INVOLVEMENT IN CARE DECISION-MAKING AND ADVERSE OUTCOME ONSET IN COMMUNITY-DWELLING CARE RECIPIENTS IN JAPAN
INVOLVEMENT IN CARE DECISION-MAKING AND ADVERSE OUTCOME ONSET IN COMMUNITY-DWELLING CARE RECIPIENTS IN JAPAN
复制标题
DOI：
10.1093/geroni/igac059.2563
复制
发表时间：
2022-12-20
影响因子：
7
通讯作者：
中科院分区：
文献类型：
--
作者：
老年人参与护理决策可能会提高他们的日常生活动力和生活质量。此外，它可以有助于他们在长期护理中获得更好的预后。我们研究了决策参与和不良后果的发生之间的关联，如机构化和死亡，在长期护理的老年人。本研究使用了日本65岁及以上的社区住宅护理接受者的两年纵向调查数据。对参与者进行了关于机构化开始和死亡的跟踪。参与决策的状况是根据一个项目和以下回答选项中的选择进行评估的：“非常参与”、“相当参与”、“不太参与”、“从未参与”、“未澄清的愿望”和“没有人支持决策”。多变量logistic回归分析估计了不良结局发生的比值比（OR）和95%置信区间（CI），包括住院和死亡。共有707名参与者没有严重的认知障碍（MMSE>12），并且在基线时没有缺失变量，并对随访调查做出回应。在基线时，36.5%的人报告说他们非常参与决策。在17.5%的参与者中观察到不良结局的发生（机构化，5.1%;死亡，12.4%）。与高度参与决策的人相比，即使在调整协变量后，未参与决策的人也更有可能发生不良事件（OR=2.86 [95%CI：1.21-6.76]，p=0.016）。我们的研究结果表明，决策参与日常护理的重要性，在长期护理中更好地照顾。
The involvement of older adults in care decision-making may enhance their daily life motivation and quality of life. Furthermore, it could contribute to their better prognosis in long-term care. We examined the association between decision-making involvement and the onset of adverse outcomes, such as institutionalization and death, among older adults under long-term care. This study used two-year longitudinal survey data of Japanese community-dwelling care recipients aged 65 and above. The participants were followed regarding the onset of institutionalization and deaths. The status of involvement in decision-making was assessed based on one item and the selection among the following response options: “very much involved,” “fairly involved,” “not very involved,” “never involved,” “unclarified wishes,” and “absence of person supporting decision-making.” A multivariable logistic regression analysis estimated the odds ratios (OR) and 95% confidence intervals (CI) for the onset of adverse outcomes, composite of institutionalization and death. A total of 707 participants with no severe cognition disabilities (MMSE>12) and no missing variables at the baseline were included and responded to the follow-up survey. At the baseline, 36.5% reported being very much involved in decision-making. The onset of adverse outcomes was observed in 17.5% of participants (institutionalization, 5.1%; death, 12.4%). Compared to those with very high involvement in decision making, those who were not involved were more likely to have adverse events, even after adjusting for covariates (OR=2.86 [95% CI: 1.21-6.76], p=0.016). Our findings show the importance of decision-making involvement in daily care regarding better prognoses in long-term care.