老年功能障碍人群中与患者激活相关的因素。
Factors associated with patient activation in an older adult population with functional difficulties.
作者信息
Gleason Kelly T, Tanner Elizabeth K, Boyd Cynthia M, Saczynski Jane S, Szanton Sarah L
机构信息
School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
School of Nursing, Johns Hopkins University, Baltimore, MD, USA; School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
出版信息
Patient Educ Couns. 2016 Aug;99(8):1421-6. doi: 10.1016/j.pec.2016.03.011. Epub 2016 Mar 17.
OBJECTIVE
Patient activation, the patient's knowledge, skill, and confidence to manage his or her health, is an important indicator of future health and use of health care resources. Understanding factors associated with patient activation in an older population with functional difficulties may inform care in this population. This study aimed to determine whether patient activation is associated with depression, chronic conditions, family support, difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), hospitalizations, education, and financial strain.
METHODS
(N=277), We administered surveys measuring patient activation, financial strain, depressive symptoms, family support, and chronic conditions to an older adult population. We tested association through multivariate linear regressions controlling for race, sex, and age.
RESULTS
Patient activation is significantly (p<0.05), positively associated with family support and self-rated overall health, and significantly (p<0.05), negatively associated with depressive symptoms and difficulties with ADLs and IADLs. We found no association between patient activation and financial stress, hospitalizations, and education.
CONCLUSIONS
Older age, depressive symptoms, and difficulties with ADLs and IADLs were associated with decreased patient activation.
PRACTICE IMPLICATIONS
Developing interventions tailored to older adults' level of patient activation has the potential to improve outcomes for this population.
目的
患者激活度，即患者管理自身健康的知识、技能和信心，是未来健康状况及医疗资源利用的一项重要指标。了解与存在功能障碍的老年人群患者激活度相关的因素，可为该人群的护理工作提供参考。本研究旨在确定患者激活度是否与抑郁、慢性病、家庭支持、日常生活活动（ADL）困难、工具性日常生活活动（IADL）困难、住院情况、教育程度和经济压力相关。
方法
（N = 277），我们对老年人群进行了调查，测量患者激活度、经济压力、抑郁症状、家庭支持和慢性病情况。我们通过控制种族、性别和年龄的多元线性回归来检验相关性。
结果
患者激活度与家庭支持和自我评定的总体健康状况显著正相关（p < 0.05），与抑郁症状以及ADL和IADL困难显著负相关（p < 0.05）。我们发现患者激活度与经济压力、住院情况和教育程度之间没有关联。
结论
高龄、抑郁症状以及ADL和IADL困难与患者激活度降低相关。
实践意义
制定针对老年人患者激活度水平的干预措施，有可能改善该人群的治疗效果。
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