Serrano-Urrea Ramón, Gómez-Rubio Virgilio, Palacios-Ceña Domingo, Fernández-de-Las-Peñas César, García-Meseguer María José
Department of Mathematics, Faculty of Computer Science Engineering, University of Castilla-La Mancha, Albacete, Spain.
Department of Mathematics, Faculty of Industrial Engineering, University of Castilla-La Mancha, Albacete, Spain.
PLoS One. 2017 Aug 28;12(8):e0183945. doi: 10.1371/journal.pone.0183945. eCollection 2017.
High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents' functional disability.
A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data.
The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences.
In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.
此前在养老院中已观察到功能受限的高患病率。残疾可能不仅取决于居民的特征，还取决于设施的特征。本研究的目的是：1. 描述居住在西班牙养老院中的老年人功能残疾的患病率；2. 分析个人和养老院特征与居民功能残疾之间的关系。
进行了一项横断面研究，收集了西班牙阿尔瓦塞特省34所养老院中895名居民的数据。通过巴氏指数评估功能状态。考虑到数据的两个层面（个人和机构特征），我们采用了多层次分析，以便考虑数据中不同的变异来源。
总样本中功能残疾的患病率为79.8%。拟合度最佳的多层次模型显示，女性、年龄较大、对健康的负面自我认知以及居住在私立养老院是与功能残疾显著相关的因素。在分离个人和机构效应后，各机构显示出显著差异。
与先前的研究结果一致，我们的研究发现机构养老的老年人中功能依赖程度很高。性别、年龄、对健康的自我认知以及机构所有权与功能状态相关。通过多层次模型区分个人和机构效应有助于评估养老院的质量。
