Nilsson Maria H, Ullén Susann, Ekström Henrik, Iwarsson Susanne
Department of Health Sciences, Lund University, Lund, Sweden.
Memory Clinic, Skåne University Hospital, Malmö, Sweden.
BMC Geriatr. 2016 Jul 27;16:146. doi: 10.1186/s12877-016-0319-x.
There are knowledge gaps about the life situation for people ageing with Parkinson's disease (PD), with virtually no understanding of home and health dynamics. Therefore, the aim of the present study was to explore the association between aspects of health and objective as well as perceived housing in people with PD.
Participants were recruited from three hospitals in the region of Skåne in southern Sweden. The sample for the present study included 231 (62 % men) participants with PD, with a mean age of 75 (min-max, 45-93) years. The data collection procedure included a self-administered postal survey and a subsequent home visit where structured interviews, observations and clinical assessments were administered. To study the association between aspects of health and housing canonical correlation was applied. Twelve variables (6 in the health and 6 in the housing set) were included. This corresponds to about 20 individuals per variable and is considered sufficient to accurately interpret the largest (i.e., first) canonical correlation.
The analysis between the health variables and housing variables set yielded two significant pairs of variates with the canonical correlations 0.68 (p < 0.0001) and 0.33 (p = 0.0112), respectively. For the first pair of variates the canonical R(2) was 0.46. The results showed that external control beliefs and behavioral aspects of meaning of home contributed the most to the housing variate, whereas difficulties/dependence in activities of daily living (ADL) and functional limitations contributed the most to the health variate. Although a significant relationship was found for the second canonical correlation, the shared variance between the two variates was considerably lower; R(2) = 0.11.
This study suggests that people with PD who have more functional limitations, difficulties in ADL and are more dependent perceive their homes as less meaningful from a behavioral perspective. Moreover, they tend to rely on external influences managing their housing situation. With this kind of knowledge at hand, health care and social services professionals are in a better position to observe and efficiently address problems related to health and housing among people with PD.
对于帕金森病（PD）患者的生活状况存在知识空白，几乎没有人了解家庭与健康的动态关系。因此，本研究的目的是探讨PD患者的健康状况与客观及主观住房情况之间的关联。
参与者从瑞典南部斯科讷地区的三家医院招募。本研究的样本包括231名（62%为男性）PD患者，平均年龄为75岁（最小-最大年龄，45-93岁）。数据收集程序包括一份自填式邮政调查问卷以及随后的家访，在家访中进行结构化访谈、观察和临床评估。为研究健康状况与住房情况之间的关联，应用了典型相关分析。纳入了12个变量（健康组6个，住房组6个）。这相当于每个变量约20名个体，被认为足以准确解释最大的（即第一个）典型相关。
健康变量组与住房变量组之间的分析产生了两对显著的变量对，典型相关系数分别为0.68（p<0.0001）和0.33（p = 0.0112）。对于第一对变量对，典型R(2)为0.46。结果表明，外部控制信念和家庭意义的行为方面对住房变量的贡献最大，而日常生活活动（ADL）中的困难/依赖以及功能限制对健康变量的贡献最大。虽然第二典型相关存在显著关系，但两个变量对之间的共同方差要低得多；R(2)=0.11。
本研究表明，功能限制更多、ADL有困难且依赖性更强的PD患者，从行为角度来看，会觉得自己的家意义较小。此外，他们往往依赖外部影响来管理自己的住房状况。掌握这类知识后，医疗保健和社会服务专业人员就能更好地观察并有效解决PD患者中与健康和住房相关的问题。
