METHODS: We undertook a retrospective cohort study of older Māori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later. Odds ratios (OR) and 95% confidence interval (CI) were calculated to determine the difference in proportion of variables of interest (indicative of movement, socialising, sleep and nutrition, alongside general physical and mental health status) between participants\' HC and subsequent LTCF assessments.
RESULTS: Changes in well-being measures were investigated among 1531 Māori (mean age 76.2 years, 61% female). Odds of having a fall (OR: 0.40 [95% CI 0.34, 0.48]), being lonely (OR: 0.13 [95% CI 0.09, 0.18]), sleeping difficulty (OR: 0.74 [95% CI 0.60, 0.91]) and fatigue (OR: 0.18 [95% CI 0.14, 0.23]) reduced on moving to LTC. However, the presence of depression (OR 3.96 [95% CI 2.58, 6.09]) and dependence with locomotion (OR 1.56 [95% CI 1.23, 1.97]) significantly increased when moving from home to LTC.
CONCLUSIONS: Despite some indicators of functional and health-related decline, significant improvements are also apparent across multiple domains of well-being. Further investigation of resident and family perceptions of well-being in association with a move to LTC is warranted.
方法:我们对新西兰(NZ)的老年毛利人进行了一项回顾性队列研究,这些人在家中接受了健康需求评估(interRAI-HC评估),并在入住护理机构后接受了后续评估(interRAI-LTCF)。从2013年7月1日至2018年12月21日的所有RAI-HC评估均已确定,并与至少6个月后进行的LTCF评估相匹配。计算比值比(OR)和95%置信区间(CI),以确定感兴趣变量比例的差异(指示运动,社会化,睡眠和营养,除了一般的身体和心理健康状况),参与者的HC和随后的LTCF评估之间。
结果:调查了1531名毛利人(平均年龄76.2岁,61%女性)。跌倒的几率(OR:0.40[95%CI0.34,0.48]),孤独(OR:0.13[95%CI0.09,0.18]),睡眠困难(或:0.74[95%CI0.60,0.91])和疲劳(或:0.18[95%CI0.14,0.23])在移至LTC时减少。然而,从家中搬到LTC时,抑郁的存在(OR3.96[95%CI2.58,6.09])和运动依赖性(OR1.56[95%CI1.23,1.97])显著增加。
结论:尽管有一些功能和健康相关的下降指标,在福祉的多个领域也有明显的改善。有必要对居民和家庭对迁往LTC的幸福感的看法进行进一步调查。