Adult Day Health Center Participation and Health-Related Quality of Life
Adult Day Health Center Participation and Health-Related Quality of Life
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DOI：
10.1093/geront/gnp172
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发表时间：
2010-08-01
期刊：
影响因子：
5.7
通讯作者：
Covinsky, Kenneth
中科院分区：
文献类型：
--
作者：
Schmitt, Eva M.;Sands, Laura P.;Covinsky, Kenneth
目的：本研究的目的是评估成人日间健康中心（ADHC）的参与和健康相关的生活质量之间的关联。设计和方法：病例对照前瞻性研究，使用医学结局调查表36（SF-36）比较16个ADHC项目的新入组受试者与未参加ADHC的可比社区居住老年人。在研究入组、6个月和12个月时进行评估。结果如下：ADHC参与者（n = 57）和对照组受试者（n = 67）在基线时在年龄、种族多样性、医疗状况、抑郁、认知、移民史、教育、收入和婚姻状况方面相似。比较组中独居的受试者明显更多（p = 0.002）。入组一年后，SF-36领域的角色身体和角色情感显著改善。ADHC参与者的调整后角色身体评分有所改善（23 vs. 36），但对照组有所下降（38 vs. 26，按组交互时间p = 0.01），ADHC参与者的角色情感评分有所改善（62 vs. 70），但对照组有所下降（65 vs. 48，按组交互时间p = 0.02）。次要分析显示，日常身体功能，抑郁情绪或认知功能的变化并不能解释ADHC参与者的角色身体和角色情感评分的改善。两组在SF-36领域的身体功能、社会功能和心理健康方面的趋势无显著差异。影响：ADHC的参与可能会提高老年人的生活质量。生活质量可能是告知ADHC的护理规划、项目改进和政策制定的关键措施。
Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable community-dwelling older adults who did not attend an ADHC. Assessments were conducted at study enrollment, 6 and 12 months. Results: ADHC participants (n = 57) and comparison group subjects (n = 67) were similar at baseline in age, ethnic diversity, medical conditions, depression, cognition, immigration history, education, income, and marital status. Significantly more comparison group subjects lived alone (p = .002). One year after enrollment, the SF-36 domains role physical and role emotional improved significantly. Adjusted role physical scores for ADHC participants improved (23 vs. 36) but declined for the comparison group (38 vs. 26, time by group interaction p = .01), and role emotional scores improved for ADHC participants (62 vs. 70) but declined for the comparison group (65 vs. 48, time by group interaction p = .02). Secondary analyses revealed that changes in daily physical functioning, depressed affect, or cognitive functioning did not explain the improvements found in role physical and role emotional scores for ADHC participants. No significant differences in trends for the 2 groups occurred for the SF-36 domains physical functioning, social functioning, and mental health. Implications: ADHC participation may enhance older adults' quality of life. Quality of life may be a key measure to inform care planning, program improvement, and policy development of ADHC.