Going It Together: Persistence of Older Adults' Accompaniment to Physician Visits by a Family Companion
Going It Together: Persistence of Older Adults' Accompaniment to Physician Visits by a Family Companion
复制标题
DOI：
10.1111/j.1532-5415.2011.03770.x
复制
发表时间：
2012-01-01
影响因子：
6.3
通讯作者：
Roter, Debra L.
中科院分区：
文献类型：
--
作者：
Wolff, Jennifer L.;Boyd, Cynthia M.;Roter, Debra L.
目标：虽然老年人经常有人陪同进行例行医生就诊，并且通常接受与残疾相关的任务援助，但这种帮助的重叠和持续性尚不清楚。本研究调查了定期就诊的老年人是否 (1) 也接受任务援助，以及 (2) 在 12 个月内继续由同一位家庭同伴陪伴。设计：观察性研究。设置：全国代表性调查。参与者：对 2006 年医疗保险当前受益人调查 (MCBS) 做出回应的 65 岁及以上社区居民 (n = 11,582) 和一个子集 (n = 7,510）谁在 2005 年和 2006 年做出了回应。测量：由家庭同伴陪同去看医生，并接受日常生活活动 (ADL) 或工具性日常生活活动 (IADL) 的任务协助。从 2005 年和 2006 年的调查答复中可以看出，持续的陪伴和家庭陪伴的参与始终如一。 结果：在社区居住的老年人中，18.6% 的人仅陪同去看医生，12.7% 的人陪同看医生并接受任务协助。与仅有人陪伴的老年人相比，接受任务援助的有人陪伴老年人年龄更大，受教育程度更低，自评健康状况更差。提供任务协助的家庭同伴（与不提供任务协助的家庭同伴相比）更积极地参与医生就诊过程，并且更常被认为始终在场。四分之三 (74.5%) 的陪同老年人在 12 个月内持续陪同去看医生，几乎总是 (87.9%) 由同一位家庭同伴陪同。接受任务协助与持续陪伴密切相关（aOR = 2.52；95% CI：1.93-3.29）。结论：老年人通常会持续陪伴就诊，最常见的是持续参与的家庭同伴。研究结果对医患伙伴关系和以患者为中心的医疗之家具有重要意义。 《老年学杂志》60：106-112，2012 年。
OBJECTIVES: Although older adults are often accompanied to routine physician visits and commonly receive disability-related task assistance, the overlap and persistence of this help is not well understood. This study investigates whether older adults who are accompanied to routine physician visits (1) also receive task assistance and (2) continue to be accompanied at 12-months by the same family companion.DESIGN: Observational study.SETTING: Nationally representative survey.PARTICIPANTS: Community-dwelling adults aged 65 and older who responded to the Medicare Current Beneficiary Survey (MCBS) in 2006 (n = 11,582) and a subset (n = 7,510) who responded in 2005 and 2006.MEASUREMENTS: Accompaniment to physician visits by a family companion and receipt of task assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Persistent accompaniment and consistent family companion involvement was ascertained from 2005 and 2006 survey responses.RESULTS: Among community-dwelling older adults, 18.6% were accompanied to physician visits only, and 12.7% were accompanied to physician visits and received task assistance. Accompanied older adults who received task assistance were older, less educated, and had worse self-rated health than their counterparts who were accompanied only. Family companions who provided task assistance (vs those who did not) were more actively engaged in physician visit processes and more often identified as always present. Three-fourths (74.5%) of accompanied older adults were persistently accompanied to physician visits at 12 months, nearly always (87.9%) by the same family companion. Receipt of task assistance was strongly associated with persistent accompaniment (aOR = 2.52; 95% CI: 1.93-3.29).CONCLUSIONS: Older adults' accompaniment to physician visits typically persists, most often by consistently involved family companions. Findings have implications for the patient-physician partnership and the patient-centered medical home. J Am Geriatr Soc 60:106-112, 2012.