Ohta Ryuichi, Yakabe Toshihiro, Sano Chiaki
Community Care, Unnan City Hospital, Unnan, JPN.
Family Medicine, Unnan City Hospital, Unnan, JPN.
Cureus. 2024 Feb 27;16(2):e55088. doi: 10.7759/cureus.55088. eCollection 2024 Feb.
Background With the global increase in aging populations, frailty syndrome, characterized by decreased strength, endurance, and physiological function, has become a critical issue. This study focuses on rural Japanese communities, where the prevalence of frailty syndrome can be notably high due to factors such as multimorbidity, polypharmacy, and a significant population of elderly individuals. This research addresses the gap in understanding frailty's manifestations and impacts in rural settings, considering unique challenges such as social isolation, limited healthcare access, and the broader social determinants of health. Methodology The study employs a narrative review with PubMed and a thematic analysis of semi-structured interviews with 21 elderly community workers in Unnan City. The analysis used the framework of frailty syndrome affected by physiological, social, psychological, and economic factors. The analysis focused on identifying themes related to the social determinants of health affecting frailty and potential solutions. Results The following five themes emerged from the analysis: Aging, Rural Contexts, Isolation, Lack of Knowledge of Frailty Syndrome, and Lack of Help-Seeking Behavior for Frailty Syndrome. Four solution-oriented themes were identified, namely, Public Dialogue and Educational Workshops, Frailty Syndrome Health Meetings, Social Engagement Activities, and Political Advocacy for Accessibility to Community Centers. These findings highlight the critical role of community engagement, education, and infrastructure improvements in addressing frailty syndrome in rural areas. Conclusions This study underscores the complexity of frailty syndrome in rural Japanese communities, emphasizing the need for targeted interventions that address the unique challenges faced by these populations. By fostering public dialogue, improving healthcare access, and enhancing social support, it is possible to mitigate the impacts of frailty syndrome and improve the quality of life for elderly residents in rural settings. This research contributes to a deeper understanding of frailty in aging societies and the importance of considering social determinants of health in developing effective solutions.
背景 随着全球老龄化人口的增加，以力量、耐力和生理功能下降为特征的衰弱综合征已成为一个关键问题。本研究聚焦于日本农村社区，由于多种疾病并存、多种药物治疗以及老年人口众多等因素，衰弱综合征在这些社区的患病率可能特别高。本研究针对农村地区在理解衰弱的表现和影响方面的差距，考虑了诸如社会隔离、医疗服务可及性有限以及更广泛的健康社会决定因素等独特挑战。
方法 本研究采用对PubMed进行叙述性综述以及对宇南市21名老年社区工作者进行半结构化访谈的主题分析。分析使用了受生理、社会、心理和经济因素影响的衰弱综合征框架。分析重点是确定与影响衰弱的健康社会决定因素相关的主题以及潜在解决方案。
结果 分析得出了以下五个主题：老龄化、农村环境、隔离、对衰弱综合征缺乏了解、以及对衰弱综合征缺乏求助行为。确定了四个以解决方案为导向的主题，即公众对话和教育工作坊、衰弱综合征健康会议、社会参与活动以及争取社区中心可达性的政治倡导。这些发现凸显了社区参与、教育和基础设施改善在应对农村地区衰弱综合征方面的关键作用。
结论 本研究强调了日本农村社区衰弱综合征的复杂性，强调需要有针对性的干预措施来应对这些人群面临的独特挑战。通过促进公众对话、改善医疗服务可及性以及加强社会支持，有可能减轻衰弱综合征的影响，提高农村老年居民的生活质量。本研究有助于更深入地理解老龄化社会中的衰弱问题以及在制定有效解决方案时考虑健康社会决定因素的重要性。
