Fukasawa Masako, Yamaguchi Haruyasu
Gunma University Graduate School of Health Sciences, Japan.
J Rural Med. 2016;11(1):17-24. doi: 10.2185/jrm.2903. Epub 2016 Jun 16.
In Japan, the Integrated Community Care System aims to support residents to live as independently as possible at home. Koreisya-Kyoshitsu and Fureaiikiiki salons are two types of group activities for community-dwelling elderly. We investigated effective ways of conducting such activities.
We analyzed 96 subjects from 8 salons and 354 subjects from 10 Koreisya-Kyoshitsu. Self-completed questionnaires included the following: attributes, the Motor Fitness Scale (MFS), revised Philadelphia Geriatric Center Morale Scale (PGCMS), Measurement of Psychological Independence (MPI), instrumental activities of daily living (IADL), and self-rated health status (SRH). Follow-up assessment was conducted 6 months later. Representatives from 8 salons and staff members from 10 Koreisya-Kyoshitsu answered an additional questionnaire on management.
In Koreisya-Kyoshitsu, physical performance (MFS) (p = 0.007) and subjective well-being (PGCMS) (p = 0.001) improved significantly, whereas psychological independence (MPI) deteriorated significantly (p = 0.015). The MFS scores significantly improved in the sub-group with a high number of sessions (7 or more) (p = 0.043), as well as in the non-volunteer sub-group (p = 0.004). The PGCMS scores significantly improved in the sub-group with a high number of sessions (p < 0.001). The MPI scores significantly deteriorated in the sub-group with a low frequency of sessions (6 or less) and in the non-volunteer sub-group (p = 0.013 and p = 0.010, respectively). In salons, the frequency of going out decreased significantly (p = 0.049). Functional status (IADL) significantly improved in the "twice or more a month" sub-group (p = 0.046), whereas it significantly deteriorated in the "once a month" sub-group (p = 0.004). The proportion of volunteers/organizers in Koreisya-Kyoshitsu (23.4%) was significantly lower than that in salons (39.6%).
The frequency (number) of sessions, but not the volunteer/non-volunteer attribute, was a key factor in obtaining the health promotion effects of group activities in both Koreisya-Kyoshitsu and salons.
在日本，综合社区护理系统旨在支持居民尽可能独立地在家生活。“Koreisya-Kyoshitsu”和“Fureaiikiiki”沙龙是针对社区老年人的两种集体活动类型。我们研究了开展此类活动的有效方法。
我们分析了来自8个沙龙的96名受试者和来自10个“Koreisya-Kyoshitsu”的354名受试者。自行填写的问卷包括以下内容：属性、运动体能量表（MFS）、修订后的费城老年中心士气量表（PGCMS）、心理独立性测量（MPI）、日常生活工具性活动（IADL）以及自评健康状况（SRH）。6个月后进行随访评估。8个沙龙的代表和10个“Koreisya-Kyoshitsu”的工作人员回答了一份关于管理的补充问卷。
在“Koreisya-Kyoshitsu”中，身体表现（MFS）（p = 0.007）和主观幸福感（PGCMS）（p = 0.001）显著改善，而心理独立性（MPI）显著恶化（p = 0.015）。在活动次数较多（7次或更多）的亚组中，MFS得分显著提高（p = 0.043），在非志愿者亚组中也是如此（p = 0.004）。在活动次数较多的亚组中，PGCMS得分显著提高（p < 0.001）。在活动频率较低（6次或更少）的亚组和非志愿者亚组中，MPI得分显著恶化（分别为p = 0.013和p = 0.010）。在沙龙中，外出频率显著降低（p = 0.049）。在“每月两次或更多次”的亚组中，功能状态（IADL）显著改善（p = 0.046），而在“每月一次”的亚组中则显著恶化（p = 0.004）。“Koreisya-Kyoshitsu”中的志愿者/组织者比例（23.4%）显著低于沙龙中的比例（39.6%）。
活动的频率（次数）而非志愿者/非志愿者属性是在“Koreisya-Kyoshitsu”和沙龙中获得集体活动健康促进效果的关键因素。
