80岁以上独居老人居家致跌环境干预效果评估

目的通过对社区老年人居家环境的安全性评估,促进居家致跌危险环境改造,降低老年人跌倒的发生。方法在上海市某社区选取全部80岁以上独居老人家庭,2009年8月进行入户评估调查,观察居家致跌危险环境,完成《评估表》,并且提出整改意见,首次入户后发放宣传资料、防滑垫,街道政府安装扶手和督促整改,2010年8月再次入户调查并进行效果评估。结果干预前跌倒发生人次率为22.87%,因跌倒住院人次率为4.62%。干预后跌倒发生人次率为4.62%,因跌倒住院发生人次率为0.49%,干预前后跌倒的发生率(χ2=41.304,P<0.05)和住院发生率(χ2=12.122,P<0.05)显著下降,差异均有统计学意义。干预后居家致跌环境也有了明显的改善。结论居家致跌环境因素增加了老人跌倒发生的风险,开展有针对性的居家危险环境评估并改造意义重大。     

上海市花木社区独居老人心理健康及睡眠状况调查分析

随着上海市人口老龄化的迅速发展,老年人口比重的上升,老年人口中一个特殊的群体—独居老人群体的规模也在不断扩大,据统计上海市独居老人近19万人.独居老人由于其家庭功能受损,相对于与子女同住的老人而言,他们的生存境况不容乐观.目前的现状是给予老人生活、身体健康的关心照护较多,而忽视了老年心理状况的变化.本次调查旨在分析上海市花木社区独居老人心理健康及睡眠状况,探讨解决问题的方法和策略,提高独居老人的生活质量.     

社区照顾对独居老人健康水平的影响研究

目的：探究社区照顾对独居老人健康水平的影响。方法：采用2018年中国老年健康影响因素跟踪调查（CLHLS）中独居老人的全样本,基于有序Probit模型分析不同社区照顾内容对独居老人健康水平的影响,并从性别和年龄两个角度进行异质性分析。结果：起居照料对独居老人各维度的健康水平均有显著正向影响,日常购物能显著提升独居老人的自评健康和心理健康水平,上门看病和情感慰藉只是对健康保持的影响较为显著。异质性分析发现,起居照料和日常购物对高龄独居老人自评健康和心理健康的影响更为显著,上门看病和情感慰藉更利于男性独居老人提高自评健康和心理健康水平。结论：建立独居老人档案,引入“日间照料中心”“跨代共居”等市场化手段,为独居老人打造居家与社区机构相结合的健康支持体系。     

老西门社区独居老人生活状况与卫生服务需求调查

为科学制订社区老年人保健计划，完善社区老龄服务，我们对上海市黄浦区老西门社区独居老人的生活状况与卫生服务需求进行了调查，现报道如下。     

上海某社区独居老人心理健康状况6年随访调查

目的为有效地开展社区独居老人的心理健康服务提供依据。方法每3年随访调查1次,每次调查采用二阶段分层随机抽样方法入户调查,调查工具自编一般情况问卷,心理健康筛查量表选用症状自评量表(SCL-90)及抑郁自评量表(SDS)。结果 418名随访独居老人中,每月≤1次或无子女(亲友)探望者达27%,有5.0%的独居老人无子女或因各种原因无电话联系;2005年、2008年和2011年的随访发现,出现各种心理异常状况的比例分别为72.25%、46.89%和53.40%;采用症状自评量表(SCL-90)筛查阳性的比例分别为31.58%、22.01%和25.24%;抑郁自评量表(SDS)总分>53常模的独居老人分别占25.60%、11.72%和17.48%。结论独居老人由于子女离去而失去相应的社会支持和情感交流对象,缺少精神慰藉已成为独居老人心理健康的主要问题之一,如何关注独居老人心理健康问题是老年社会服务的重要课题,值得进一步研究。     

