摘要
目的·了解老人常见老年综合征的分布特征,为不同类型老人的照护提供参考。方法·于2017年5—11月对上海市5所医疗机构和6所养老机构的590位老人进行问卷调查,采用中文版老年连续评估记录和评价条目集(continuity assessment record and evaluation,CARE)为调查工具,对常见的13种老年综合征进行k-均值聚类并分析各类老年综合征的分布特征。结果·590位老人中,97.8%的老人患有至少1种老年综合征。发生率位居前5位的老年综合征依次为日常生活能力下降(80.7%)、认知功能障碍(80.5%)、多重用药(44.7%)、视力障碍(45.3%)和听力障碍(42.9%)。k-均值聚类结果显示,老人老年综合征分为4类较为合理:第1类老人表现为老年综合征发生率较高(即为高发组),平均每位老人患有(5.6±1.1)种老年综合征,其日常生活能力下降、认知功能障碍、视力障碍、听力障碍和谵妄的发生率较高;第2类老人表现为老年综合征发生率极高(即为极高组),平均每位老人患有(8.3±1.1)种老年综合征,除了疼痛、抑郁和压疮发生率较低外,其余老年综合征发生率几乎均高于其他3类;第3类老人表现为老年综合征发生率较低(即为低发组),平均每位老人患有(2.0±1.2)种老年综合征,其多重用药和跌倒的发生率较高;第4类老人表现为老年综合征发生率适中(即为中等组),平均每位老人患有(4.0±1.3)种老年综合征,其日常生活能力下降、认知功能障碍、多重用药、尿失禁和跌倒的发生率较高。结论·对老年综合征进行分类分析,有助于识别发生不同类型老年综合征的高危人群,进而开展有针对性的干预治疗。
Objective·To investigate the distribution of geriatric syndromes in older adults in order to provide reference for the care of different types of the elderly.Methods·This study described distribution of 13 geriatric syndromes of 590 older adults from 5 hospitals and 6 nursing homes in Shanghai based on k-means clustering.The data were collected by Chinese version of continuity assessment record and evaluation(CARE)between May and November 2017.Results·97.8%of the 590 older adults suffered from at least 1 geriatric syndrome.The top 5 geriatric syndromes were impairment in activities of daily living(80.7%),cognitive impairment(80.5%),polypharmacy(44.7%),visual impairment(45.3%),and hearing impairment(42.9%).The results of k-means clustering showed that the geriatric syndrome was divided into 4 clusters.Cluster 1(named high incidence group of geriatric syndromes)exhibited high prevalence of impairment in activities of daily living,cognitive impairment,visual impairment,hearing impairment and delirium.On average,each older adult had 5.6±1.1 geriatric syndromes.Cluster 2(named extremely high group)exhibited the highest prevalence of geriatric syndromes,excluding pain,depression and pressure ulcer.On average,each older adult had 8.3±1.1 geriatric syndromes.Cluster 3 was named low incidence group of geriatric syndromes,each older adult having 2.0±1.2 geriatric syndromes.The incidence of polypharmacy and fall was relatively high.Cluster 4(named medium group)exhibited high prevalence of impairment in activities of daily living,cognitive impairment,polypharmacy,urinary incontinence and fall.On average,each older adult had 4.0±1.3 geriatric syndromes.Conclusion·Classification of geriatric syndromes is helpful to identify the high-risk older adults who may suffer certain patterns of geriatric syndromes,and thus to carry out targeted interventions.
作者
姜彩霞
邹敏
姜丽萍
JIANG Cai-xia;ZOU Min;JIANG Li-ping(Shanghai Jiao Tong University School of Nursing,Shanghai 200025,China;of Nursing,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2018年第9期1072-1078,共7页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市教育委员会护理高原学科项目-国际合作科研基金(H1jy1605gj)
国家自然科学基金(71874107)~~
关键词
老人
老年综合征
聚类分析
认知功能障碍
older adult
geriatric syndrome
cluster analysis
cognitive impairment
