Activities of Daily Living of Home Healthcare Patients.
Activities of Daily Living of Home Healthcare Patients.
复制标题
DOI：
10.1097/nhh.0000000000000736
复制
发表时间：
2019-05-01
影响因子：
--
通讯作者：
Shang, Jingjing
中科院分区：
文献类型：
--
作者：
Osakwe, Zainab Toteh;Larson, Elaine;Shang, Jingjing
日常生活活动(ADLS)是衡量家庭医疗服务质量的重要指标，但很少有研究描述HHC患者的ADLS。这项研究的目的是(1)描述接受家庭护理的患者的ADL依赖的类型和水平，(2)确定入院时严重ADL依赖的危险因素，以及(3)确定在HHC住院期间ADL改善的预测因素。这是对2013年国家成果和评估信息集(OASIS-C)的5%随机样本(n=105,654)的二次数据分析。因变量为入院时的ADL严重依赖程度和入院至出院时的ADL改善。约三分之二(65%)的患者(n=99,991)在入院时有严重的ADL依赖(7种或更多ADL依赖)。年龄较大、女性和决策能力受损与入院时严重的ADL依赖有关。在105,654名患者中，58.1%(n=89,997)的患者ADL有所改善。ADL的改善与HHC住院时间、女性和既往住院时间的增加有关。临床医生、政策制定者和机构可以将重点放在可修改的特征上，以实现ADL改善的目标。
Activities of daily living (ADLs) is an important measure of the quality of care provided in home healthcare (HHC), but few studies describe the ADLs of HHC patients. The objectives of this study were to (1) describe the types and levels of ADL dependency among patients receiving home care, (2) identify the risk factors for severe ADL dependency at admission, and (3) identify the predictors of ADL improvement during an HHC stay. This was a secondary data analysis of a 5% random sample (n = 105,654) of the national Outcome and Assessment Information Set (OASIS-C) for the year 2013. The dependent variables were severe ADL dependency level at admission and ADL improvement from admission to discharge. About two thirds (65%) of the patients (n = 99,991) had severe ADL dependency (dependence in seven or more ADLs) at admission. Older age, female gender, and impaired decision-making were associated with severe ADL dependency on admission. Of the 105,654 patients, 58.1% (n = 89,997) experienced ADL improvement. ADL improvement was associated with increasing HHC length of stay, being female, and prior inpatient stay. Clinicians, policy makers, and agencies could focus on modifiable characteristics to achieve the goal of ADL improvement.