Seiger Cronfalk Berit, Fjell Astrid, Carstens Nina, Rosseland Lars Malvin Kvinge, Rongve Arvid, Rönnevik Dag-Helge, Seiger Åke, Skaug Knut, Ugland Vae Karen Johanne, Hauge Wennersberg Marianne, Boström Anne-Marie
1Department of Nursing Sciences,Ersta Sköndal Bräcke University College,Stockholm,Sweden.
2Department of Nursing,Western Norway University of Applied Sciences,Haugesund,Norway.
Prim Health Care Res Dev. 2017 May;18(3):242-252. doi: 10.1017/S1463423617000019. Epub 2017 Feb 20.
The aim was to describe the development, utilization and feasibility of a model of preventive home visits, in an urban and a rural municipality in Norway.
Older people >65 years will rise significantly in coming years. Increased age is associated with risk of disability, illness and need for public health services. Preventive home visits is assumed to help older people to maintain their functional level longer, delaying disease and thus delaying the need for health care.
Descriptive explorative design describing the development, utilization and feasibility of preventive home visits in two different settings. All 77-year-old persons living at home in an urban municipality and all 75 years and older in a rural municipality were invited to participate. A questionnaire including a substantial number of tests concerning; fall, nutrition, polypharmacy and cognitive impairment was used by Health Team Nurses as base for a risk assessment. Pilot studies were conducted to validate the questionnaire including an inter-rater reliability study of the risk assessment tool. A multiprofessional team, Health Team for the Elderly met each week to evaluate risk assessments and make recommendations to be sent to each respective general practitioner. Data were analysed using descriptive and inferential statistics. In total, 167 persons (109 from the urban municipality and 58 from the rural municipality) participated, corresponding to 60% of the approached individuals. The mean time for the visits was 108 minutes (SD 20). Missing data were identified for; Do you feel safe in your municipality (17.5%) and Are you looking forward to ageing (11.4%). In total, 36 persons (21.7%) were identified with increased risk for developing illness. We suggest that a structured model of preventive home visits and collaboration between highly specialized health care professionals are important factors for reliable health promoting risk assessments of elderly home dwellers.
目的是描述挪威一个城市和一个农村自治市预防性家访模式的发展、应用及可行性。
未来几年，65岁以上的老年人数量将大幅增加。年龄增长与残疾、疾病风险以及对公共卫生服务的需求相关。预防性家访被认为有助于老年人更长时间地维持其功能水平，延缓疾病发生，从而推迟对医疗保健的需求。
采用描述性探索性设计，描述在两种不同环境中预防性家访的发展、应用及可行性。邀请了城市自治市所有在家居住的77岁老人以及农村自治市所有75岁及以上的老人参与。健康团队护士使用一份包含大量关于跌倒、营养、多重用药和认知障碍测试的问卷作为风险评估依据。进行了试点研究以验证该问卷，包括对风险评估工具的评分者间信度研究。一个多专业团队，即老年健康团队每周会面，评估风险评估结果，并向各自的全科医生提出建议。使用描述性和推断性统计方法对数据进行分析。共有167人（城市自治市109人，农村自治市58人）参与，占所接触个体的60%。家访的平均时间为108分钟（标准差20）。发现存在缺失数据的问题有：你在所在自治市感到安全吗（17.5%）以及你期待变老吗（11.4%）。总共确定有36人（21.7%）患疾病风险增加。我们认为，预防性家访的结构化模式以及高度专业化医疗保健专业人员之间的协作是对居家老年人进行可靠的健康促进风险评估的重要因素。
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