患有视力障碍(VI)的老年人数量正在增加。随着医疗保健服务越来越多地要求患者使用技术,检查VI老年人的互联网/健康信息技术(HIT)使用情况非常重要。
这项研究旨在检查(1)与没有VI的同龄人的匹配样本相比,患有VI的老年人的互联网/HIT使用率。(2)VI与互联网/HIT使用的关联,和(3)HIT使用与心理困扰的关联,用Kessler-6屏幕评估。
数据来自2013年至2018年美国国家健康访谈调查。自我报告VI的老年人(年龄≥65岁)与无VI的老年人相匹配,以1:1的比例,根据年龄,性别,慢性疾病的数量,和功能限制(N=2866)。描述性统计和多变量逻辑回归模型,社会人口因素,健康状况,健康保险类型,和医疗保健服务用作协变量,用于检查研究问题。
总共,3.28%的老年人(18-64岁的老年人为0.84%)报告VI,其中25.7%的患者年龄≥85岁。与没有VI的人相比,具有VI的人在社会经济上处于不利地位,并且不太可能使用互联网(调整后的优势比[aOR]0.64,95%CI0.49-0.83)和HIT(aOR0.74,95%CI0.56-0.97)。然而,在互联网用户中,VI与HIT使用无关。HIT使用与轻度/中度或严重心理困扰的几率较低相关(aOR0.62,95%CI0.43-0.90),而VI与轻度/中度或严重窘迫的几率相关(aOR1.84,95%CI1.36-2.49).医疗保健提供者的接触也与使用互联网或HIT的几率更高有关。
与没有VI的同龄人相比,患有VI的老年人不太可能使用HIT,因为他们不太可能使用互联网。经历数字鸿沟的社会经济上处于不利地位的老年人需要通过费用减免或补贴来获得信息和通信技术,以覆盖互联网设备和订阅并确保持续的连接。不知道如何使用互联网/HIT但想学习的VI老年人应提供指导,特别注意无障碍功能和自适应设备。低收入的老年人也需要更好地获得预防性眼部护理和VI治疗以及其他医疗保健服务。
The number of older adults with vision impairment (VI) is growing. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI.
This study aimed to examine (1) the rates of internet/HIT use among older adults with VI compared with a matched sample of their peers without VI, (2) associations of VI with internet/HIT use, and (3) association of HIT use with psychological distress, assessed with the Kessler-6 screen.
Data were obtained from the 2013 to 2018 US National Health Interview Survey. Older adults (aged ≥65 years) with self-reported VI were matched with older adults without VI, in a 1:1 ratio, based on age, sex, number of chronic medical conditions, and functional limitations (N=2866). Descriptive statistics and multivariable logistic regression models, with sociodemographic factors, health conditions, health insurance type, and health care service use as covariates, were used to examine the research questions.
In total, 3.28% of older adults (compared with 0.84% of those aged 18-64 years) reported VI, and 25.7% of them were aged ≥85 years. Those with VI were significantly more socioeconomically disadvantaged than those without VI and less likely to use the internet (adjusted odds ratio [aOR] 0.64, 95% CI0.49-0.83) and HIT (aOR 0.74, 95% CI 0.56-0.97). However, among internet users, VI was not associated with HIT use. HIT use was associated with lower odds of mild/moderate or serious psychological distress (aOR 0.62, 95% CI 0.43-0.90), whereas VI was associated with greater odds of mild/moderate or serious distress (aOR 1.84, 95% CI 1.36-2.49). Health care provider contacts were also associated with higher odds of internet or HIT use.
Compared with their matched age peers without VI, older adults with VI are less likely to use HIT because they are less likely to use the internet. Socioeconomically disadvantaged older adults experiencing a digital divide need help to access information and communication technologies through a fee waiver or subsidy to cover internet equipment and subscription and ensure continuous connectivity. Older adults with VI who do not know how to use the internet/HIT but want to learn should be provided instruction, with special attention to accessibility features and adaptive devices. Older adults with a low income also need better access to preventive eye care and treatment of VI as well as other health care services.