老年住院患者日常生活活动能力的影响因素分析

Analysis of influential factors of activities of daily living of the elderly inpatients

目的分析老年住院患者日常生活活动能力(ADL)的影响因素,为提高老年患者生存质量提供依据。方法 275例老年住院患者为研究对象,收集其一般资料、Barthel指数评分、营养风险筛查评估表(NRS-2002)评分、体质量指数(BMI)、血常规、生化及总维生素D(VitD-T)结果 ,分析与老年住院患者ADL相关的影响因素。结果 275例老年住院患者中, 25例(9.1%)患者生活完全自理, 250例(90.9%)患者生活不能自理。单因素分析显示,生活完全自理患者与生活不能自理患者的年龄、NRS-2002评分、血清白蛋白(ALB)、前白蛋白(PA)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、白细胞计数(WBC)、血红蛋白(HGB)、VitD-T比较,差异均具有统计学意义(P<0.05);生活完全自理患者与生活不能自理患者的性别、BMI、甘油三酯(TG)、血小板计数(PLT)、红细胞计数(RBC)比较,差异均无统计学意义(P>0.05)。多元线性回归分析发现,年龄、NRS-2002评分、ALB、PA、TC、LDL-C、HGB是老年住院患者ADL的影响因素(P<0.05)。其中,血清ALB、TC和HGB是ADL的保护因素,年龄、NRS-2002评分、PA、LDL-C是ADL的危险因素。年龄、NRS-2002评分、PA、LDL-C与ADL呈负相关(r=0.283、0.136、0.020、0.042, P<0.05), ALB、TC、HGB与ADL呈正相关(r=0.082、0.166、0.124,P<0.05)。结论营养指标是老年住院患者ADL的影响因素;在临床护理工作中对老年住院患者及早进行营养评估和营养指导,改善其营养状态,可提升老年住院患者的生活自理能力,改善其疾病的预后和临床结局。

Objective To analyze the influential factors of activities of daily living(ADL) of the elderly inpatients, so as to provide basis for quality of life of elderly patients. Methods There were 275 elderly inpatients selected as the research subjects, their general data, Barthel index score, nutrition risk screening 2002(NRS-2002) score, body mass index(BMI), blood routine, biochemical and total vitamin D(VitD-T) results were collected, so as to analyze influencing factors related to ADL in elderly inpatients. Results Of the 275 elderly inpatients, 25 cases(9.1%) were completely self-care, and 250 cases(90.9%) were unable to take care of themselves. Univariate analysis showed that there were statistically significant differences in age, NRS-2002 score, serum albumin(ALB), prealbumin(PA), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), white blood cell(WBC) count, hemoglobin(HGB), VitD-T between patients who were completely self-care and those who were unable to take care of themselves(P<0.05). There was no statistically significant difference in gender, BMI, triglyceride(TG), platelet count(PLT), red blood cell(RBC) count between patients who were completely self-care and those who were unable to take care of themselves(P>0.05). Multiple linear regression analysis found that age, NRS-2002 score, ALB, PA, TC, LDL-C, HGB were the influencing factors of ADL in elderly inpatients(P<0.05). Serum ALB, TC and HGB were protective factors of ADL, age, NRS-2002 score, PA, LDL-C were risk factors of ADL. Age, NRS-2002 score, PA, LDL-C were negatively correlated with ADL(r=0.283, 0.136, 0.020, 0.042, P<0.05), ALB, TC, HGB were positively correlated with ADL(r=0.082, 0.166, 0.124, P<0.05). Conclusion Nutritional indicators are the influencing factors of ADL in elderly inpatients. In clinical nursing work, early nutritional evaluation and guidance for elderly inpatients can improve their nutritional status, improve their ability of self-care, prognosis and clinical outcome.