老年患者日常生活自理能力及相关因素分析

Analysis of daily living self-care ability and related factors in elderly patients

中文关键词: 老年    日常生活活动能力    年龄    护理等级    院内管理

英文关键词: elderly  activities of daily living ability  age  nursing level  in-hospital management

中文摘要:

      目的 分析老年患者日常生活活动能力随年龄变化的规律性及相关因素，为制定临床老年住院患者院内管理策略提供依据。方法 回顾性横断面选取2022年6月1日至2023年6月1日复旦大学附属华山医院接诊的61 776例60岁以上全病因老年住院患者；收集医院数据库中，全病因老年住院患者入院当天的一般资料、护理级别及日常生活活动能力等信息，分析Barthel指数总分及其子项目与年龄的相关性及其变化规律。结果 纳入研究的患者中，男性35 396例(57.3%),女性26 380例(42.7%);年龄61～105岁，平均(70.71±7.56)岁；日常生活活动重度依赖者8 317例(13.4%),中度依赖者4 932例(8.0%),轻度依赖者43 115例(69.8%),无需依赖者5 412例(8.8%)。自理能力与护理等级均与年龄呈显著负相关，相关系数分别为0.272、 0.178;自理能力与护理等级呈显著正相关，相关系数为0.614; Barthel指数及其子项与年龄均呈显著负相关。Barthel指数总分随年龄增长有逐渐下降的趋势；子项目中，平地行走和床椅转移的下降趋势最为显著。结论 临床老年患者日常生活活动能力会随着年龄的增长而下降。对老年患者日常生活活动能力影响较明显的是下肢步行与转移功能，应作为老年住院患者临床管理的重点。

英文摘要:

      Objective To analyze the regularity and related factors of the activities of daily living(ADL)ability of elderly patients with age,and provide a basis for formulating management strategies for elderly inpatients in clinical practice.Methods A retrospective cross-sectional study was conducted on 61 776 elderly inpatients aged 60 years and above with all-cause conditions admitted to Huashan Hospital Affiliated to Fudan University from June 1,2022,to June 1,2023.Their general information,nursing level,and ADL ability on the day of admission were collected from the hospital database.The correlation and changing regularity between the total score of the Barthel Index and its sub-items and age were analyzed.Results Among the included patients,35 396(57.3%)were male and26 380(42.7%)were female,with an age range of 61-105 years and a mean age of(70.71±7.56)years.There were8317 patients(13.4%)with severe dependence in ADL ability,4 932(8.0%)with moderate dependence,43 115(69.8%)with mild dependence,and 5 412(8.8%)with no dependence.Both self-care ability and nursing level were significantly negatively correlated with age,with correlation coefficients of 0.272 and 0.178,respectively.The self-care ability was significantly positively correlated with nursing level,with a correlation coefficient of 0.614.Both the Barthel Index total score and its sub-items were significantly negatively correlated with age.The Barthel Index total score showed a gradual decline with increasing age.Among the sub-items,the most pronounced declines were observed in walking on flat ground and transfer between bed and chair.Conclusion The ADL ability of clinical elderly patients decreases with age.The functions related to lower limb walking and transfers have a more pronounced impact on ADL ability.Therefore,they should be the focus of clinical management for elderly inpatients.