Travers Jasmine L, Hirschman Karen B, Hanlon Alexandra L, Huang Liming, Naylor Mary D
Yale University, New Haven, CT, USA.
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Inquiry. 2020 Jan-Dec;57:46958019900835. doi: 10.1177/0046958019900835.
Limited information exists on the perceived health of older adults new to receiving long-term services and supports (LTSS) compared with the year prior, posing challenges to the anticipation of health care need and optimization of wellness efforts for this growing population. In response, we sought to identify differences in perceived worsened physical health across three LTSS types (nursing home, assisted living, and home and community-based services) along with health-related quality of life (HRQoL) characteristics associated with older adults' ratings of perceived worsened physical health at the start of receiving LTSS. Enrolled LTSS recipients completed a single interview assessing their HRQoL. Bivariate and multivariable logistic regression analyses were performed to determine associations in LTSS types and HRQoL characteristics with perceived worsened physical health among older adults (≥60 years old) since 1 year prior to study enrollment. Among the 467 LTSS recipients, perceived physical health was rated as worse than the previous year by 36%. Bivariate analyses revealed no differences in perceived worsened physical health across LTSS types. In adjusted analyses, religiousness/spirituality and better mental and general health perception had a decreased odds of being associated with perceived worsened physical health ( < .05). Participants with major changes in their health in the past 6 months were more likely to report perceived worsened physical health ( < .001). Findings provide information that may be used to target efforts to enhance perceived physical health and improve quality of life among LTSS enrollees.
与上一年相比，关于新接受长期服务和支持（LTSS）的老年人的健康认知情况的信息有限，这给预测这一不断增长的人群的医疗需求以及优化健康促进工作带来了挑战。作为回应，我们试图确定三种LTSS类型（养老院、辅助生活设施以及居家和社区服务）中老年人自认为身体健康恶化情况的差异，以及与开始接受LTSS时老年人自认为身体健康恶化评分相关的健康相关生活质量（HRQoL）特征。登记的LTSS接受者完成了一次评估其HRQoL的访谈。进行了双变量和多变量逻辑回归分析，以确定LTSS类型和HRQoL特征与60岁及以上老年人自登记研究前一年以来自认为身体健康恶化之间的关联。在467名LTSS接受者中，36%的人认为自己的身体健康状况比上一年更差。双变量分析显示，不同LTSS类型的老年人自认为身体健康恶化情况没有差异。在调整分析中，宗教信仰/精神性以及更好的心理和总体健康认知与自认为身体健康恶化相关的几率降低（P<0.05）。在过去6个月中健康状况发生重大变化的参与者更有可能报告自认为身体健康恶化（P<0.001）。研究结果提供了一些信息，可用于针对性地努力提高LTSS参与者自认为的身体健康状况并改善生活质量。
