老年住院相关性失能患者内在能力现状及影响因素分析

Current status and influencing factors of intrinsic capacity in elderly patients with hospitalization-associated disability

目的:调查老年住院相关性失能(HAD)患者内在能力现状并探讨其影响因素。方法:采用便利抽样法,选取2023年11月—2024年1月在首都医科大学宣武医院住院发生HAD的203例老年患者为研究对象。采用一般资料调查表、Fried衰弱表型评分、Barthel指数、社会支持评定量表、内在能力评估工具对老年患者进行调查。采用二项Logistic回归分析探讨老年HAD患者内在能力的影响因素。结果:本研究共发放问卷203份,回收有效问卷199份,问卷有效回收率为98.03%(199/203)。199例老年HAD患者内在能力总分为5.00(4.00,6.00)分,其中认知维度得分为1.00(1.00,2.00)分,心理维度得分为2.00(1.00,2.00)分,运动维度得分为0(0,1.00)分,活力维度得分为1.00(1.00,1.00)分,感官维度得分为1.00(1.00,1.00)分。二项Logistic回归分析结果显示,住院内外科、自评健康状况、社会支持、血清白蛋白、Barthel指数是老年HAD患者内在能力的影响因素( P<0.05)。 结论:老年HAD患者内在能力处于中低水平,其中运动维度受损最为严重。医护人员应依据内在能力的影响因素为老年HAD患者制订个性化的康复措施,提升其内在能力,减少家庭及社会的照护负担。

Objective To explore the current status of intrinsic capacity in elderly patients with hospitalization-associated disability(HAD)and explore its influencing factors.Methods From November 2023 to January 2024,convenience sampling was used to select 203 elderly patients with HAD at Xuanwu Hospital of Capital Medical University as the study subjects.A survey was conducted on elderly patients using the General Information Questionnaire,Fried Frailty Phenotype,Barthel Index,Social Support Rating Scale,and Intrinsic Capacity Assessment Tool.Binomial Logistic regression was used to analyze the influencing factors of intrinsic capacity in elderly patients with HAD.Results A total of 203 questionnaires were distributed,and 199 valid questionnaires were collected,with a valid response rate of 98.03%(199/203).The total score of intrinsic capacity in 199 elderly patients with HAD was 5.00(4.00,6.00),with scores for cognitive dimension,psychological dimension,motor dimension,vitality dimension,and sensory dimension being 1.00(1.00,2.00),2.00(1.00,2.00),0(0,1.00),1.00(1.00,1.00)and 1.00(1.00,1.00),respectively.The binomial Logistic regression showed that department of medicine and surgery,self-rating health status,social support,serum albumin,and Barthel Index were the influencing factors of intrinsic capacity in elderly patients with HAD(P<0.05).Conclusions The intrinsic capacity of elderly patients with HAD is at medium to low level,with the most severe impairment in the motor dimension.Medical and nursing staff should develop personalized rehabilitation measures for elderly HAD patients based on the influencing factors of their intrinsic capacity,enhance their intrinsic capacity,and reduce the burden of care on families and society.