Multi-dimensional frailty and its risk factors among older residents in long-term care facilities in Shanghai,China  

养老机构老年人衰弱状况和危险因素的调查研究

作　　者：Huihui Wang Jing Wang Boqin Xie Bangzhong Liu Junqiao Wang 王会会;王静;谢博钦;刘邦忠;王君俏(School of Nursing,Fudan University,Shanghai,China;UNC Chapel Hill School of Nursing,Chapel Hill,NC,USA;Department of Rehabilitation,Zhongshan Hospital of Fudan University,Shanghai,China)

机构地区：[1]School of Nursing,Fudan University,Shanghai,China [2]UNC Chapel Hill School of Nursing,Chapel Hill,NC,USA [3]Department of Rehabilitation,Zhongshan Hospital of Fudan University,Shanghai,China

出　　处：《International Journal of Nursing Sciences》2021年第3期298-303,I0004,共7页国际护理科学（英文）

基　　金：This work was supported by the Fudan University Nursing Research Foundation(Fund#FNF201706).

摘　　要：Objectives:The integrated model of frailty shifted the physiologically-dominated view to an integrated and multidisciplinary view of frailty and adopted an integrated and holistic approach to the complex challenges facing frail older adults and their caregivers.There is an urgent need for researchers to identify multi-faceted frailty among older adults and to explore contributors to it.We assessed the level of frailty among older residents in long-term care(LTC)facilities in Shanghai,China and explored risk factors of multiple dimensions of frailty among older residents.Methods:It is a cross-sectional descriptive study.We interviewed 218 older residents from nine LTC facilities.We used Tilburg Frailty Indicator to assess older residents’physiological,psychological,and social frailty.The Geriatric Depression Scale,Mini-Mental state examination,Athens Insomnia Scale,and Activity of Daily Living(ADL)Scale were used to assess their depressive symptoms,cognitive function,sleep quality and ADL abilities,respectively.Results:Older residents have a moderate level of frailty in physiological,psychological and social domains.There is a high correlation among dimensions of frailty.Older residents’depressive symptoms have remained positively associated with their overall and each domain of frailty.Older residents’actual activity participation and exercise in LTC facilities are negatively associated with older residents’overall,physiological and social frailty.Conclusions:Frailty is a multi-dimensional concept and is prevalent among older residents in LTC facilities.It is important to take an integrated view on frailty and carry out appropriate and comprehensive interventions to prevent adverse outcomes and provide holistic care for frail older residents in LTC facilities.There is an urgent need to improve the quality and expand the number of activities offered within LTC facilities that would engage older residents in a person-centered way,despite their age,ADL abilities,frailty and functional limitations.目的评估养老机构老年人的衰弱程度,并探讨老年人多维度衰弱的风险因素.方法采用横断面调查研究,调查了上海市9个养老机构的218名老年人.使用Tilburg衰弱指数评估老年人的生理、心理和社会维度衰弱,分别使用老年抑郁量表、简易智力状态检查表(Mini-Mental State Examination,MMSE)、雅典失眠量表和日常生活能力(Activity of Daily Living,ADL)评估老年人抑郁症状、认知功能、睡眠质量和自理能力.结果养老机构老年人生理、心理和社会维度的衰弱程度为中等,不同维度之间呈现高度相关性.老年人的抑郁症状与其衰弱整体和各维度均呈正相关.老年人在养老机构中的实际活动参与和锻炼状况与其衰弱整体、生理和社会维度衰弱呈负相关.结论养老机构中的老年人普遍存在多维度衰弱.在进行衰弱评估时需要进行综合考虑,并采取综合干预措施,为养老机构中的老年人提供整体护理,采取个性化方式提高其活动度,防止衰弱带来的不良后果.

关 键 词：Aged Activities of daily living China COGNITION Depression Exercise FRAILTY SLEEP 

分 类 号：R473.5[医药卫生—护理学]