老年住院患者内在能力的潜在类别分析及影响因素研究  

Latent class analysis and influencing factors of intrinsic capacity in hospitalized older adults

作　　者：王玉钰 张洁[2] 郭爱敏[1] Wang Yuyu;Zhang Jie;Guo Aimin(School of Nursing,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China;Department of Geriatrics,Beijing Hospital,National Center for Geriatrics,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院护理学院,北京100144 [2]北京医院老年医学科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华现代护理杂志》2025年第13期1760-1767,共8页Chinese Journal of Modern Nursing

摘　　要：目的探讨老年住院患者内在能力的潜在类别及其影响因素,为制订精准的干预方案提供依据。方法采用便利抽样法,选取2022年4月—2023年7月在北京医院住院的371例老年患者为调查对象。采用老年人整合照护完整评估工具评估老年住院患者的内在能力,并对其进行握力测试。采用潜在类别分析对老年住院患者内在能力进行分类,采用多分类Logistic回归分析探究老年住院患者不同类别内在能力的影响因素。结果371例老年住院患者中,有78.98%(293/371)的老年患者存在不同维度的内在能力下降,其中认知、运动、活力、心理、感知觉维度受损检出率分别为36.39%(135/371)、34.23%(127/371)、21.02%(78/371)、33.69%(125/371)、47.98%(178/371)。潜在类别分析结果显示,老年住院患者内在能力水平分为3种潜在类别,分别为高运动-中感知觉组(39.08%,145/371)、低认知-高运动组(26.68%,99/371)、低运动组(34.23%,127/371)。多分类Logistic回归分析结果显示,年龄、性别、家庭月收入、是否存在多重用药、握力是老年住院患者内在能力潜在类别的影响因素(P<0.05)。结论老年住院患者内在能力受损存在异质性,应及时识别不同老年住院患者的内在能力特征,重点关注低认知-高运动、低运动的老年患者,对其尽早实施针对性干预,以预防和改善不良结局。Objective To explore the latent classes of intrinsic capacity and their influencing factors among hospitalized older adults,providing a basis for developing targeted intervention strategies.Methods A convenience sampling method was used to recruit 371 hospitalized older adults from Beijing Hospital between April 2022 and July 2023.The integrated care for older people comprehensive assessment tool was used to assess the intrinsic capacity of hospitalizd older adults,along with grip strength tests.Latent class analysis(LCA)was employed to classify the intrinsic capacity of hospitalizd older adults,and multinomial Logistic regression analysis was conducted to explore the influencing factors of different latent classes.Results Among the 371 older adults,78.98%(293/371)exhibited declines in various dimensions of intrinsic capacity,with impairment detection rates of 36.39%(135/371)in cognition,34.23%(127/371)in mobility,21.02%(78/371)in vitality,33.69%(125/371)in psychological well-being,and 47.98%(178/371)in sensory function.The LCA results identified three latent classes of intrinsic capacity:high mobility-moderate sensory group(39.08%,145/371),low cognition-high mobility group(26.68%,99/371),and low mobility group(34.23%,127/371).Multinomial Logistic regression analysis revealed that age,gender,monthly family income,polypharmacy,and grip strength were influencing factors of the latent classes of intrinsic capacity(P<0.05).Conclusions The intrinsic capacity of hospitalized older adults is heterogeneous.It is essential to promptly identify the characteristics of intrinsic capacity in different groups,with particular attention to older adults in the low cognition-high mobility group and low mobility group,and implement targeted interventions to prevent and improve adverse outcomes.

关 键 词：老年人 住院 内在能力 潜在类别分析 健康老龄化 

分 类 号：R473.5[医药卫生—护理学]