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长期居住在养老院的阿尔茨海默病和痴呆症患者的社会联系:个体和机构层面的变化探索。

Social Connectedness among Long-Stay Nursing Home Residents with Alzheimer's and Dementia: Exploring Individual and Facility-Level Variation.

机构信息

Division of Epidemiology, Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, Massachusetts, USA.

Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA.

出版信息

Dement Geriatr Cogn Disord. 2022;51(3):249-261. doi: 10.1159/000525343. Epub 2022 Jul 4.

Abstract

INTRODUCTION

This study sought to explore individual and facility-level variation in social connectedness among long-stay nursing home residents with Alzheimer's or other dementias (ADRD).

METHODS

We identified 721,074 long-stay residents with ADRD using 2016 Minimum Data Set 3.0 data. Social connectedness was defined using the social connectedness index (SCI) (high: SCI = 5, lower: 0 < SCI ≤ 4). Adjusted odds ratios (aOR) provided estimates of the associations between resident-level and facility-level characteristics, and high SCI was derived from logistic models.

RESULTS

The SCI Cronbach's alpha was 0.69; 78.6% had high SCI scores. Men were less likely than women to have higher SCI scores (aOR = 0.97; 95% CI: 0.97-0.98). Increasing age was associated with higher SCI scores (e.g., aOR [85-94 vs. 40-64 years]: 1.07; 95% CI: 1.06-1.07). Those with moderate cognitive impairment (aOR: 0.87) and severe cognitive impairment (aOR: 0.85) had reduced odds of SCI = 5 relative to those with mild/intact cognitive function. Residents living in homes with special care dementia units and with higher percentage of residents with dementia had decreased odds of high social connectedness.

DISCUSSION/CONCLUSION: Understanding resident- and nursing home-level variation in social connectedness may be important for targeting interventions that reduce isolation among residents with ADRD.

摘要

简介

本研究旨在探讨患有阿尔茨海默病或其他痴呆症(ADRD)的长期居住在养老院的居民的个体和机构层面的社交联系的变化。

方法

我们使用 2016 年最低数据集 3.0 数据,确定了 721,074 名患有 ADRD 的长期居住的居民。社交联系程度使用社交联系指数(SCI)定义(高:SCI = 5,低:0 < SCI ≤ 4)。调整后的优势比(aOR)提供了居民层面和机构层面特征与高 SCI 之间关联的估计值,高 SCI 来自逻辑模型。

结果

SCI 的 Cronbach's alpha 为 0.69;78.6%的 SCI 得分较高。男性比女性更不可能获得更高的 SCI 得分(aOR = 0.97;95%CI:0.97-0.98)。年龄越大,SCI 得分越高(例如,85-94 岁与 40-64 岁相比的 aOR:1.07;95%CI:1.06-1.07)。中度认知障碍(aOR:0.87)和严重认知障碍(aOR:0.85)的患者与轻度/完整认知功能的患者相比,SCI = 5 的可能性降低。居住在特殊护理痴呆病房的养老院中的居民以及具有较高痴呆症居民比例的居民,社交联系紧密的可能性降低。

讨论/结论:了解患有 ADRD 的居民和养老院层面社交联系的变化可能对于针对减少这些患者孤立的干预措施很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bad5/9501789/e38ccd414615/dem-0051-0249-g01.jpg

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