养老机构和居家养老老年人疼痛感知状况及影响因素研究-来自中国的证据
Pain perception of older adults in nursing home and home care settings: evidence from China.
机构信息
School of Social Development and Public Policy, Beijing Normal University, 19 Xinjiekou Wai St, Beijing, 100875, China.
Columbia University School of Social Work, 1255 Amsterdam Ave, New York, NY, 10027, USA.
出版信息
BMC Geriatr. 2018 Jul 3;18(1):152. doi: 10.1186/s12877-018-0841-0.
BACKGROUND
In the past decade, the number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%. Older adults, their family members, and policymakers in China are concerned about patient outcomes in different care settings because older adults who have a similar functional status and LTC needs may choose either nursing home care or home care. The aim of this study was to compare pain perception in nursing home care and home care settings for physically dependent older adults in China.
METHODS
Multi-stage sampling method was used to recruit respondents aged 65 and older from Yichang City, China, in 2015. The researchers employed a two-step analytical strategy-zero-inflated ordered probit regression followed by propensity score matching method-to model the effect of contrasting residence types on pain perception.
RESULTS
Zero-inflated ordered probit regression analysis with participants unmatched (n = 484) showed that compared with older adults who received home care, those who received nursing home care did not have more severe pain (β = 0.088, SE = 0.196, p = 0.655). After propensity-score matching, the research found that older adults in the home care group perceived less pain compared with the nursing home group (β = 0.489, SE = 0.169, p = 0.004).
CONCLUSIONS
The older adults who received home care perceived significantly less pain than the nursing home residents. The pain of older adults may differ based on the type of LTC services and therapy intensity they received, and home care might lead to less pain and better comfort than nursing home care.
背景
在过去的十年中，中国老年人的长期护理（LTC）服务数量每年平均增长 10%。中国的老年人、他们的家庭成员和政策制定者都关注不同护理环境下的患者结局，因为具有相似功能状态和 LTC 需求的老年人可能会选择养老院护理或家庭护理。本研究旨在比较中国身体依赖的老年人在养老院护理和家庭护理环境中的疼痛感知。
方法
采用多阶段抽样方法，于 2015 年从中国宜昌市招募 65 岁及以上的受访者。研究人员采用两步分析策略——零膨胀有序概率回归，随后采用倾向评分匹配方法——来模拟对比居住类型对疼痛感知的影响。
结果
在未匹配参与者（n=484）的零膨胀有序概率回归分析中，与接受家庭护理的老年人相比，接受养老院护理的老年人疼痛程度没有更严重（β=0.088，SE=0.196，p=0.655）。经过倾向评分匹配后，研究发现，家庭护理组的老年人比养老院组感知到的疼痛更少（β=0.489，SE=0.169，p=0.004）。
结论
接受家庭护理的老年人感知到的疼痛明显低于养老院居民。老年人的疼痛可能因接受的长期护理服务类型和治疗强度而异，家庭护理可能比养老院护理导致更少的疼痛和更好的舒适度。
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