老年住院患者社会支持状况及影响因素的分析

目的 了解老年住院患者社会支持现状和预后的关系,进一步分析影响社会支持的相关因素.方法 选取同济大学附属同济医院老年科2012年4月至6月65岁以上符合条件的住院患者.住院期间,运用老年综合评估（CGA）对患者进行评估.老年综合评估由多个量表构成,其中包含有社会支持量表（SSRS）.根据社会支持量表评估结果将患者分为低组与中高组.出院后跟踪随访1年,1年后对患者再次入院和存活情况进行比较.本文统计学方法采用t检验、Х^2检验和多元回归分析.结果 老年住院患者社会支持总分（26.58±8.99）低于国内常模（34.56±3.73）（t=-7.52,P＜0.05）,其中高龄、家庭成员人数少、情绪低落、日常生活能力和工具性日常生活能力差的住院患者社会支持较低（t=-2.54、8.22、-6.61、6.72、6.95,P＜0.05）,同时无配偶的患者社会支持也较低（Х^2=8.58,P＜0.05）.随访后,两组患者再次入院与存活人数无明显差异（Х^2=1.94、3.28,P＞0.05）.采用多元回归分析显示,社会支持的主要影响因素是家庭成员人数、性格特征和生活能力.结论 医护人员应积极关注老年住院患者,根据具体影响因素给予社会支持,提高患者生活质量.

Social support of elderly in-patients and its influential factors

Objective To investigate the social support of the elderly hospitalized individuals and its relationship with outcomes and to study its influential factors.Methods The elderly in-patients aged〉65 years old who were treated from April to June 2012 in Geriatric Department were recruited.The comprehensive geriatric assessment （CGA） that included social support scale （SSRS） was used.According to SSRS,the patients were assigned to the lower or higher score group.The participants were followed up for 1 year,and 12-month mortality and re-hospitalization were recorded.Student＇s t test,Chi-square test and multiple logistic regression were used for data analysis.Results The total score of social support was 26.58±8.99,which was significantly lower than the national norm （34.56±3.73,t =-7.52,P〈0.05）.Those with advanced age,less household,depression,insufficient ability of daily life and instrument daily life showed relatively lower SSRS （t values were-2.54,8.22,-6.61,6.72 and 6.95,respectively; all P〈0.05）.The patients with no spouse also got less social support （Х^2 =8.58,P〈0.05）.At 1 year,no significant difference of re-hospitalization and mortality was found between the two groups （Х^2 values were 1.94 and 3.28,respectively; both P〉0.05）.In multiple logistic regression analysis,fanily member,characteristics and living ability were the major influential factors of social support.Conclusions Medical staff should pay more attention to the elderly hospitalized patients and offer them sufficient social support to improve their quality of life.