Doroszkiewicz Halina, Sierakowska Matylda
Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland.
Department of Integrated Medical Care Medical, University of Bialystok, Bialystok, Poland.
Scand J Caring Sci. 2021 Mar;35(1):134-142. doi: 10.1111/scs.12827. Epub 2020 Feb 24.
The growing number of elderly people results in the intensification of disability, reduced level of independency and quality of life as well as augmented demand on medical and social services. The aim of the study was to identify factors associated with probability of care dependency in disabled geriatric patients.
The study involved 200 patients aged 60 or over, consecutively admitted to the Geriatrics Unit. A cross-sectional quantitative study design. The study carried out using the questionnaire evaluating the patients' biopsychosocial needs and level of care dependency: the Polish version of the Care Dependency Scale (CDS). Data regarding the patients' self-care, locomotor function, emotional status, cognitive function, vision, hearing, the risk of pressure sores or falls, self-assessed health status and the sense of loneliness were obtained from medical documentation using selected elements of the CGA (Comprehensive Geriatric Assessment).
The mean CDS score (15-75) for all the evaluated patients was 55.3 ± 15.1-43.4 ± 11.9 in the category of dependent patients and 67.5 ± 4.6 in the category of independent of care, respectively (p < 0.001). The participants' mean age was 81.8 ± 6.6 (in the dependent category, 83.3, and in the independent category, 80.2). The final model produced statistically significant independent factors: cognitive ability, Instrumental-ADL performance, locomotive ability and age.
The progressing care dependency increased with the worsening of cognitive functions, difficulties performing I-ADL, locomotion impairment and advanced age. To support independent living of elderly people, healthcare professionals should recognise the situation in the community to carry out interventions aimed at preventing and minimising disability and delaying institutionalisation.
老年人数量的不断增加导致残疾加剧、独立性和生活质量下降，以及对医疗和社会服务的需求增加。本研究的目的是确定与老年残疾患者护理依赖可能性相关的因素。
该研究纳入了200名60岁及以上的患者，他们连续入住老年病科。采用横断面定量研究设计。该研究使用评估患者生物心理社会需求和护理依赖水平的问卷进行：波兰版护理依赖量表（CDS）。使用综合老年评估（CGA）的选定要素从医疗记录中获取有关患者自我护理、运动功能、情绪状态、认知功能、视力、听力、压疮或跌倒风险、自我评估健康状况和孤独感的数据。
所有评估患者的平均CDS评分（15 - 75）在依赖患者类别中为55.3±15.1，在独立护理类别中为43.4±11.9，在无需护理类别中为67.5±4.6（p < 0.001）。参与者的平均年龄为81.8±6.6岁（在依赖类别中为83.3岁，在独立类别中为80.2岁）。最终模型产生了具有统计学意义的独立因素：认知能力、工具性日常生活活动能力、运动能力和年龄。
随着认知功能恶化、执行工具性日常生活活动困难、运动障碍和高龄，护理依赖程度不断增加。为了支持老年人的独立生活，医疗保健专业人员应了解社区情况，开展旨在预防和减少残疾以及延迟机构化的干预措施。
