北京市东城区老年人失能状况评估分析

Assessment and analysis of disability status of elderly people in Dongcheng District of Beijing

  • 摘要:
      目的  采用失能老年人健康评估量表评估北京市东城区托底、扶助老年人及养老机构老年人失能状况。
      方法  选取北京市东城区9个街道、4家养老院的老年人,2019年10月采用问卷调查法进行入户评估,分析失能老年人健康评估量表结果。
      结果  评估老年人共526例,有效人数507例,平均年龄为(85.96±5.92)岁。日常生活活动能力量表得分为(23.08±20.73)分;精神状态与社会参与能力评估表的总得分为(10.53±9.26)分;感知觉与沟通能力评估量表的总得分为(3.01±2.51)分。老年综合征罹患项数为(2.38±1.54)个。失能共分5级,0级(能力完好)45例(8.87%),1级(轻度失能)123例(24.26%),2级(中度失能)131例(25.84%),3级(重度失能)110例(21.70%),4级(极重度失能)98例(19.33%)。老年综合征罹患项数越多,失能等级越高,差异有统计学意义(P < 0.05)。多因素分析显示失能严重程度与跌倒(OR=3.40)、谵妄(OR=4.32)、多重用药(OR=1.82)、携带管路(OR=5.26)、慢性疼痛(OR=2.68)、睡眠障碍(OR=1.92)、吞咽障碍(OR=5.69)呈正相关。
      结论  建议整合区域内资源,发展以社区为依托的居家照护,提升养老机构服务能力,尽早识别并干预老年综合征,为失能老年人提供精准服务。

     

    Abstract:
      Objective  To evaluate the disability status of the elderly people with policy arrangement, support and in nursing facility in Dongcheng District of Beijing by the Health Assessment Scale for disabled elderly people.
      Methods  The elderly people from 9 streets and 4 nursing facilities in Dongcheng District of Beijing were selected and assessed at home by questionnaire in October 2019, and the results of the Health Assessment Scale for Disabled Elderly People were analyzed.
      Results  A total of 526 elderly patients were evaluated, and 507 of them were effective in evaluation, with an average age of (85.96±5.92) years. The score of Activities of Daily Living was (23.08±20.73) points, the total score of Scale for Mental State and Social Participation Capacity was (10.53±9.26) points, and the total score of Scale for Perception and Communication Ability was (3.01±2.51) points. The number of geriatric syndromes was (2.38±1.54). Assessment of disability were classified into 5 grades, including 45 cases (8.87%) with grade 0 (normal capability), 123 cases (24.26%) with grade 1 (mild disability), 131 cases (25.84%) with grade 2 (moderate disability), 110 cases (21.70%) with grade 3 (severe disability) and 98 cases (19.33%) with grade 4 (extremely severe disability). The more the number of items of geriatric syndrome was, the higher the disability grade would be, and there was a significant difference (P < 0.05). Multivariate analysis showed that the severity of disability was positively correlated with falling (OR=3.40), delirium (OR=4.32), multiple drug use (OR=1.82), carrying pipeline (OR=5.26), chronic pain (OR=2.68), sleep disorder (OR=1.92) and dysphagia (OR=5.69).
      Conclusion  It is suggested to integrate regional resources, develop community-based home care, improve the service ability of nursing facility for elderly people, identify and intervene geriatric syndrome as soon as possible, and provide accurate services for the disabled elderly people.

     

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