Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Korea.
Burke Rehabilitation Hospital, White Plains, NY, USA.
J Korean Med Sci. 2020 Feb 24;35(7):e43. doi: 10.3346/jkms.2020.35.e43.
The 48/6 Model of Care is an integrative care initiative for improving the health outcomes of hospitalized older patients; however, its applicability in community-dwelling older adults as a health screening tool has not been investigated. The present study aimed to examine the applicability of this model, prevalence of dysfunction in 6 care areas, and its relationship with self-reported mobility in community-dwelling older adults.
This was a cross-sectional survey study of community-dwelling adults aged 65 or older. Participants were screened for problems using 9 items corresponding to the 6 care areas of the 48/6 Model of Care (cognitive functioning, functional mobility, pain management, nutrition and hydration, bladder and bowel management, and medication management). Mobility was assessed via the Life-Space Assessment (LSA). We examined the correlation between each screening item and the LSA.
A total of 444 older adults (260 women, 58.6%) participated. The mean number of health problems was 2.3 ± 2.1, with the most common being pain, cognitive impairment, and urinary incontinence. These problems and LSA scores were significantly different by age groups. A multiple regression analysis showed that polypharmacy (β = -10.567, < 0.001), dysphagia (β = -9.610, = 0.021), and pain (β = -7.369, = 0.004) were significantly associated with life-space mobility after controlling for age.
The 48/6 Model of Care is applicable to community-dwelling older adults, who show high prevalence of dysfunction in the 6 care areas. This study supports the role of the model in screening for the health status of older adults living in the community, and in estimating mobility.
48/6 护理模式是一项综合性护理计划,旨在改善住院老年患者的健康结局;然而,其作为健康筛查工具在社区居住的老年人中的适用性尚未得到研究。本研究旨在探讨该模型的适用性、6 个护理领域功能障碍的患病率,以及其与社区居住的老年人自我报告的移动能力之间的关系。
这是一项针对 65 岁或以上社区居住成年人的横断面调查研究。使用与 48/6 护理模式的 6 个护理领域(认知功能、功能性移动能力、疼痛管理、营养和水合作用、膀胱和肠道管理以及药物管理)相对应的 9 个项目对参与者进行了问题筛查。通过生活空间评估(LSA)评估移动能力。我们检查了每个筛查项目与 LSA 之间的相关性。
共有 444 名老年人(260 名女性,58.6%)参与了研究。健康问题的平均数量为 2.3 ± 2.1,最常见的问题是疼痛、认知障碍和尿失禁。这些问题和 LSA 评分在不同年龄组之间存在显著差异。多元回归分析显示,多种药物治疗(β = -10.567,<0.001)、吞咽困难(β = -9.610,= 0.021)和疼痛(β = -7.369,= 0.004)与控制年龄后生活空间移动能力显著相关。
48/6 护理模式适用于社区居住的老年人,他们在 6 个护理领域中表现出高功能障碍的患病率。本研究支持该模型在筛查社区居住的老年人健康状况和估计移动能力方面的作用。