Factors associated with toileting disability in older adults without dementia living in residential care facilities.
Factors associated with toileting disability in older adults without dementia living in residential care facilities.
复制标题
居住在寄宿护理机构中的无痴呆症老年人如厕障碍的相关因素。
DOI：
10.1097/nnr.0000000000000017
复制
发表时间：
2014
期刊：
影响因子：
2.5
通讯作者：
Zhao,Hong
中科院分区：
文献类型：
--
作者：
Talley,KristineMC;Wyman,JeanF;Bronas,UlfG;Olson-Kellogg,BeckyJ;McCarthy,TeresaC;Zhao,Hong
背景：没有痴呆症的老年人居住在有如厕障碍的家庭护理设施中，护理费用和依赖性都增加了。了解相关因素可以指导预防和管理策略。目的：本研究的目的是确定该人群中如厕障碍的患病率及其相关因素。方法：这是对2010年全国住宿护理设施调查的横断面分析。对年龄在65岁或以上、无痴呆症、有可能实施行为干预的成年人进行了亚样本(n=2395)研究。相关因素按致残过程分为病理因素、损伤因素、功能受限因素、共存障碍因素、个体内外因素。采用Logistic回归模型，采用分层两阶段概率抽样设计，确定影响居民如厕障碍的因素。结果：居民多为85岁及以上的白人女性。如厕障碍患病率为15%。相关因素包括：报告健康状况一般或差；居住在四个或更少居民的设施中；生活在营利性设施中；有大便失禁、尿失禁、更多的身体障碍和视觉和听力障碍；以及在洗澡、穿衣和转移方面需要帮助。讨论：应该为非痴呆症患者设计多成分和多学科的预防和管理措施。未来需要测试预防措施的有效性的研究，应该包括大小便失禁的治疗；针对行走、站立、坐着、弯腰、伸手和抓握障碍的体力活动计划；以及改善穿衣、洗澡和转移技能的治疗。
Background:Older adults without dementia living in residential care facilities with toileting disability have increased care costs and dependency. Understanding associated factors could guide prevention and management strategies.Objective:The aim of this study was to identify the prevalence of and factors associated with toileting disability in this population.Methods:This was a cross-sectional analysis of the 2010 National Survey of Residential Care Facilities. A subsample (n= 2,395) of adults aged 65 years or older, without dementia, and with the potential to implement behavioral interventions was examined. Associated factors were classified according to the disablement process as pathologies, impairments, functional limitations, coexisting disabilities, and intraindividual and extraindividual factors. Logistic regression models accounting for the stratified two-stage probability sampling design were used to identify factors associated with toileting disability.Results:Residents were mostly White women, aged 85 years and older. Prevalence of toileting disability was 15%. Associated factors included reporting fair or poor health; living in a facility with four or less residents; living in a for-profit facility; having bowel incontinence, urinary incontinence, more physical impairments, and visual and hearing impairments; and needing assistance with bathing, dressing, and transferring.Discussion:Multicomponent and multidisciplinary prevention and management efforts should be designed for residents without dementia. Future studies testing the efficacy of prevention efforts are needed and should include treatments for incontinence; physical activity programs targeting impairments with walking, standing, sitting, stooping, reaching, and grasping; and therapy to improve dressing, bathing, and transferring skills.