Han Tung-Chen, Lin Huey-Shyan, Chen Ching-Min
Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
Department of Nursing, Meiho University, Neipu 912009, Taiwan.
Healthcare (Basel). 2022 Mar 24;10(4):609. doi: 10.3390/healthcare10040609.
Aging is accompanied by many chronic comorbidities and disabilities, and entails medical expenses, which affects the quality of life among older adults. The purpose of this study was to investigate whether the health status of older adults with chronic diseases mediates chronic disease self-management to predict quality of life.
This research adopted a cross-sectional correlation study design. Convenient sampling was performed in outpatient departments commonly visited by older adults in a medical center in Southern Taiwan. The following measures were collected: (1) Physiological measurement: left handgrip, right handgrip, and lower extremities' muscle strength. (2) Questionnaires: cognitive function was measured by the Alzheimer's disease (AD)-8 scale, possible frailty with the Kihon Checklist (KCL), functional statu with the Barthel Index (BI) and the Lawton and Brody Instrumental Activities of Daily Living (IADL) scales, and self-management for chronic disease and quality of life with the (WHOQOL)-BREF, Taiwan version.
Chronic disease self-management is correlated with health status and is directly related to quality of life. Chronic disease self-management also indirectly affects quality of life through health status (cognitive status and risk of frailty), showing that health status partly mediates the correlation between chronic disease self-management and quality of life.
A health status feedback system should be introduced in related chronic disease self-management measures for older adults so that they can be aware of their own health status and so that their quality of life is improved. Custom-made nursing interventions are necessary for the reduction in or delay of disability or risk of frailty in older adults, thereby enhancing their quality of life.
衰老伴随着许多慢性合并症和残疾，并带来医疗费用，这影响了老年人的生活质量。本研究的目的是调查患有慢性疾病的老年人的健康状况是否介导慢性病自我管理以预测生活质量。
本研究采用横断面相关性研究设计。在台湾南部一家医疗中心老年人常去的门诊部门进行便利抽样。收集了以下测量指标：（1）生理测量：左手握力、右手握力和下肢肌肉力量。（2）问卷：认知功能通过阿尔茨海默病（AD）-8量表测量，可能的衰弱通过简易体能检查表（KCL）测量，功能状态通过巴氏指数（BI）以及洛顿和布罗迪日常生活活动能力量表（IADL）测量，慢性病自我管理和生活质量通过世界卫生组织生活质量量表简表（WHOQOL）-BREF台湾版测量。
慢性病自我管理与健康状况相关，且与生活质量直接相关。慢性病自我管理还通过健康状况（认知状态和衰弱风险）间接影响生活质量，表明健康状况部分介导了慢性病自我管理与生活质量之间的相关性。
应在针对老年人的相关慢性病自我管理措施中引入健康状况反馈系统，以便他们能够了解自己的健康状况，从而提高生活质量。定制的护理干预对于减少或延缓老年人的残疾或衰弱风险是必要的，从而提高他们的生活质量。
