社会支持和应对方式对Housebound老年人家庭照顾者照顾负担的影响

目的:了解社会支持和应对方式对Housebound老年人家庭照顾者照顾负担影响,为改善其照顾负担提供依据。方法:于2017年12月〜2018年1月,对唐山市社区Housebound老年人家庭照顾者应用一般情况调查表、社会支持量表、特质应对方式量表和Zarit照顾者负担量表进行调查。结果:Housebound老年人家庭照顾者照顾负担总分为(32.60±20.94)分,处于中等水平;积极应对与照顾负担总分呈负相关(P<0.05),消极应对与家庭照顾者照顾负担总分呈正相关(P<0.05),社会支持与照顾分担总分呈负相关(P<0.05);多因素回归分析显示:性别、年龄、老年人关系、婚姻、文化程度、月收入、工作情况、照顾老年人时间、与社会支持、应对方式是家庭照顾者照顾负担的影响因素。结论:Hoiiseboimd老年人家庭照顾者感知的照顾负担呈中等水平,社区工作之中应引导其采取积极的应对方式,加强社会支持,使其照顾负担感知降低。     

国外老年人居家不出(housebound)及其影响因素的研究现状

居家不出(house bound)或称为"home-bound",最早对housebound的关注是从1963年开始,由美国人Snellgrove~([1])提出.当时的研究背景是:在率先进入老龄化社会的发达国家,伴随着老年人口的增加,出现了卧床人群也随之增长的问题,消耗了大量的医疗经费、降低了老年人群的生活质量,给医疗、护理、家庭照顾、社会支援等方面带来了巨大的压力.     

老年职工Housebound的躯体、心理、社会因素分析

[目的]探讨housebound在老年职业人群中发生的影响因素. [方法]对A市某煤业集团所有住宅社区进行随机整群抽样,共抽取4个社区,对抽得4个社区内60岁及以上老年职工采用自行编制的调查量表及国际通用量表(FIM、GDS简表),进行面对面访谈式调查. [结果]老年职业人群housebound发生率为17.59%.单因素分析发现:年龄、婚姻、经济收入、家庭人口数、住房层次、视力障碍、听力障碍、脑卒中、糖尿病、饮酒、锻炼身体、爱好、健康自我评价、孤独、抑郁、有无亲密朋友、参加社会活动、与邻居交往情况、亲属往来等因素影响housebound的发生.非条件多因素Logistic回归分析表明:外出需要照顾、自理能力差、文化程度高、住房面积大、不锻炼身体、社会活动少、无亲密朋友、抑郁是housebound发生的危险因素. [结论]Housebound在老年职业人群中发生率较高.影响housebound发生的因素包括躯体、心理和社会各方面,因此应采取相应的措施来预防和控制housebound的发生.     

社区老年人居家不出危险因素分析及风险预测模型构建

目的 了解社区老年人居家不出的现状和风险因素,并构建其风险预测模型。方法 采用便利抽样方法对青岛市3个社区中符合条件的587名社区老年人采用统一调查问卷（一般资料、居家不出状态、日常生活活动能力量表、老年抑郁量表和社会支持评定量表等）入户访谈式调查,采用单因素分析和Logistic回归分析居家不出风险因素,建立风险预测模型,采用ROC曲线下面积对预测模型进行评价。结果 587名调查对象中居家不出者107名（18.2%）,本研究共纳入高龄（81~96岁,OR=3.062）、经济来源为政府低保（OR=33.199）、缺乏兴趣爱好（OR=4.285）、缺乏身体锻炼（有时,OR=9.457;不锻炼,OR=32.432）、严重功能障碍（OR=7.609）、抑郁（OR=16.050）6个危险因素。基于以上危险因素构建的风险预测模型ROC曲线下面积为0.937,灵敏度为0.944,特异度为0.765,Youden指数为0.709。结论 社区老年人居家不出发生率较高,影响居家不出发生的高危因素较多,在社区工作中应进行及时有效评估。构建的居家不出风险预测模型具有较高的预测能力和判断能力,可作为社区老年人居家不出的风险筛查工具。     

煤矿老年职工居家不出现状及影响因素分析

且的探讨某煤业集团离退休老年职业人群中居家不出发生的现状及影响因素。方法对某市某煤业集团所属住宅社区进行随机整群抽样，共抽取4个社区，采用自行编制的调查表及国际通用量表，对社区内≥60岁老年职工进行外出状况、自理能力、心理状况、社会活动等内容面对面访谈式调查，并进行单因素及多因素分析。结果该集团老年职业人群居家不出发生率为17.59%。单因素分析发现，年龄、婚姻、经济收入、住房层次、生活需要照顾、视力障碍、听力障碍、脑卒中、糖尿病、日常生活能力、饮酒、锻炼身体、爱好、健康自我评价、孤独、抑郁、有无亲密朋友、参加社会活动、与邻居交往情况、亲属往来等因素影响居家不出的发生。非条件Logistic回归分析表明，日常生活需要照顾、高文化程度、高经济收入、不锻炼身体、不参加社会活动、无亲密朋友、抑郁、日常生活自理能力（FIM）差是居家不出发生的危险因素。结论居家不出在该集团老年职业人群中发生率较高。影响居家不出发生的因素包括躯体、心理和社会各方面。因此，应采取相应措施预防和控制居家不出的发生。     

