University Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de la Corniche 10, CH-1010, Lausanne, Switzerland.
BMC Geriatr. 2020 Feb 18;20(1):69. doi: 10.1186/s12877-020-1439-x.
In view of population aging, a better knowledge of factors influencing the type of long-term care (LTC) among older adults is necessary. Previous studies reported a close relationship between incontinence and institutionalization, but little is known on opinions of older citizens regarding the most appropriate place of care. This study aimed at evaluating the impact of urine and/or fecal incontinence on preferences of community-dwelling older citizens.
We derived data from the Lausanne cohort 65+, a population-based study of individuals aged from 68 to 82 years. A total of 2974 community-dwelling persons were interviewed in 2017 on the most appropriate place of LTC delivery for three vignettes displaying a fixed level of disability with varying degrees of incontinence (none, urinary, urinary and fecal). Multinomial logistic regression analyses explored the effect of respondents' characteristics on their opinion according to Andersen's model.
The level of incontinence described in vignettes strongly determined the likelihood of considering institutional care as most appropriate. Respondents' characteristics such as age, gender, educational level, being a caregiver, knowledge of shelter housing or feeling supported by family influenced LTC choices. Self-reported incontinence and other indicators of respondents' need, however, had no significant independent effect.
Among older community-dwelling citizens, urinary and fecal incontinence play a decisive role in the perception of a need for institutionalization. Prevention and early initiation of support for sufferers may be a key to prevent this need and ensure familiar surrounding as long as possible.
鉴于人口老龄化，我们需要更好地了解影响老年人长期护理（LTC）类型的因素。先前的研究报告称，尿失禁与机构化之间存在密切关系，但对于老年人对最适宜护理地点的看法，人们知之甚少。本研究旨在评估尿失禁和/或粪便失禁对社区居住老年人护理偏好的影响。
我们从洛桑队列 65+中提取数据，这是一项针对 68 至 82 岁人群的基于人群的研究。2017 年，共有 2974 名居住在社区的人接受了访谈，内容是为三个病例描述提供最适宜的 LTC 交付地点，这些病例描述显示出固定程度的残疾和不同程度的失禁（无、尿失禁、尿失禁和粪便失禁）。多变量逻辑回归分析根据安德森模型探讨了受访者特征对其意见的影响。
病例描述中描述的失禁程度强烈决定了认为机构护理最合适的可能性。受访者的特征，如年龄、性别、教育水平、是否是照顾者、对庇护住房的了解或是否感到家庭支持，影响了 LTC 的选择。然而，自我报告的失禁和其他受访者需求指标没有显著的独立影响。
在社区居住的老年人中，尿失禁和粪便失禁在感知对机构化的需求方面起着决定性的作用。预防和早期为患者提供支持可能是预防这种需求并确保尽可能长时间保持熟悉环境的关键。
