机构养老老年人日常生活活动能力的动态变化：一项为期两年的纵向研究。

Dynamics of activities of daily living performance in institutionalized older adults: A two-year longitudinal study.

作者信息

Jerez-Roig Javier, de Brito Macedo Ferreira Lidiane Maria, Torres de Araújo José Rodolfo, Costa Lima Kenio

机构信息

Postgraduate Program in Collective Health, Odontology Department, Federal University of Rio Grande do Norte (UFRN), Avenida Salgado Filho 1787, CEP 59010-000, Lagoa Nova, Natal-RN, Brazil; Can Misses Hospital, Ibiza, Spain.

Postgraduate Program in Collective Health, Odontology Department, Federal University of Rio Grande do Norte (UFRN), Avenida Salgado Filho 1787, CEP 59010-000, Lagoa Nova, Natal-RN, Brazil.

出版信息

Disabil Health J. 2017 Apr;10(2):279-285. doi: 10.1016/j.dhjo.2016.12.001. Epub 2016 Dec 18.

DOI:10.1016/j.dhjo.2016.12.001

PMID:28034573

Abstract

BACKGROUND

It is fundamental to analyze the evolution of functioning for the planning of strategies aimed at preventing or delaying dependency. However, there is a lack of studies focused on the evolution of functional performance in institutionalized older adults in Latin America.

OBJECTIVE

Verify the incidence of functional decline, functional maintenance and functional improvement in the basic activities of daily living (BADL) in institutionalized older adults, as well as analyze the evolution of functional performance.

METHODS

A two-year, five-wave longitudinal study is presented herein, with assessments applied every 6 months, carried out in residents of 10 nursing homes in the city of Natal-RN (Brazil). The items 'eating', 'personal hygiene', 'dressing', 'bathing', 'transferring' and 'walking' were assessed by a 5-points Likert scale. Sociodemographic, institution-related and health-related variables were considered for descriptive analyses.

RESULTS

The sample consisted of 280 older adults, of which 150, 53.6% (95% CI: 47.7-59.3%) experienced decline, 94, 33.6% (95% CI: 28.3-39.3%) maintained functional performance, 40, 14.3% (95% CI: 10.7-18.9%) presented improvement at least in one assessment, and only 18 (6.4%; CI 95%: 4.1-9.9%) improved functional performance with no decline over the period. 'Eating' presented the highest decline (-0.54 points), followed by 'walking' (-0.43), 'dressing' (-0.35) and 'transferring' (-0.31). The BADL that suffered less decline were 'toileting' (-0.22), 'personal hygiene' (-0.24) and 'bathing' (-0.29).

CONCLUSIONS

Half of institutionalized older adults experienced functional decline and less than 15% improved functional performance. 'Eating' suffered the most pronounced decline, followed by mobility and self-care activities.

摘要

背景

分析功能演变对于制定预防或延缓失能的策略至关重要。然而，拉丁美洲针对机构养老老年人功能表现演变的研究匮乏。

目的

验证机构养老老年人日常生活基本活动（BADL）中功能下降、功能维持和功能改善的发生率，并分析功能表现的演变。

方法

本文呈现了一项为期两年、分五波次的纵向研究，每6个月进行一次评估，研究对象为巴西纳塔尔市（RN）10家养老院的居民。通过5点李克特量表对“进食”“个人卫生”“穿衣”“洗澡”“转移”和“行走”项目进行评估。描述性分析考虑了社会人口学、机构相关和健康相关变量。

结果

样本包括280名老年人，其中150人（53.6%，95%置信区间：47.7 - 59.3%）出现功能下降，94人（33.6%，95%置信区间：28.3 - 39.3%）维持了功能表现，40人（14.3%，95%置信区间：10.7 - 18.9%）至少在一次评估中出现改善，且仅有18人（6.4%；95%置信区间：4.1 - 9.9%）在该期间功能表现改善且无下降。“进食”的下降幅度最大（-0.54分），其次是“行走”（-0.43）、“穿衣”（-0.35）和“转移”（-0.31）。下降幅度较小的BADL项目是“如厕”（-0.22）、“个人卫生”（-0.24）和“洗澡”（-0.29）。