CAJ | 학술논문

目的：运用日本老年身体虚弱筛查量表对哈尔滨2所社区老年人进行身心健康评估，探索老年人健康管理的有效措施，并检验量表的适用性。方法于2013年7—9月采用整群随机抽样法抽取哈尔滨市道里区乡政社区和海富康城社区内60岁及以上居民1500人为调查对象进行问卷调查。调查内容：基本情况、生活行为（吸烟、饮酒、运动、早餐、零食、睡眠）、健康状况和身体虚弱状况。比较不同性别老年人的基本情况、生活行为、健康状况和身体虚弱状况；采用因子分析和Cronbach′sα系数对日本老年身体虚弱筛查量表进行信效度分析；并采用Spearman相关分析和多元线性回归分析虚弱程度的影响因素。结果共发放调查问卷1500份，回收有效问卷1331份，有效率为88.7％。按1.0％的复检率随机抽取13份问卷重复调查，2次结果的相关系数为0.932，问卷重测信度好。其中男619人，女712人。男性与女性的经济收入、受教育程度、婚姻状况、居住情况和就业情况比较，差异有统计学意义（ P＜0.05）；男性吸烟率及饮酒率高于女性（P＜0.001）。老年人慢性病患病率前5位是高血压（37.3％，496／1331）、骨和关节疾病（22.2％，295／1331）、冠心病（18.9％，252／1331）、糖尿病（15.2％，202／1331）和心律不齐（14.5％，193／1331）。健康状况非常好和好占37.7％（502／1331），一般占45.3％（603／1331），不太好占15.3％（203／1331），不好占1.7％（23／1331）；不同性别老年人健康状况自我评估情况比较，差异有统计学意义（ u＝3.870， P＝0.049）。根据因子内容赋予5个维度，分别为行为、情感、社会参与、身体活动、认知能力，各维度因子系数达0.400及以上， KMO值为0.882， Cronbach′sα系数为0.835。从虚弱内容来看，记忆力下降占65.0％（865／1331），害怕摔倒占49.3％（656／1331），咀嚼食物能力下降占47.1％（627／1331），喝茶呛咳占44.9％（598／1331），经常口渴占42.8％（570／1331），外出次数减少占41.8％（556／1331）。从虚弱程度来看，无虚弱36.3％（483／1331），轻度虚弱32.7％（435／1331），中度虚弱23.3％（310／1331），中重度虚弱和重度虚弱分别是6.8％（91／1331）和0.9％（12／1331）。从虚弱维度来看，有虚弱感占33.5％（446／1331）；各维度虚弱率由高到低依次是：认知49.7％（622／1331），身体活动能力41.8％（556／1331），情感28.9％（385／1331），行为26.7％（355／1331），社会参与24.4％（325／1331）。多元线性回归分析结果显示，睡眠不好、吸烟、缺乏个人兴趣爱好、年龄大的老年人虚弱程度较重， BMI高、有运动习惯、营养均衡老年人虚弱程度较轻（ P＜0.05）。结论老年人慢性病以高血压、冠心病、骨和关节疾病为主，身体虚弱状况表现为记忆力下降、口腔和下肢运动功能减退。该量表适用于哈尔滨老年人的身体虚弱状况评价。目的：運用日本老年身體虛弱篩查量錶對哈爾濱2所社區老年人進行身心健康評估，探索老年人健康管理的有效措施，併檢驗量錶的適用性。方法于2013年7—9月採用整群隨機抽樣法抽取哈爾濱市道裏區鄉政社區和海富康城社區內60歲及以上居民1500人為調查對象進行問捲調查。調查內容：基本情況、生活行為（吸煙、飲酒、運動、早餐、零食、睡眠）、健康狀況和身體虛弱狀況。比較不同性彆老年人的基本情況、生活行為、健康狀況和身體虛弱狀況；採用因子分析和Cronbach′sα繫數對日本老年身體虛弱篩查量錶進行信效度分析；併採用Spearman相關分析和多元線性迴歸分析虛弱程度的影響因素。結果共髮放調查問捲1500份，迴收有效問捲1331份，有效率為88.7％。按1.0％的複檢率隨機抽取13份問捲重複調查，2次結果的相關繫數為0.932，問捲重測信度好。其中男619人，女712人。男性與女性的經濟收入、受教育程度、婚姻狀況、居住情況和就業情況比較，差異有統計學意義（ P＜0.05）；男性吸煙率及飲酒率高于女性（P＜0.001）。老年人慢性病患病率前5位是高血壓（37.3％，496／1331）、骨和關節疾病（22.2％，295／1331）、冠心病（18.9％，252／1331）、糖尿病（15.2％，202／1331）和心律不齊（14.5％，193／1331）。健康狀況非常好和好佔37.7％（502／1331），一般佔45.3％（603／1331），不太好佔15.3％（203／1331），不好佔1.7％（23／1331）；不同性彆老年人健康狀況自我評估情況比較，差異有統計學意義（ u＝3.870， P＝0.049）。根據因子內容賦予5箇維度，分彆為行為、情感、社會參與、身體活動、認知能力，各維度因子繫數達0.400及以上， KMO值為0.882， Cronbach′sα繫數為0.835。從虛弱內容來看，記憶力下降佔65.0％（865／1331），害怕摔倒佔49.3％（656／1331），咀嚼食物能力下降佔47.1％（627／1331），喝茶嗆咳佔44.9％（598／1331），經常口渴佔42.8％（570／1331），外齣次數減少佔41.8％（556／1331）。從虛弱程度來看，無虛弱36.3％（483／1331），輕度虛弱32.7％（435／1331），中度虛弱23.3％（310／1331），中重度虛弱和重度虛弱分彆是6.8％（91／1331）和0.9％（12／1331）。從虛弱維度來看，有虛弱感佔33.5％（446／1331）；各維度虛弱率由高到低依次是：認知49.7％（622／1331），身體活動能力41.8％（556／1331），情感28.9％（385／1331），行為26.7％（355／1331），社會參與24.4％（325／1331）。多元線性迴歸分析結果顯示，睡眠不好、吸煙、缺乏箇人興趣愛好、年齡大的老年人虛弱程度較重， BMI高、有運動習慣、營養均衡老年人虛弱程度較輕（ P＜0.05）。結論老年人慢性病以高血壓、冠心病、骨和關節疾病為主，身體虛弱狀況錶現為記憶力下降、口腔和下肢運動功能減退。該量錶適用于哈爾濱老年人的身體虛弱狀況評價。