老年人居家不出现状及心理因素分析

目的 了解河北省唐山市社区老年人居家不出状况及进行心理因素分析.方法 对唐山市社区采用随机整群抽样调查方法,抽取5个社区.对社区内符合条件的60岁～的老年人,采用统一的调查量表进行调查,根据外出频率以每周外出1次以及几乎不外出作为居家不出的评价标准,并进行心理状况分析.结果 老年人居家不出发生率为18.78%.不同年龄组间居家不出发生率差异有统计学意义(P<0.01),随着年龄的增长老年人居家不出发生率也在增加;无配偶的老年人居家不出发生率23.46%,高于有配偶的老年人17.00%,女性居家不出发生率28.87%,较男性15.95%老年人高;不同职业老年人居家不出发生率差异有统计学意义,干部的发生率较低(P<0.05).老年人心理状况影响居家不出发生率,自我评价不健康、有孤独、抑郁者居家不出的发生率较高.结论 老年人居家不出发生率较高,应采取措施预防和控制居家不出的发生,关注老年人心理健康.     

Incidence of disability in housebound elderly people in a rural community in Japan

Background:   Although being housebound is acknowledged conceptually as a risk factor for disability and social isolation, there has been little epidemiologic research on housebound status. This study aimed to explore whether being housebound is a risk factor for disability and whether a low level of social contact increases that risk in elderly persons.
Methods:   A questionnaire pertaining to demographic characteristics was administered to 2932 community-dwelling elderly persons (aged 65 years and older) in October 2000. There were 2459 responses, and 2180 respondents were independently performing activities of daily living. Of these, 2046 were followed up until March 2003. These 2046 people became the subjects of our analysis. At the end of the follow-up period, the 2046 subjects were assessed for disability.
Results:   Overall, 7.5% of the subjects were housebound at baseline, and about half of these were able to leave the house unassisted, seldom did so but had social contact. At the end of the follow-up period, 12.7% of subjects were identified as disabled. The incidence of disability was higher in housebound than in non-housebound subjects aged less than 85 years but did not differ significantly among subjects aged more than 85 years. Levels of disability were higher in all housebound subjects groups than in non-housebound subjects. Subjects without social contact exhibited a higher incidence of disability than others, although the difference was not statistically significant.
Conclusion:   Being housebound appears to be a risk factor for disability in community-dwelling individuals aged 65–85 years who are living independently, but a low level of social contact was not proved to be an additional risk factor for disability among housebound elderly persons.     

青岛市社区老年人居家不出现状及影响因素研究

目的了解社区老年人居家不出现状及影响因素,为针对性干预提供参考。方法对587名老年人采用一般资料调查问卷、居家不出状态量表、日常生活能力量表、老年抑郁量表和社会支持评定量表进行问卷调查。结果 587人中居家不出107人(占18.2%),不同性别、年龄、婚姻状况、经济来源、患病种数、吸烟饮酒情况、活动爱好、锻炼身体、助行器使用、日常生活能力、抑郁及社会支持度的老年人居家不出发生率差异有统计学意义(均P0.01),其中高龄、缺乏活动爱好、疏于锻炼身体、抑郁状态、日常生活能力及收入低下是居家不出的危险因素(OR=3.062～33.199)。结论社区老年人居家不出发生率较高,应针对主要影响因素制订切实可行的干预措施,帮助老年人尽可能多地外出,以丰富老年人生活,实现积极养老。     

Characteristics of housebound elderly by mobility level in Japan

Abstract The purpose of the present study was to describe characteristics of the housebound elderly by their mobility levels. Disabled elderly people in Japan were interviewed at home by nurses. Housebound status was defined as people who left the house less than once a week. Characteristics of housebound elderly were compared with non-housebound elderly by three mobility levels: (i) Non-walking group ( n = 72); 5 m-walking group ( n = 153); going-by-bus group ( n = 96). Housebound elderly were not found in the going-by-bus group. Among the elderly in the non-walking group, the cognitive function of the housebound elderly was significantly lower and the housebound elderly were less well cared for; however, their caregivers rated their caregiving burden significantly lower than did caregivers of the non-housebound elderly. Among those in the 5 m-walking group, the autonomy and social networks of the housebound elderly were significantly less than for the non-housebound. The characteristics of housebound elderly showed differences by mobility levels.     

老年人居家不出现状及与健康自评、抑郁关系

目的 探讨老年居家不出状态与健康自评、抑郁的关系.方法 以河北省唐山市5个社区内≥60岁的老年人为研究对象,采用面对面访谈式方法进行问卷调查;应用SPSS 13.0软件进行单因素和多因素非条件Logistic回归分析.结果 在调查的1 475名老年人中,老年居家不出状态发生率为18.8%,女性居家不出状态发生率(20.9%)高于男性(15.9%),无配偶者居家不出状态发生率(23.5%)高于有配偶者(16.9%),随年龄增高居家不出状态发生率也随之增加,差异均有统计学意义(P<0.01);非条件Logistic回归分析结果显示:不锻炼、抑郁、高龄、女性、健康自评差是居家不出状态发生的危险因素.结论 健康自评、抑郁与老年人居家不出状态的发生相关.