排便异常对高龄老年人身心健康影响

Effect of abnormal defecation on physical and mental health among community oldest elderly

目的了解唐山市高龄老年人排便异常的情况,分析排便异常对高龄老年人身心健康的影响。方法于2016年7月—2017年1月,采用分层随机整群抽样方法,选取唐山市10个社区卫生服务中心下设的各社区中≥75岁的老年人,使用日常生活能力量表、孤独量表、家庭支持量表进行评测。结果3448名高龄老年人中存在排便异常的占54.37%,其中小便失禁者占11.5%;大便失禁者占9.2%;便秘者占33.6%。存在不同程度的日常生活功能障碍者占48.2%,中等程度及以上孤独感的占69.0%。多因素分析结果显示,小便失禁(OR=3.242)、大便失禁(OR=1.576)、便秘(OR=1.562)、文化程度(OR=0.854)、家庭支持(OR=0.783)是高龄老年人日常生活功能障碍的影响因素;小便失禁(OR=1.861)、大便失禁(OR=1.540)、便秘(OR=1.488)、文化程度(OR=0.636)、家庭支持(OR=0.393)是高龄老年人孤独感的影响因素(均P<0.05)。结论高龄老年人身心健康状况不容乐观,通过分析排便异常对高龄老年人身心健康的影响,提出有针对性的身体照护和精神照护,提高高龄老年人的生活质量,实现健康积极老龄化。

Objective To examine the prevalence of abnormal defecation and its influence on physical and mental health among community-dwelling oldest elderly in Tangshan city.Methods We conducted a household questionnaire survey among 3448 residents aged≥75 years recruited with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city of Hebei province between July 2016 and January 2017.Activities of Daily Living,University of California at Los Angeles Loneliness Scale,and Perceived Social Support from Family were used in the study.Results The self-reported prevalence rate of abnormal defecation was 54.37%among all the participants.Of the participants with abnormal defecation,33.6%,11.5%,and 9.2%reported constipation,urinary incontinence,and fecal incontinence.Various degree of impaired activities of daily life and moderate or severe perceived loneliness were reported by48.2%and 69.0%of the participants.Multivariate analyses revealed following significant influencing factors of impaired activities of daily life:urinary incontinence(odds ratio[OR]=3.242),fecal incontinence(OR=1.576),constipation(OR=1.562),education level(OR=0.854),and family support(OR=0.783)(all P<0.05)and significant influencing factors of perceived loneliness:urinary incontinence(OR=1.861),fecal incontinence(OR=1.540),constipation(OR=1.488),education level(OR=0.636),and family support(OR=0.393)(P<0.05 for all)among the participants.Conclusion The physical and mental health condition are not good and significantly influenced by abnormal defecation among community oldest elderly in Tangshan city,suggesting that targeted interventions need to be promoted among the elderly for healthy aging of the population.