Singh Abhishek, Bairwa Mohan, Goel Shewtank, Bypareddy Ravi, Mithra Prassana
Department of Community Medicine, Shaheed Hasan Khan Mewati Government Medical College, Nalhar (Mewat) Haryana, PIN- 122107, India.
Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar New Delhi - 110029 India.
Malays J Med Sci. 2016 Sep;23(5):44-50. doi: 10.21315/mjms2016.23.5.6. Epub 2016 Oct 5.
Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified.
A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs.
185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender ( = 0.046), elderly aged 70 years and above ( = 0.032), those living alone ( = 0.035), low monthly family income ( = 0.044), financially fully dependent elderly ( = 0.0002), and those having 3 or more physical disabilities ( = 0.033).
The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities.
在印度北方邦农村地区,社区专家尚未对足够简单、可供基层医护人员使用的替代指标进行深入研究。我们评估了农村老年人日常生活活动(ADL)中的身体残疾情况以及身体残疾方面未满足的需求。同时还确定了老年人身体残疾未满足需求的预测因素。
在印度北方邦农村一家三级医疗中心的农村实地实践区域,对老年居民开展了一项基于社区的横断面研究。采用与规模成比例的概率抽样技术(PPS),从9个村庄中选取了335名60岁及以上的参与者。研究工具包括关于社会人口学细节、社会经济状况的表格以及斯坦福健康评估问卷。进行多变量逻辑回归分析以确定未满足需求的预测因素。
185人(55.2%)在一项或多项活动受限方面存在身体残疾。按性别划分,老年女性在一项或多项ADL类别中的身体残疾情况比老年男性更多(66.8%对42.0%)。近三分之一(32.5%)的受试者在一项或多项身体残疾方面存在未满足的需求。研究中确定的未满足需求的预测因素为女性(P = 0.046)、70岁及以上的老年人(P = 0.032)、独居者(P = 0.035)、家庭月收入低(P = 0.044)、经济上完全依赖他人的老年人(P = 0.0002)以及患有3项或更多身体残疾的人(P = 0.033)。
该研究结果表明,残疾人的大量需求仍未得到满足。需要做出更大、更有针对性的努力来识别社区中处于风险的老年人。这些预测因素可作为替代指标,基层医护人员能够轻松利用它们为农村社区的老年人规划和提供服务。