老年失能患者居家照护不良事件现况及影响因素分析
|
摘要
目的通过调查老年失能患者居家照护不良事件的发生情况,对其影响因素进行分析,为进一步的干预提供依据。方法采用整群抽样法从宁夏医科大学总医院2016年1月至2017年1月15个收治老年失能患者最多的科室中随机抽取5个科室(康复科、神经内科、心内科、肾脏内科、全科医学科)。对符合纳入标准的492例出院老年失能患者及1名主要照护者进行调查,内容包括居家照护不良事件、日常生活活动能力、家庭照护能力。结果出院1年后,16.46%(81/492)的老年失能患者发生了居家照护不良事件。Logistic回归分析显示,居家环境不安全、使用辅助器具、返家医疗处置种类多、家庭照护能力得分是老年失能患者居家照护不良事件发生的影响因素(OR=0.627、3.307、0.583、0.939,P<0.05)。结论老年失能患者发生居家照护不良事件受多方面因素的影响,建议改造不安全居家环境,有针对性地培训照护者,提高家庭照顾水平,以减少居家照护不良事件的发生。
Objective To investigate home care adverse events among elderly incapacitated patients.Through the study of factors affecting to provide the basis for further intervention.Methods Adopted cluster sampling method,5departments (department of rehabilitation,department of neurology,department of cardiology,department of nephrology,department of general medicine)from the 15 departments with the largest number of elderly incapacitated patients in General Hospital of Ningxia Medical Universityfrom January 2016 to January 2017 were randomly selected.A total of 492 discharged elderly incapacitated patients and one primary caregiver who met the inclusion criteria were investigated,the survey included home care adverse events,activities of daily life,and family care ability.Results One year after discharge,16.46% (81/492)of the elderly incapacitated patients had home care adverse events.Multivariate logistic regression analysis showed that assessment of home environmental no safety,used assistive devices,many types of home nursing disposal,and home care ability scores were major influencing factors of home care adverse events among elderly incapacitated patients (OR=0.627,3.307,0.583,0.939,P<0.05).Conclusion Home care adverse events of elderly incapacitated patients is influenced by many factors.It is suggested to improve the unsafe home environment,train caregivers and improve the level of family care,so as to reduce the occurrence of home care adverse events.
Objective To investigate home care adverse events among elderly incapacitated patients.Through the study of factors affecting to provide the basis for further intervention.Methods Adopted cluster sampling method,5departments (department of rehabilitation,department of neurology,department of cardiology,department of nephrology,department of general medicine)from the 15 departments with the largest number of elderly incapacitated patients in General Hospital of Ningxia Medical Universityfrom January 2016 to January 2017 were randomly selected.A total of 492 discharged elderly incapacitated patients and one primary caregiver who met the inclusion criteria were investigated,the survey included home care adverse events,activities of daily life,and family care ability.Results One year after discharge,16.46% (81/492)of the elderly incapacitated patients had home care adverse events.Multivariate logistic regression analysis showed that assessment of home environmental no safety,used assistive devices,many types of home nursing disposal,and home care ability scores were major influencing factors of home care adverse events among elderly incapacitated patients (OR=0.627,3.307,0.583,0.939,P<0.05).Conclusion Home care adverse events of elderly incapacitated patients is influenced by many factors.It is suggested to improve the unsafe home environment,train caregivers and improve the level of family care,so as to reduce the occurrence of home care adverse events.
引文
[1]中华人民共和国民政部.2015年社会服务发展统计公报[EB/OL].2016-07-11[2017-01-12].http://www.mca.gov.cn/article.
[2]OSMUN WE,CHAN N,SOLOMON R.Approach to caring for developmentally disabled adults in the community:medical,ethical,and legal considerations[J].Can Fam Physician,2015,61(1):27-31.
[3]SCHILDMEIJER KGI,UNBECK M,EKSTEDT M,et al.Adverse events in patients in home healthcare:a retrospective record review using trigger tool methodology[J].BMJ,2018,8(1):1-10.
[4]靳修,芦鸿雁,禹晓琴.老年患者家庭照护能力量表的信效度研究[J].中国全科医学,2016,19(1):84-87.
[5]凡芸,马海萍,彭幼清.家庭病床患者护理不良事件现况调查及影响因素分析[J].中国全科医学,2017,17(15):1758-1761.
[6]MADIGAN E.A description of adverse events in home healthcare[J].Home Healthc Nurse,2007,25(3):191-197.
