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有沟通障碍的老年人及其在就医时对沟通支持的使用:一项全国代表性研究。

Older adults with communication disabilities and their use of communication support at doctor's visits: a nationally representative study.

作者信息

Oshita Jennifer Y, Gell Nancy M, Reed Nicholas S, Stransky Michelle L, MacLean Charles D

机构信息

Center for Bioethics and Humanities, University of Colorado, Aurora, CO, USA.

Nursing and Health Sciences, University of VT, Burlington, VT, USA.

出版信息

Disabil Rehabil. 2025 Jan;47(2):406-413. doi: 10.1080/09638288.2024.2351155. Epub 2024 Jun 3.

Abstract

PURPOSE

Older adults with communication disabilities (CDs) experience barriers to receiving care and face a paucity of accommodations for their disability. Utilizing someone that supports communication with healthcare providers (communication support persons) may be a way that this group self-supports their disability. We examined if this utilization was independently associated with CDs among older adults. We also sought to understand if socioeconomic factors were associated with utilization.

METHODS

We used the 2015 National Health and Aging Trends Survey (NHATS) to conduct a cross-sectional analysis of Medicare beneficiaries ( = 5954) with functional hearing, expressive, or cognitive difficulties. We calculated a weighted, population prevalence and an adjusted prevalence ratio (APR) controlling for sociodemographic, health and other disability factors.

RESULTS

Among community dwelling older adults, having CDs was associated with higher utilization of a communication support person at medical visits (APR: 1.41 [CI: 1.27 - 1.57]). Among adults with CDs, Black adults and women had lower levels of utilization as compared to White adults and men, respectively.

CONCLUSION

Communication support persons may be a way that older adults with CDs self-support their disability. However, not all older adults with CDs bring someone and variation by social factors could suggest that unmet support needs exist.

摘要

目的

有沟通障碍(CDs)的老年人在接受护理时面临障碍,且针对其残疾的便利设施匮乏。利用能协助与医疗服务提供者沟通的人(沟通支持人员)可能是该群体自我应对残疾问题的一种方式。我们研究了这种利用方式是否与老年人中的沟通障碍独立相关。我们还试图了解社会经济因素是否与这种利用方式有关。

方法

我们使用2015年国家健康与老龄化趋势调查(NHATS)对有功能性听力、表达或认知困难的医疗保险受益人(n = 5954)进行横断面分析。我们计算了加权的人群患病率以及控制了社会人口统计学、健康和其他残疾因素后的调整患病率比(APR)。

结果

在社区居住的老年人中,患有沟通障碍与在就诊时更高频率地使用沟通支持人员相关(APR:1.41 [CI:1.27 - 1.57])。在患有沟通障碍的成年人中,黑人成年人和女性的使用水平分别低于白人成年人和男性。

结论

沟通支持人员可能是患有沟通障碍的老年人自我应对残疾问题的一种方式。然而,并非所有患有沟通障碍的老年人都会带人前来,且存在因社会因素导致的差异,这可能表明存在未满足的支持需求。

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