Sugita Yuta, Hara Tsuyoshi, Ohnuma Takeshi, Kogure Eisuke, Urano Tomohiko
Division of Physical Therapy, Doctoral Program in Health Science Graduate School of Medicine, International University of Health and Welfare.
Nishinasuno General Home Care Center.
Nihon Ronen Igakkai Zasshi. 2022;59(1):49-57. doi: 10.3143/geriatrics.59.49.
The present study investigated the relationship between the type of residential area and each factor of the International Classification of Functioning, Disability and Health (ICF) framework among elderly subjects receiving home-visit rehabilitation.
This was a cross-sectional study conducted at two institutions. A total 84 participants (46 men and 38 women, age: 79.1±7.8 years old) who were receiving home-visit rehabilitation in urban and rural areas were examined. The parameters measured included the modified Gait Efficacy Scale (mGES), grip strength, 30-seconds chair stand test (CS-30), Functional Independence Measure (FIM), Life-Space Assessment (LSA), Frenchay Activities Index (FAI), Ikigai-9, and Home and Community Environment (HACE), which is based on the ICF concepts of health status, physical structure, physical and mental functions, activities, participation, personal factors, and environmental factors respectively; these points were evaluated by physical or occupational therapists. The health status was based on the diagnosis obtained from the clinical record.
Receiving home-visit rehabilitation in a rural area was significantly associated with the LSA (odds ratio [OR]=1.075, p=0.028), optimistic and positive feelings for life (OR=0.698, p=0.040), and community mobility scores (OR=5.755, p=0.001).
Environmental factors, activities, and personal factors differed depending on the region where the elderly subject received home-visit rehabilitation. Thus, intervention methods concerning home-visit rehabilitation may need to be adjusted according to the region where the patient lives.
本研究调查了接受家访康复治疗的老年受试者居住区域类型与《国际功能、残疾和健康分类》（ICF）框架各因素之间的关系。
这是一项在两家机构进行的横断面研究。共检查了84名在城市和农村地区接受家访康复治疗的参与者（46名男性和38名女性，年龄：79.1±7.8岁）。测量的参数包括改良步态效能量表（mGES）、握力、30秒椅子站立测试（CS - 30）、功能独立性测量（FIM）、生活空间评估（LSA）、法恩赛活动指数（FAI）、生趣量表 - 9以及家庭和社区环境（HACE），这些分别基于ICF的健康状况、身体结构、身心功能、活动、参与、个人因素和环境因素的概念；这些指标由物理治疗师或职业治疗师进行评估。健康状况基于从临床记录中获得的诊断。
在农村地区接受家访康复治疗与生活空间评估（优势比[OR]=1.075，p = 0.028）、对生活的乐观积极感受（OR = 0.698，p = 0.040）以及社区活动能力得分（OR = 5.755，p = 0.001）显著相关。
老年受试者接受家访康复治疗的区域不同，环境因素、活动和个人因素也有所不同。因此，家访康复治疗的干预方法可能需要根据患者居住的区域进行调整。
