老年失能患者居家照护不良事件现况及影响因素分析

Analysis on the status of home care adverse events and influence factors of the elderly incapacitated patients

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,5 departments(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 University from 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.