Tse M M Y, Lai C, Lui J Y W, Kwong E, Yeung S Y
School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
J Psychiatr Ment Health Nurs. 2016 Jun;23(5):303-11. doi: 10.1111/jpm.12303.
WHAT IS KNOWN ON THE SUBJECT?: Frailty and multimorbidity are common in later life. A higher level of frailty is associated with a higher risk of adverse physical and psychological health situations. Older adults with pain have been reported to be lonelier and more depressed, as well as less happy and less satisfied with their life as compared to those without pain. In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Frailty index is positively correlated with the presence of pain, and associated with gender, functional mobility and loneliness. Among these significant variables, loneliness was the factor that contributed the most to the frailty index. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being. All nurses are advised to improve the management of pain in older people in order to lower the levels of pain, frailty and psychological distress among this population. Nursing care should address the loneliness level especially the problem of social loneliness among older adults particularly those living in nursing homes.
Introduction In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. Aim To examine the levels of frailty, pain and psychological parameters among older adults living in Hong Kong nursing homes, and the cross-sectional relationships among these items. Methods A cross-sectional study was conducted among 178 residents from six nursing homes. Frailty, pain, mobility, happiness, loneliness and life satisfaction of participants were assessed using validated questionnaires. Results A multiple linear regression (R(2) = 0.338, P < 0.05) showed that the frailty index was associated with loneliness, functional mobility and gender. Among these significant variables, loneliness was the factor that contributed the most to the frailty index. Discussion It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being. Findings suggest that apart from improving mobility and reducing pain, loneliness could be a target of psychosocial interventions to reduce frailty and improve quality of life. Implications for practice It is advised that nursing care should address loneliness, especially the problem of social loneliness among older adults particularly those living in nursing homes.
关于该主题已知的信息有哪些？：衰弱和多种疾病共存现象在晚年很常见。较高程度的衰弱与不良身心健康状况的较高风险相关。据报道，与无疼痛的老年人相比，有疼痛的老年人更孤独、更抑郁，对生活的幸福感和满意度也更低。鉴于老年人疼痛的高患病率以及衰弱的可逆性，为了制定以患者为中心的干预措施，探索疼痛、衰弱和心理参数之间的关系很重要。本文对现有知识的补充有哪些？：衰弱指数与疼痛的存在呈正相关，且与性别、功能活动能力和孤独感有关。在这些显著变量中，孤独感是对衰弱指数贡献最大的因素。对实践有哪些启示？：将医疗保健的重点放在身心健康的生理和心理方面至关重要。建议所有护士改善对老年人疼痛的管理，以降低该人群的疼痛、衰弱和心理困扰水平。护理工作应关注孤独感水平，尤其是老年人中的社会孤独问题，特别是那些住在养老院的老人。
引言 鉴于老年人疼痛的高患病率以及衰弱的可逆性，为了制定以患者为中心的干预措施，探索疼痛、衰弱和心理参数之间的关系很重要。目的 研究香港养老院老年人的衰弱、疼痛和心理参数水平，以及这些指标之间的横断面关系。方法 对来自六所养老院的178名居民进行横断面研究。使用经过验证的问卷评估参与者的衰弱、疼痛、活动能力、幸福感、孤独感和生活满意度。结果 多元线性回归（R² = 0.338，P < 0.05）显示，衰弱指数与孤独感、功能活动能力和性别有关。在这些显著变量中，孤独感是对衰弱指数贡献最大的因素。讨论 将医疗保健的重点放在身心健康的生理和心理方面至关重要。研究结果表明，除了改善活动能力和减轻疼痛外，孤独感可能是心理社会干预的目标，以减少衰弱并提高生活质量。对实践的启示 建议护理工作应关注孤独感，尤其是老年人中的社会孤独问题，特别是那些住在养老院的老人。