关于对独居老年人开展社区综合性康复适宜技术的评估和分析

目的探索社区综合性康复适宜技术对独居老年人的作用。方法以问卷形式调查黄浦区老西门街道418名≥60岁独居老人对于社区综合性康复适宜技术干预的认可率和满意率。结果干预后，社区独居老人对综合性康复适宜技术的认可率以及对本中心,综合服务的满意率均高于干预前，差异有统计学意义（P＜0．01）。结论社区各层面应重视综合性康复适宜技术的持续推广应用，提高独居老人的生活质量。     

老年人家中致跌危险因素评估

老年人跌倒的年发生率约为30％~([1,2])。跌倒在老年人往往导致骨折和其他创伤等严重后果,甚至危及老人生命~([1,3,4,5,6,7]),故预防跌倒是维护老人的生命和健康,促进健康老龄化的重要课题。致老年人跌倒的原因较复杂,多与个体和环境因素有关~([6,8])。家庭是中国老年人养老的主要场所。据报道,老年人3/4的跌倒发生在家中~([9]),故居家环境安全是预防跌倒的基本措施。文献曾报道用居家安全量表评估居家环境危险因素,各作者采用的评估方法各异,得出的结论亦不同~([1,10])。本研究的目的是用居家环境致跌危险因素评估     

上海市花木社区80岁以上独居老人社区卫生利用及需求调查

随着社会的进步与发展,老龄人口迅速增加,空巢老人、独居老人数量也相应增加.80岁以上独居老人更是社区老人中一个特殊群体,也是政府与社会关注的热点.老年人作为慢性病的主要人群,其慢性病管理与医疗护理不可能集中在医院进行[1],社区卫生服务中心则成为这些工作的主要承担者.依据以需求为导向[2]合理使用医疗护理资源的原则,我们对花木社区80岁以上独居老人的社区卫生服务利用现状及需求意愿进行了调查.     

社区独居老人防治意外伤害知晓率干预效果分析

上海是一个老龄化城市。截止2008年末，上海全市户籍人口1391．04万人。60岁及以上老年人口300．57万人，占总人口的21．6％。“纯老家庭”老年人总数86．38万人，其中80岁及以上老年人24．26万人，单身独居老年人18．80万人。意外伤害是影响老年人健康的原因之一。上海市意外伤害死亡率排在心脑血管疾病、肿瘤疾病、呼吸道疾病之后，位列第四，其中，老年人摔倒占了一半左右。     

独居老人自救要牢记

随着独居老人的增多，安全如何保证至关重要。因为独居老人一旦身体有恙或发生意外而没有被及时发现，很容易出现不测。因此，独居老人学会自救很重要。     

独居老年人生活及精神健康状况调查

目的分析山东省济南市独居老年人生活现状及精神健康状况。方法采用调查问卷收集160名独居老人和911名非独居老人的生活现状及精神健康状况等,应用2χ检验和秩和检验进行统计分析。结果独居老人中女性99人,占61.88%,男性61人,占38.12%,平均年龄为74.45岁,文化程度小学及以下105人,占65.62%;城乡独居老人的平均月收入分别为1 816.40和274.46元,非独居老人分别为1 911.37和372.59元;城乡独居老人中从不与亲戚、朋友交往的比例分别为20.93%和25.68%;从不参加体育活动的比例为60.47%和94.59%;独居老年人的精神健康得分为45.21分,低于非独居老年人的46.81分。结论与非独居老人相比较,独居老年人尤其是农村独居老人的生活状况较差,精神健康水平较低,需进一步改善。     

Loneliness and social support of older people living alone in a county of Shanghai,China

China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross‐sectional questionnaire survey with a stratified random cluster sample of 521 community‐dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one‐to‐one ‘befriending’ and group activity programmes together with identification of vulnerable subgroups.     

