促进健康的干预措施对谁有效？独立进行日常生活活动的预测因素。
For whom is a health-promoting intervention effective? Predictive factors for performing activities of daily living independently.
作者信息
Dahlin-Ivanoff Synneve, Eklund Kajsa, Wilhelmson Katarina, Behm Lina, Häggblom-Kronlöf Greta, Zidén Lena, Landahl Sten, Gustafsson Susanne
机构信息
Department of Health and Rehabilitation, The Sahlgrenska Academy at the University of Gothenburg, Institute of Neuroscience and Physiology, Box 455, SE 405 30, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, University of Gothenburg Centre for Ageing and Health (AgeCap), SE 405 30, Gothenburg, Sweden.
出版信息
BMC Geriatr. 2016 Oct 6;16(1):171. doi: 10.1186/s12877-016-0345-8.
BACKGROUND
Health-promoting interventions tailored to support older persons to remain in their homes, so-called "ageing in place" is important for supporting or improving their health. The health-promoting programme "Elderly Persons in the Risk Zone," (EPRZ) was set up for this purpose and has shown positive results for maintaining independence in activities of daily living for older persons 80 years and above at 1- and 2 year follow-ups. The aim of this study was to explore factors for maintaining independence in the EPRZ health-promoting programme.
METHODS
Total of 459 participants in the original trial was included in the analysis; 345 in the programme arm and 114 in the control arm. Thirteen variables, including demographic, health, and programme-specific indicators, were chosen as predictors for independence of activities of daily living. Logistic regression was performed separately for participants in the health promotion programme and in the control arm.
RESULTS
In the programme arm, being younger, living alone and self-rated lack of tiredness in performing mobility activities predicted a positive effect of independence in activities of daily living at 1-year follow-up (odds ratio [OR] 1.18, 1.73, 3.02) and 2-year, (OR 1.13, 2.01, 2.02). In the control arm, being less frail was the only predictor at 1-year follow up (OR 1.6 1.09, 2.4); no variables predicted the outcome at the 2-year follow-up.
CONCLUSIONS
Older persons living alone - as a risk of ill health - should be especially recognized and offered an opportunity to participate in health-promoting programmes such as "Elderly Persons in the Risk Zone". Further, screening for subjective frailty could form an advantageous guiding principle to target the right population when deciding to whom health-promoting intervention should be offered.
TRIAL REGISTRATION
The original clinical trial was registered at ClinicalTrials.gov. Identifier: NCT00877058 , April 6, 2009.
背景
量身定制的促进健康干预措施，旨在支持老年人居家养老，即所谓的“就地养老”，对于维持或改善他们的健康状况至关重要。为此设立了促进健康项目“处于风险区域的老年人”（EPRZ），并在1年和2年的随访中显示出对80岁及以上老年人在日常生活活动中保持独立的积极效果。本研究的目的是探索EPRZ促进健康项目中维持独立性的因素。
方法
原试验中的459名参与者纳入分析；345名在项目组，114名在对照组。选择13个变量，包括人口统计学、健康状况和特定项目指标，作为日常生活活动独立性的预测因素。对健康促进项目组和对照组的参与者分别进行逻辑回归分析。
结果
在项目组中，年龄较轻、独自生活以及自评在进行移动活动时不疲劳，预测在1年随访时（优势比[OR] 1.18、1.73、3.02）和2年随访时（OR 1.13、2.01、2.02）对日常生活活动独立性有积极影响。在对照组中，身体不太虚弱是1年随访时唯一的预测因素（OR 1.6、1.09、2.4）；在2年随访时没有变量预测结果。
结论
独自生活的老年人——作为健康不佳的风险人群——应得到特别关注，并提供机会参与“处于风险区域的老年人”等促进健康项目。此外，在决定对哪些人提供促进健康干预措施时，筛查主观虚弱程度可形成一个有利的指导原则，以确定合适的人群。
试验注册
原临床试验在ClinicalTrials.gov注册。标识符：NCT00877058，2009年4月6日。
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