[7]GILL T,TAYLOR AW,PENGELLY A.Pengelly A.Apopulation based survey of factors relating to the prevalence of falls in older people[J].Gerontology,2005,51(5):340-345.
[8]胡梦梦,皮红英,宋杰.失能老人跌倒的危险因素及预防进展[J].护理管理杂志,2015,15(10):714-716.
[9]北京医院,国家老年医学中心,中国老年保健医学研究会老龄健康服务与标准化分会,中国老年保健医学杂志编辑委员会.居家(养护)老年人跌倒干预指南[J].中国老年保健医学杂志,2018,16(3):32-33.
[10]张晶,王斌全,魏绍辉.脑卒中失能老年患者辅助器具使用情况的调查分析[J].护理学杂志,2017,32(1):85-88.
[11]刘捷,赵庆华,肖明朝.社区失能老年人安全危险经历感受的质性研究[J].中国实用护理杂志,2014,30(35):1-4.
[12]彭培培,皮红英,聂丹.社区失能老年人照护服务需求调查研究[J].护理研究,2015,29(2):568-571.
[13]RODRIGUEZ M.Use of informal and formal care among community dwelling dependent elderly in Spain[J].Eur J Public Health,2013,24(4):668-673.
[14]靳修,张红,芦鸿雁.西部农村老年患者家庭照护能力的纵向研究[J].护理学杂志,2016,31(9):101-103.
[15]胡秀英,白春兰,徐小凤,等.急速老龄化进程下中国老年人全程健康照护模式探讨[J].中国护理管理杂志,2018,18(5):590-596.
[16]SINN CJ,BETINI RSD,WRIGHT J.Adverse events in home care:identifying and responding with inter RAI scales and clinical assessment protocols[J].Can J Aging,2018,1(8):1-10.
[2]OSMUN WE,CHAN N,SOLOMON R.Approach to caring for developmentally disabled adults in the community:medical,ethical,and legal considerations[J].Can Fam Physician,2015,61(1):27-31.
[3]SCHILDMEIJER KGI,UNBECK M,EKSTEDT M,et al.Adverse events in patients in home healthcare:a retrospective record review using trigger tool methodology[J].BMJ,2018,8(1):1-10.
[4]靳修,芦鸿雁,禹晓琴.老年患者家庭照护能力量表的信效度研究[J].中国全科医学,2016,19(1):84-87.
[5]凡芸,马海萍,彭幼清.家庭病床患者护理不良事件现况调查及影响因素分析[J].中国全科医学,2017,17(15):1758-1761.
[6]MADIGAN E.A description of adverse events in home healthcare[J].Home Healthc Nurse,2007,25(3):191-197.
[7]GILL T,TAYLOR AW,PENGELLY A.Pengelly A.Apopulation based survey of factors relating to the prevalence of falls in older people[J].Gerontology,2005,51(5):340-345.
[8]胡梦梦,皮红英,宋杰.失能老人跌倒的危险因素及预防进展[J].护理管理杂志,2015,15(10):714-716.
[9]北京医院,国家老年医学中心,中国老年保健医学研究会老龄健康服务与标准化分会,中国老年保健医学杂志编辑委员会.居家(养护)老年人跌倒干预指南[J].中国老年保健医学杂志,2018,16(3):32-33.
[10]张晶,王斌全,魏绍辉.脑卒中失能老年患者辅助器具使用情况的调查分析[J].护理学杂志,2017,32(1):85-88.
[11]刘捷,赵庆华,肖明朝.社区失能老年人安全危险经历感受的质性研究[J].中国实用护理杂志,2014,30(35):1-4.
[12]彭培培,皮红英,聂丹.社区失能老年人照护服务需求调查研究[J].护理研究,2015,29(2):568-571.
[13]RODRIGUEZ M.Use of informal and formal care among community dwelling dependent elderly in Spain[J].Eur J Public Health,2013,24(4):668-673.
[14]靳修,张红,芦鸿雁.西部农村老年患者家庭照护能力的纵向研究[J].护理学杂志,2016,31(9):101-103.
[15]胡秀英,白春兰,徐小凤,等.急速老龄化进程下中国老年人全程健康照护模式探讨[J].中国护理管理杂志,2018,18(5):590-596.
[16]SINN CJ,BETINI RSD,WRIGHT J.Adverse events in home care:identifying and responding with inter RAI scales and clinical assessment protocols[J].Can J Aging,2018,1(8):1-10.