老年患者住院相关性失能的研究进展

Research progress in the hospitalization-associated disability among elderly patients

住院患者出院时与入院2周前(急性发病前)相比,丧失一项或多项日常生活自理能力的现象,被称为住院相关性失能(hospitalization-associated disability,HAD)。老年患者HAD的发病率高,常导致再入院率、长期照料率及病死率增加,给患者、家庭和社会带来负担。临床医护人员早期识别老年患者HAD的危险因素,并采取针对性干预措施,对预防和改善老年患者HAD至关重要。目前国外对HAD的研究较为完善,国内对HAD的研究还处于起步阶段,尚缺乏对HAD发病率、影响因素和干预措施的系统研究和报道。国内临床护理实践可借鉴国外成熟的干预措施,进行文化调试,为老年患者营造良好的院内环境,注重老年患者HAD影响因素的评估,针对评估结果为老年住院患者提供个性化、以患者功能为中心的护理措施,维持其住院期间的功能,预防HAD的发生。

Hospitalized patients who lose one or more activities of daily living at the time of discharge compared with 2 weeks before admission(before acute onset)are referred to as hospitalization-associated disability(HAD).The incidence of HAD is high among elderly patients,which leads to the increased readmission rates,long-term care rates,and mortality,bringing a huge burden on patients,families,and society.It is vital for doctors and nurses to identify the risk factors of HAD of the elderly patients and take targeted intervention measures to prevent and improve HAD.At present,the research on HAD in foreign countries is relatively perfect,while the research on HAD in China is still in its infancy,and there is still lack of systematic research and reports on the incidence,influencing factors,and intervention measures of HAD.Domestic clinical nursing practice can learn from foreign mature interventions,carry out cultural adjustment,create a friendly environment in the hospital for elderly patients,pay attention to the assessment of the influencing factors of HAD in elderly patients,and provide personalized and patient-centered nursing measures for hospitalized elderly patients according to the assessment results,maintain their function during hospitalization and prevent the occurrence of HAD.