Sandvoll Anne Marie, Grov Ellen Karine, Simonsen Morten
Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway.
Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
PeerJ. 2020 Oct 19;8:e10202. doi: 10.7717/peerj.10202. eCollection 2020.
The Norwegian regulations for nursing homes consider access to meaningful activities to be an indicator for the quality of nursing homes. Activities of daily living (ADL) provide important basic self-care skills for nursing home residents. Due to the physical changes caused by ageing and comorbidities, nursing home residents may experience functional decline over time, which may affect their ability to perform meaningful ADL, such as outdoor activity, which is considered a valuable and meaningful activity in Norwegian culture. This study aimed to investigate the association between ADL status, institution-dwelling and outdoor activity among nursing home residents.
This cross-sectional study included 784 residents aged >67 years living in 21 nursing homes in 15 Norwegian municipalities between November 2016 and May 2018. The Barthel Index was used to assess the nursing home residents' ADL status. Other variables collected were age, gender, body weight and height, visits per month, institution, ward, and participation in weekly outdoor activities. Descriptive statistics were used to provide an overview of the residents' characteristics. A Poisson regression model was used to test the association between the outdoor activity level as the dependent variable and ADL score, institution, and other control variables as independent variables.
More than half (57%) of the nursing home residents in this sample did not go outdoors. More than 50% of the residents had an ADL score <10, which indicates low performance status. Further, we found that residents' ADL status, institution, ward, and number of visits had an impact on how often the residents went outdoors.
The nursing home residents in this study rarely went outdoors, which is interesting because Norwegians appreciate this activity. Differences in the number of visits might explain why some residents went outdoors more often than other residents did. Our findings also highlight that the institutions impact the outdoor activity. How the institutions are organized and how important this activity is considered to be in the institutions determine how often the activity is performed.
The low frequency of the outdoor activities might be explained by a low ADL score. More than 50% of the residents had an ADL score <10, which indicates low performance status. Despite regulations for nursing home quality in Norway, this result suggests that organizational differences matter, which is an important implication for further research, health policy and practice.
挪威养老院法规将能否参与有意义的活动视为衡量养老院质量的一项指标。日常生活活动（ADL）为养老院居民提供重要的基本自我护理技能。由于衰老和合并症引起的身体变化，养老院居民可能会随着时间的推移出现功能衰退，这可能会影响他们进行有意义的日常生活活动的能力，比如户外活动，在挪威文化中户外活动被视为一项有价值且有意义的活动。本研究旨在调查养老院居民的日常生活活动状况、机构居住情况与户外活动之间的关联。
这项横断面研究纳入了2016年11月至2018年5月期间居住在挪威15个自治市21家养老院中的784名年龄大于67岁的居民。采用巴氏指数评估养老院居民的日常生活活动状况。收集的其他变量包括年龄、性别、体重和身高、每月探访次数、机构、病房以及每周参与户外活动的情况。描述性统计用于概述居民的特征。采用泊松回归模型来检验以户外活动水平为因变量，以日常生活活动得分、机构及其他控制变量为自变量之间的关联。
该样本中超过一半（57%）的养老院居民未外出。超过50%的居民日常生活活动得分低于10分，这表明其功能状态较差。此外，我们发现居民的日常生活活动状况、机构、病房和探访次数对居民外出的频率有影响。
本研究中的养老院居民很少外出，这一点很有意思，因为挪威人重视这项活动。探访次数的差异可能解释了为什么一些居民比其他居民更常外出。我们的研究结果还凸显出机构对户外活动有影响。机构的组织方式以及该活动在机构中被视为的重要程度决定了这项活动的开展频率。
户外活动频率较低可能是由于日常生活活动得分较低所致。超过50%的居民日常生活活动得分低于10分，这表明其功能状态较差。尽管挪威有养老院质量法规，但这一结果表明机构组织上的差异很重要，这对进一步的研究、卫生政策和实践具有重要意义。