목적：운용일본노년신체허약사사량표대합이빈2소사구노년인진행신심건강평고，탐색노년인건강관리적유효조시，병검험량표적괄용성。방법우2013년7—9월채용정군수궤추양법추취합이빈시도리구향정사구화해부강성사구내60세급이상거민1500인위조사대상진행문권조사。조사내용：기본정황、생활행위（흡연、음주、운동、조찬、령식、수면）、건강상황화신체허약상황。비교불동성별노년인적기본정황、생활행위、건강상황화신체허약상황；채용인자분석화Cronbach′sα계수대일본노년신체허약사사량표진행신효도분석；병채용Spearman상관분석화다원선성회귀분석허약정도적영향인소。결과공발방조사문권1500빈，회수유효문권1331빈，유효솔위88.7％。안1.0％적복검솔수궤추취13빈문권중복조사，2차결과적상관계수위0.932，문권중측신도호。기중남619인，녀712인。남성여녀성적경제수입、수교육정도、혼인상황、거주정황화취업정황비교，차이유통계학의의（ P＜0.05）；남성흡연솔급음주솔고우녀성（P＜0.001）。노년인만성병환병솔전5위시고혈압（37.3％，496／1331）、골화관절질병（22.2％，295／1331）、관심병（18.9％，252／1331）、당뇨병（15.2％，202／1331）화심률불제（14.5％，193／1331）。건강상황비상호화호점37.7％（502／1331），일반점45.3％（603／1331），불태호점15.3％（203／1331），불호점1.7％（23／1331）；불동성별노년인건강상황자아평고정황비교，차이유통계학의의（ u＝3.870， P＝0.049）。근거인자내용부여5개유도，분별위행위、정감、사회삼여、신체활동、인지능력，각유도인자계수체0.400급이상， KMO치위0.882， Cronbach′sα계수위0.835。종허약내용래간，기억력하강점65.0％（865／1331），해파솔도점49.3％（656／1331），저작식물능력하강점47.1％（627／1331），갈다창해점44.9％（598／1331），경상구갈점42.8％（570／1331），외출차수감소점41.8％（556／1331）。종허약정도래간，무허약36.3％（483／1331），경도허약32.7％（435／1331），중도허약23.3％（310／1331），중중도허약화중도허약분별시6.8％（91／1331）화0.9％（12／1331）。종허약유도래간，유허약감점33.5％（446／1331）；각유도허약솔유고도저의차시：인지49.7％（622／1331），신체활동능력41.8％（556／1331）， 정감28.9％（385／1331）， 행위26.7％（355／1331），사회삼여24.4％（325／1331）。다원선성회귀분석결과현시，수면불호、흡연、결핍개인흥취애호、년령대적노년인허약정도교중， BMI고、유운동습관、영양균형노년인허약정도교경（ P＜0.05）。결론노년인만성병이고혈압、관심병、골화관절질병위주，신체허약상황표현위기억력하강、구강화하지운동공능감퇴。해량표괄용우합이빈노년인적신체허약상황평개。
Objective To make evaluation on the elderly in two communities of Harbin using Japan′s Assessment Scale for Elderly Frailty, in order to investigate the current status of the physical and psychological health of the elderly , find effective measures for the management of elderly health and test the applicability of the scale .Methods From June to September in 2013, using cluster random sampling method , we enrolled 1 500 residents aged over 60 from Xiangzheng Community and Haifukang Community in Daoli District of Harbin .Questionnaire survey was conducted with all subjects .The survey content included basic information, life habits (smoking, drinking, exercise, breakfast, snack and sleep), the self-assessment of health condition and physical frailty.Comparison was made between males and females about basic information , life habits, the self-assessment of health condition and chronic diseases; factor analysis and Cronbach′sαcoefficient were employed to analyze the reliability and validity of the scale; spearman correlation analysis and multiple regression analysis were undertaken to investigate the influencing factors.Results We sent out 1 500 questionnaires , and 1 331 effective questionnaires were returned with an effective recovery rate of 88.7%.With a recheck rate of 1.0%, we randomly chose 13 questionnaires for repeated survey , and the correlation coefficient of two survey results