Gobbens Robbert J J, Uchmanowicz Izabella
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands.
Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.
SAGE Open Nurs. 2023 Jan 5;9:23779608221150598. doi: 10.1177/23779608221150598. eCollection 2023 Jan-Dec.
More and more researchers are convinced that frailty should refer not only to physical limitations but also to psychological and social limitations that older people may have. Such a broad, or multidimensional, definition of frailty fits better with nursing, in which a holistic view of human beings, and thus their total functioning, is the starting point.
In this article, which should be considered a Practice Update, we aim at emphasizing the importance of the inclusion of other domains of human functioning in the definition and measurement of frailty. In addition, we provide a description of how district nurses view frailty in older people. Finally, we present interventions that nurses can perform to prevent or delay frailty or its adverse outcomes. We present, in particular, results from studies in which the Tilburg Frailty Indicator, a multidimensional frailty instrument, was used.
The importance of a multidimensional assessment of frailty was demonstrated by usually satisfactory results concerning adverse outcomes of mortality, disability, an increase in healthcare utilization, and lower quality of life. Not many studies have been performed on nurses' opinions about frailty. Starting from a multidimensional definition of frailty, encompassing physical, psychological, and social domains, nurses are able to assess and diagnose frailty and conduct a variety of interventions to prevent or reduce frailty and its adverse effects. Because nurses come into frequent contact with frail older people, we recommend future studies on opinions of nurses about frailty (e.g., screening, prevention, and addressing).
越来越多的研究人员确信,衰弱不仅应指身体上的限制,还应包括老年人可能存在的心理和社会限制。这种宽泛的、或多维度的衰弱定义更符合护理学,在护理学中,对人的整体观以及因此而来的人的整体功能,是出发点。
在这篇应被视为实践更新的文章中,我们旨在强调在衰弱的定义和测量中纳入人类功能其他领域的重要性。此外,我们描述了社区护士如何看待老年人的衰弱。最后,我们介绍了护士可以采取的预防或延缓衰弱及其不良后果的干预措施。我们特别展示了使用多维衰弱工具蒂尔堡衰弱指标的研究结果。
对衰弱进行多维度评估的重要性体现在关于死亡率、残疾、医疗保健利用率增加和生活质量降低等不良后果的结果通常令人满意。关于护士对衰弱看法的研究并不多。从包括身体、心理和社会领域的多维度衰弱定义出发,护士能够评估和诊断衰弱,并开展各种干预措施以预防或减少衰弱及其不良影响。由于护士经常接触体弱的老年人,我们建议未来开展关于护士对衰弱看法(如筛查、预防和应对)的研究。