伊朗基于老年人功能能力的居家支持与医疗服务。

Home-based supportive and health care services based on functional ability in older adults in Iran.

作者信息

Mobasseri Khorshid, Matlabi Hossein, Allahverdipour Hamid, Kousha Ahmad

机构信息

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

J Educ Health Promot. 2024 Apr 29;13:124. doi: 10.4103/jehp.jehp_422_23. eCollection 2024.

DOI:10.4103/jehp.jehp_422_23

PMID:38784273

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11114482/

Abstract

BACKGROUND

Home-based care is affordable due to population aging, increased chronic disease, and higher hospitalization costs. The objective was to evaluate home-based supportive and health care services provided to older adults and identify possible associations between activities of daily living (ADLs), instrumental ADL (IADLs) classifications, sociodemographic variables, clinical characteristics, and perceived social support among older adults.

MATERIALS AND METHODS

In this cross-sectional study, 700 people aged 60 years and older were selected by stratified cluster sampling. Areas of Tabriz City were selected as clusters, and 55 comprehensive urban health centers were selected as stratifies. Chi-square, Pearson's and Spearman's tests, and multiple linear regression were used for statistical analyses. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS 24.0, SPSS Inc., Chicago, USA). The study instrument included demographic characteristics of older adults and caregivers, health services provided at home, and two valid questionnaires, including the KATZ index of independence in (instrumental) activities of daily living and a multidimensional scale of perceived social support. Scores on scales and demographic variables were collected during telephone interviews. The study lasted from April 25, 2022, to October 30, 2022.

RESULTS

A high level of perceived social support was 56.6%. The study found that 51.3% of participants had family caregivers. Most participants had ADL independence (85.4%), while 22.9% and 24.3% were dependent and needed assistance with IADL, respectively. Women had a lower ADL score and a higher IADL score than men ( < 0.05). The obtained results of multiple regression analysis revealed a negative and significant association between unemployment, illiteracy, increasing age, five and more medications, and ADL and IADL dependency ( < 0.05).

CONCLUSION

Empowering older adults to reduce dependency, and designing a formal home-based care system is recommended.

摘要

背景

由于人口老龄化、慢性病增加以及住院费用上升，居家护理成本较低。目的是评估为老年人提供的居家支持性和医疗保健服务，并确定老年人日常生活活动（ADL）、工具性日常生活活动（IADL）分类、社会人口统计学变量、临床特征以及感知到的社会支持之间可能存在的关联。

材料与方法

在这项横断面研究中，通过分层整群抽样选取了700名60岁及以上的老年人。选取大不里士市的区域作为群，选取55个综合城市健康中心作为层。采用卡方检验、Pearson检验和Spearman检验以及多元线性回归进行统计分析。使用社会科学统计软件包（SPSS 24.0，SPSS公司，美国芝加哥）进行统计分析。研究工具包括老年人和照顾者的人口统计学特征、在家提供的医疗服务，以及两份有效问卷，包括KATZ（工具性）日常生活活动独立性指数和感知社会支持多维量表。在电话访谈期间收集量表得分和人口统计学变量。研究从2022年4月25日持续到2022年10月30日。

结果

高水平的感知社会支持率为56.6%。研究发现，51.3%的参与者有家庭照顾者。大多数参与者在ADL方面具有独立性（85.4%），而分别有22.9%和24.3%的参与者在IADL方面存在依赖且需要帮助。女性的ADL得分低于男性，IADL得分高于男性（P<0.05）。多元回归分析的结果显示，失业、文盲、年龄增长、服用五种及以上药物与ADL和IADL依赖之间存在负向且显著的关联（P<0.05）。