was 0.932, which indicated good reliability and validity .Among the subjects , 619 were male and 712 were female.Significant difference (P<0.05) was noted in income, educational level, marital status, residential condition and employment status between males and females; males were higher ( P<0.001 ) than females in smoking rate and drinking rate.The five chronic diseases with the highest prevalence were hypertension ( 37.3%, 496/1 331 ) , bone and joint diseases (22.2%, 295/1 331), coronary heart disease (18.9%, 252/1 331) , diabetes mellitus (15.2%, 202/1 331) and arrhythmia (14.5%, 193/1 331); the subjects who were very healthy and healthy accounted for 37.7% (502/1 331), the subjects who were barely healthy accounted for 45.3% ( 603/1 331 ) , and subjects who were not healthy accounted for 1.7%(23/1 331 ); males and females were significantly different ( u =3.870, P =0.049 ) in the self -assessment of health condition.The five dimensions assigned according to factors are behavior , emotion, social participation , physical activity and cognitive competence.For each of the five dimensions , the factor coefficient reaches 0.400, the KMO value is 0.882, and Cronbach′sαcoefficient is 0.835.For the manifestations of frailty , subjects with memory deterioration occupied 65.0% ( 865/1 331), subjects who were afraid of tumbling took up 49.3% (656/1 331), subjects who have declining masticatory ability took up 47.1% (627 /1 331), subjects who often choked and coughed when drinking tea accounted for 44.9% (598/1 331), subjects who were always thirty took up 42.8% (570/1 331), and subjects who had declining times of going out accounted for 41.8% (556 /1 331); for the degree of frailty, the proportions for no frailty, mild frailty, moderate frailty, moderately severe frailty and severe frailty were 36.3% (483/1 331), 32.7% (435/1 331), 23.3% (310/1 331), 6.8% (91/1 331) and 0.9% (12/1 331); for the dimensions of frailty, the overall frailty rate was 33.5% (446/1 331), and the frailty rates in cognition, physical performance, emotion, behavior, social participation were 49.7% (622/1 331), 41.8% (556 /1 331), 28.9% (385/1 331), 26.7% (355/1 331) and 24.4% (325/1 331) .Subjects with poor sleep and a lack of hobbies had stronger feeling of frailty and higher BMI ( P<0.05 ) , while subjects who had exercise habit and paid attention to nutritional balance had weaker feeling of frailty .Conclusion The most prevalent chronic diseases were hypertension , coronary heart disease and bone and joint diseases , and the manifestations of frailty were memory deterioration occupied , hypokinesis in lower limbs and oral cavity.The scale is applicable for the assessment of elderly frailty .