社区居住老年人康复后的预后预测因素。
Predictors of outcomes following reablement in community-dwelling older adults.
作者信息
Tuntland Hanne, Kjeken Ingvild, Langeland Eva, Folkestad Bjarte, Espehaug Birgitte, Førland Oddvar, Aaslund Mona Kristin
机构信息
Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen; Centre for Care Research Western Norway, Bergen University College, Bergen.
National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital; Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo.
出版信息
Clin Interv Aging. 2016 Dec 29;12:55-63. doi: 10.2147/CIA.S125762. eCollection 2017.
BACKGROUND
Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking.
OBJECTIVE
The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up.
METHODS
The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM).
RESULTS
The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively.
CONCLUSION
The results indicate that diagnosis, functional level, sex and motivation are significant predictors of outcomes following reablement.
背景
恢复能力训练是针对社区居住的老年人的一种康复干预措施，最近已在多个国家实施。其目的是提高老年人认为重要的日常活动中的功能能力。日常生活中的表现及对表现的满意度是恢复能力训练的主要结果。然而，缺乏关于哪些因素能预测更好的结果以及谁能从恢复能力训练中获得最大益处的证据基础。
目的
本研究的目的是确定在10周随访时预测职业表现及对该表现满意度的潜在因素。
方法
本研究的样本来自一项在挪威评估恢复能力训练效果的全国性临床对照试验，由居住在34个自治市的712名参与者组成。基于加拿大职业表现测量量表（COPM），采用多元线性回归来研究在10周随访时职业表现（COPM-P）及对该表现的满意度（COPM-S）的可能预测因素。
结果
结果表明，在10周随访时显著预测更好的COPM-P和COPM-S结果的因素分别是COPM-P和COPM-S的更高基线分数、女性、以骨折作为主要健康状况以及对康复的高积极性。相反，显著预测更差的COPM-P和COPM-S结果的因素是患有除中风以外的神经系统疾病、以头晕/平衡问题作为主要健康状况以及有疼痛/不适。此外，有焦虑/抑郁是更差的COPM-P结果的一个预测因素。这两个回归模型分别解释了职业表现及对该表现满意度这两个因变量总方差的38.3%和38.8%。
结论
结果表明，诊断、功能水平、性别和积极性是恢复能力训练后结果的重要预测因素。
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