Nakagawa Yuji, Goda Akio, Fujii Kazushi, Shimazaki Rua, Orita Naoki, Yoshino Daisuke, Kawara Toru, Sakurai Masayuki, Ito Yoshihiro, Maki Yoshinori
Rehabilitation, Hikari Hospital, Otsu, JPN.
Physical Therapy, Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa, JPN.
Cureus. 2024 Feb 6;16(2):e53740. doi: 10.7759/cureus.53740. eCollection 2024 Feb.
Increasing elderly population is a major health concern worldwide, requiring various at-home care services. The aim of home-visit rehabilitation therapy is to support at-home living of the elderly and to promote their participation in social activities. There is a paucity of data about the clinical conditions of this population that can contribute to the achievement of goals in-home visit rehabilitation therapy.
This study aimed to clarify clinical variables that could be related to the achievement of goals in-home visit rehabilitation therapy.
We collected retrospective clinical data of the older adults who underwent home-visit rehabilitation therapy between July 2006 and June 2021. We searched the clinical variables of home-visit rehabilitation therapy users and their frequency of utilization of home-visit rehabilitation therapy services from the clinical record. The initial and final clinical variables evaluated in this study included the abilities of daily living, degree of being bedridden, dementia rating, and levels of support or long-term care. Those variables were evaluated by rehabilitation therapists and doctors. The users were divided into three groups according to the reason for terminating rehabilitation therapy: goal achievement (achieved group), aggravation of underlying disease (aggravated group), and treatment suspension because of their own/others' wish (suspended group). The clinical parameters concerning the rehabilitation program, care level, and activities of daily living were evaluated among the groups. The clinical parameters concerning the rehabilitation program, care level, and activities of daily living were statistically evaluated among those three groups, using the chi-square test and Kruskal-Wallis test.
In the achieved, aggravated, and suspended groups, 45, 190, and 38 users were respectively enrolled. The aggravated group showed significantly higher final care level (p = 0.002), degree of being bedridden (p=0.001), and dementia rating (p = 0.017) and significantly lower Barthel index scores (p < 0.001) and Frenchay Activities Index scores (p = 0.001) than the achieved group. Persons requesting the therapy were significantly older adults themselves in the achieved group (p = 0.018). The therapy was significantly performed more than once per week in the achieved group (p = 0.018).
Older adults undergoing self-motivated home-visit rehabilitation therapy more than once per week may contribute to the achievement of the goal.
全球老年人口不断增加是一个重大的健康问题，需要各种居家护理服务。家访康复治疗的目的是支持老年人居家生活并促进他们参与社会活动。关于这一人群临床状况的数据匮乏，而这些数据有助于实现家访康复治疗的目标。
本研究旨在阐明可能与家访康复治疗目标达成相关的临床变量。
我们收集了2006年7月至2021年6月期间接受家访康复治疗的老年人的回顾性临床数据。我们从临床记录中查找家访康复治疗使用者的临床变量及其使用家访康复治疗服务的频率。本研究中评估的初始和最终临床变量包括日常生活能力、卧床程度、痴呆评分以及支持或长期护理水平。这些变量由康复治疗师和医生进行评估。根据终止康复治疗的原因，将使用者分为三组：目标达成（达成组）、基础疾病加重（加重组）以及因自身/他人意愿而中止治疗（中止组）。在各组之间评估有关康复计划、护理水平和日常生活活动的临床参数。使用卡方检验和克鲁斯卡尔 - 沃利斯检验对这三组之间有关康复计划、护理水平和日常生活活动的临床参数进行统计学评估。
达成组、加重组和中止组分别纳入了45名、190名和38名使用者。与达成组相比，加重组的最终护理水平（p = 0.002）、卧床程度（p = 0.001）和痴呆评分（p = 0.017）显著更高，而巴氏指数评分（p < 0.001）和法国ay活动指数评分（p = 0.001）显著更低。在达成组中，要求治疗的人本身显著为老年人（p = 0.018）。在达成组中，治疗显著每周进行不止一次（p = 0.018）。
每周接受不止一次自我激励的家访康复治疗 的老年人可能有助于实现目标。
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