Older people living alone in Shanghai: A questionnaire survey of their life experience

Globally the number of older people living alone is increasing. Little is known about the life experience of older people living alone in Mainland China. This study aimed to explore older people's experience regarding different components of their lives. A cross‐sectional survey of 387 older people aged 60 years and above and living alone in two communities in Shanghai was conducted from April to July 2015. A structured questionnaire including 15‐item Geriatric Depression Scale, Activity of Daily Living Scale, UCLA Loneliness Scale version 3, Social Support Rate Scale and Older People's Quality of Life Questionnaire was used to assess the health status, loneliness, social support, quality of life and demographic information. A total of 15.7% of the participants rated their health as poor with 56.8% reporting chronic diseases and 26.9% reporting being depressed. A total of 71.1% of the participants reported a high level of functional ability. However, 54.3% and 21.7% of the participants reported a moderately and moderately high level of loneliness respectively. The median of SSRS was 30 and the mean of Older People's Quality of Life Questionnaire was 120.2, indicating a lower level of social support and quality of life. There were statistically significant differences in health, loneliness, social support and quality of life across the participants with different characteristics. Interventions to improve the health status, reduce loneliness, increase social support and maintain or improve quality of life of older people living alone in Shanghai could be developed and implemented. Potential interventions include providing frequent home care services, early detection of depression, encouraging more contacts from children and other family members, and providing support from other sources.     

Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham, UK

The objectives of this work were: to estimate the incidence of falls within an at-risk group of community-dwelling elderly people; to assess the risk factors associated with incident falls; to examine the effects of incident falls on survival. A random sample of 1042 community-dwelling older people in Nottingham (UK) were interviewed in 1985 and survivors re-interviewed at 4-year follow-up. The at-risk group was defined as survivors who had not fallen in the year prior to the baseline interview (n=444). One-year fall recall was assessed using a questionnaire and included physical health, mobility, prescribed drugs and time spent walking. Body-weight and handgrip strength were measured. Eight-year post-fall mortality was recorded. In 1989 117 new fallers were identified. These people fell a total of 233 times in the year prior to re-interview (incidence rate: 524.8 per 1000 person-years at risk; 95% confidence intervals (CI): 473.3–576.3). People aged less than 75 were more likely to fall outdoors than people aged 75and over (2=5.715, df=1, p=0.017). Risk factors associated with falling were: being less healthy (odds ratio (OR): 0.55; p=0.052); having a walking speed in the range stroll/very slow/non-ambulant compared with normal/brisk/fast (OR: 1.99; p<0.01); and number of prescribed drugs (OR: 1.30; p=0.01). When analysed separately, indoor and outdoor falls presented differential risk profiles, with evidence that indoor falls were associated with frailty, while outdoor falls were associated with compromised health status in more active people. In 8-year post-fall monitoring, multiple (3+) fallers and indoor fallers showed a significant excess mortality. The differences in risk factors for, and prognoses following, indoor and outdoor falls, emphasise the complex interactions between intrinsic and extrinsic factors associated with falling among older people.     

石家庄市社区老年人预防跌倒知识与行为调查

目的 了解石家庄市社区老年人预防跌倒知识、态度与行为的现况,为制订老年人跌倒的干预措施提供依据.方法 采用分层随机抽样方法,按照石家庄市老年人口的比例,随机抽取石家庄市桥西区维明社区和开达社区的60岁及以上、居住至少满1年的老年人作为调查对象.结果 1609名调查对象中关于“别人适用的拐杖不一定适合您使用”的知晓率最高,为88.4％,关于“服用药物会增加跌倒的风险”的知晓率最低,仅为26.7％;预防跌倒相关行为中关于“因为担心跌倒而减少自己的日常活动或运动”比例最高,为74.1％,“目前正在服用钙片”比例最低,为18.4％.结论 石家庄市社区老年人预防跌倒知识知晓率及相关行为实施率处于低水平.     

