The Home Environment and Disability-Related Outcomes in Aging Individuals: What Is the Empirical Evidence?
The Home Environment and Disability-Related Outcomes in Aging Individuals: What Is the Empirical Evidence?
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DOI：
10.1093/geront/gnp056
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发表时间：
2009-06-01
期刊：
影响因子：
5.7
通讯作者：
Iwarsson, Susanne
中科院分区：
文献类型：
--
作者：
Wahl, Hans-Werner;Fange, Agneta;Iwarsson, Susanne
目的：建立在残疾过程模型和概念的人与环境的配合（P-E适合），这篇评论文章探讨了2个关键问题，家庭环境的作用：（一）什么是最近的证据支持家庭环境和残疾相关的结果之间的关系？和（B）关于家庭改造对残疾相关结果的影响，最近有哪些证据？设计和方法：使用计算机和手动搜索，我们识别了1997年1月1日至2006年8月31日期间发表的相关同行评审原创出版物和评论文章。对于研究问题1，确定了25项原始研究，对于研究问题2，确定了29项原始研究和10篇综述文章。结果如下：对于研究问题1，存在家庭环境与老年人残疾相关结果之间关系的证据，但受横断面设计和研究质量差的限制。对于研究问题2，基于随机对照试验的证据表明，改善家庭环境可以提高功能能力，但与跌倒相关的结果并不多。也有证据表明，使用p-e契合视角的研究比不使用该框架的研究结果更具支持性。含义：有相当多的证据支持家庭环境在残疾过程中的作用，但也有不一致的研究结果。未来的研究应优化心理测量性能的家庭环境评估工具，并探讨客观特征和家庭环境的感知属性的作用，以了解人与环境的动态及其对老年残疾相关的结果的影响。
Purpose: Building on the disablement process model and the concept of person-environment fit (p-e fit), this review article examines 2 critical questions concerning the role of home environments: (a) What is the recent evidence supporting a relationship between home environments and disability-related outcomes? and (b) What is the recent evidence regarding the effects of home modifications on disability-related outcomes? Design and Methods: Using computerized and manual search, we identified relevant peer-reviewed original publications and review articles published between January 1, 1997, and August 31, 2006. For Research Question 1, 25 original investigations and for Research Question 2, 29 original investigations and 10 review articles were identified. Results: For Research Question 1, evidence for a relationship between home environments and disability-related outcomes for older adults exists but is limited by cross-sectional designs and poor research quality. For Research Question 2, evidence based on randomized controlled trials shows that improving home environments enhances functional ability outcomes but not so much falls-related outcomes. Some evidence also exists that studies using a p-e fit perspective result in more supportive findings than studies that do not use this framework. Implications: Considerable evidence exists that supports the role of home environments in the disablement process, but there are also inconsistencies in findings across studies. Future research should optimize psychometric properties of home environment assessment tools and explore the role of both objective characteristics and perceived attributions of home environments to understand person-environment dynamics and their impact on disability-related outcomes in old age.