Mouchaers Ines, Verbeek Hilde, Kempen Gertrudis I J M, van Haastregt Jolanda C M, Vlaeyen Ellen, Goderis Geert, Metzelthin Silke F
Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands.
Living Lab of Ageing and Long Term Care, Maastricht, the Netherlands.
Eur J Ageing. 2022 Jan 29;19(3):397-411. doi: 10.1007/s10433-021-00668-w. eCollection 2022 Sep.
Ageing with a disability increases the risk of hospitalization and nursing home admission. Ageing in place interventions aiming to reduce disability are often not sufficiently effective and inadequately theory-based. There are many models available on disability, but it is unclear how they define disability, what their differences are, and how they evolved throughout the years. This paper aims to provide an overview of the evolution of these models and to elaborate on the causal mechanisms of disability. A literature review was conducted as part of the TRANS-SENIOR international training and research network. PubMed and Google Scholar were searched, and snowball sampling was applied to eligible publications. Data were extracted from the included publications, and a thematic analysis was performed on the retrieved data. Overall, 29 publications were included in the final sample. All included models arose from three original models and could be divided into two types: linear models and models on the interaction between the person and the environment. Thematic analysis led to three distinct evolutionary trends: (1) from a unidirectional linear path to a multidirectional nonlinear path, (2) from the consequences of disease towards the consequences of person-environment interaction, and (3) from disability towards health and functioning. Our findings suggest that by optimizing the use of personal as well as environmental resources, and focusing on health and functioning, rather than disability, an older person's independence and wellbeing can be improved, especially while performing meaningful daily activities in accordance with the person's needs and preferences.
残疾状态下的老龄化会增加住院和入住养老院的风险。旨在减少残疾的就地养老干预措施往往效果不佳且缺乏充分的理论依据。关于残疾有许多模型，但不清楚它们如何定义残疾、彼此有何差异以及多年来是如何演变的。本文旨在概述这些模型的演变，并详细阐述残疾的因果机制。作为跨老年国际培训和研究网络的一部分，进行了一项文献综述。检索了PubMed和谷歌学术，并对符合条件的出版物应用了滚雪球抽样法。从纳入的出版物中提取数据，并对检索到的数据进行主题分析。最终样本共纳入29篇出版物。所有纳入的模型均源自三个原始模型，可分为两类：线性模型和人与环境相互作用模型。主题分析得出三个不同的演变趋势：（1）从单向线性路径到多向非线性路径，（2）从疾病后果到人与环境相互作用的后果，（3）从残疾到健康和功能。我们的研究结果表明，通过优化个人和环境资源的利用，并关注健康和功能而非残疾，老年人的独立性和幸福感可以得到提高，尤其是在根据个人需求和偏好进行有意义的日常活动时。