我国独居老人自评健康状况及其影响因素研究

目的 了解影响我国独居老人自评健康状况的影响因素,为改善我国独居老人健康及生活质量提供参考依据。方法 通过自评问卷调查方法,采用2018年中国老年健康影响因素跟踪调查（CLHLS）数据,了解独居老人健康状况,采用卡方检验以及多因素logistic 回归方法分析独居老人健康状况的影响因素。结果 1236名独居老年人中,自评健康较好的有551人,占比44.6%,较差的685人,占比55.4%;子女经常看望（OR =1.840,95%CI:1.080~3.135)、体育锻炼（OR =1.813,95%CI:1.385~2.372)、饮酒（OR =1.531,95%CI:1.061~2.209）、体检（OR =1.347,95%CI:1.033~1.756）、慢性病(OR =0.682,95%CI:0.532~0.875)、霉味(OR =0.533,95%CI:0.391~0.726)、睡眠6~9小时（OR =0.528,95%CI:0.393~0.710）、睡眠时间>9小时（OR =0.411,95%CI:0.283~0.597）与独居老人自评健康有关。结论 我国独居老人自评健康状况总体较差。应重视独居老人的子女关怀、生活行为方式、居住环境及慢性病状况等,更好地改善独居老人的健康状况。     

独居老年人常见心理问题的社区干预评价

目的探讨适宜的丰十区干预措施对独居老年人心理健康的作用。方法采用“症状自评量表（SCL-90）”、“抑邯自评量表（SDS）”和自制问卷调查表。对老西门社区418名≥60岁独居老人作心理健康水平问卷调查，什展“生理-心理-社会”综合干预并进行效果评价。结果经过干预。研究对象的SDS评分和情绪低落、抑郁及焦虑的发生率均较干预前下降，差异有统计学意义（P＜0．01）。结论社区全科医学综合干预刘改善独居老人心理健康水平。提高其生活质量是行之有效的。     

独居老年人心理健康状况与社会支持关系

目的了解独居老年人心理健康与社会支持的关系,为改善独居老年人的生活质量提供依据。方法用健康自评量表(SRHMS)对云南省昆明市18个社区中≥65岁的63名独居老年人和112名对照进行测评和比较。结果独居老年人心理健康和正向情绪得分分别为(5.78±1.68)和(6.62±2.29)分,明显低于对照(6.59±1.46)和(7.49±1.76)分(P0.01);角色活动/社会适应(6.13±1.72)分,社会资源/社会接触(5.51±2.24)分、社会支持(5.52±1.91)分,明显低于对照的(7.14±1.76),(6.79±1.81),(6.37±1.61)分(P0.01)。结论独居老年人的心理健康较差,社会支持亟待加强。     

老西门社区独居老年人慢性病现患状况分析与对策探讨

目的了解本社区独居老年人慢性病患病状况，为开展有效健康干预提供依据。方法采用随机抽样方法对社区中418名≥60岁的独居老人作慢性病患病情况的问卷调查。结果独居老年人的慢性病患病率高，心血管病、骨质疏松症等疾病顺位靠前，92．82％的老人同时患有1至数种慢性疾病。结论要重视独居老年人慢性病的防治和管理，以降低患病率，提高独居老年人生活与生命质量。     

Incidence, risk factors and consequences of falls among elderly subjects living in the community: A criteria-based analysis

In order to obtain an overview of the incidences, risk factorsand health consequences of falls among elderly persons livingin the community from the available literature, a Medline computersearch of publications over the period 1981–1994 was carriedout. Fourteen studies met the following inclusion criteria:i) the study is an original investigation of falls among theelderly, ii) the study deals with the incidence, risk factorsand/or consequences of falls among the elderly and iii) thestudy refers to a population at risk consisting of persons aged60 years or over belonging to a population relevant to generalpractice. The selected studies were subjected to a methodologicalassessment on the basis of 10 methodological criteria. All thestudies were independently assessed by 1 author and 1 assistantto obtain a methodological consensus. The relevant outcomesof these studies are reported. Pooling of data was not performedbecause of relevant differences between the studies. Two studiesmet all methodological criteria and 2 other studies were secondbest. These 4 studies were given preference. Approximately 30%of subjects older than 65 years fall at least once a year andapproximately 15% fall recurrently. The main risk factors forfalls among the elderly belong to the intrinsic (patient-related)risk factors: cognitive impairment, balance and gait disorders,use of sedatives and hypnotics, a history of stroke, advancedage, arthritis of the knee and a high level of dependence. Extrinsic(environment-related) risk factors did not play a significantrole in any of the studies. Not all studies dealt with the healthconsequences of falls among the elderly. Major injuries werereported in 0.5–9% and fractures in 3–14%.