficulties at home provided baseline data; 285 (89%) provided 12-month data. For 17 everyday activities, the most frequently used strategy was changing method of performance ( M = 10.27 activities), followed by changing frequency ( M = 6.17), assistive devices ( M = 5.38), and receiving help ( M = 3.37; p = .001). Using each strategy type was associated with functional difficulties at baseline ( ps < .0001), whereas each strategy type except changing method predicted functional decline 12 months later ( ps < .0001). Changing frequency of performing activities was associated with depressed mood ( p < .0001) and poor mastery ( p < .0001) at both baseline and 12 months ( ps < .02). Findings suggest that strategy type may be differentially associated with functional decline and well-being although reciprocal causality and the role of other factors in these outcomes cannot be determined from this study.
我们研究了四种代偿策略(辅助设备、接受帮助、改变频率或执行方式)的普遍性及其与幸福感的即时和长期关系。共有319名在家中存在功能困难的老年人(年龄>70岁)提供了基线数据;285名(89%)提供了12个月的数据。对于17项日常活动,最常用的策略是改变执行方式(M = 10.27项活动),其次是改变频率(M = 6.17)、辅助设备(M = 5.38)和接受帮助(M = 3.37;p = .001)。使用每种策略类型都与基线时的功能困难相关(p值<.0001),而除改变执行方式外的每种策略类型都预测了12个月后的功能衰退(p值<.0001)。改变活动执行频率在基线和12个月时均与情绪低落(p < .0001)和掌控感差(p < .0001)相关(p值<.02)。研究结果表明,策略类型可能与功能衰退和幸福感存在不同的关联,尽管本研究无法确定这些结果中的相互因果关系以及其他因素的作用。