芬兰接受长期护理的老年人生活意愿的相关因素。

IF 2.7 Q2 HEALTH CARE SCIENCES & SERVICES
Palliative Care and Social Practice Pub Date : 2023-11-30 eCollection Date: 2023-01-01 DOI:10.1177/26323524231212513
Paula Andreasen, Leena Forma, Ilkka Pietilä
{"title":"芬兰接受长期护理的老年人生活意愿的相关因素。","authors":"Paula Andreasen, Leena Forma, Ilkka Pietilä","doi":"10.1177/26323524231212513","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A living will document is known to be an important tool for preparing for future care together with healthcare professionals. A living will supports an older person's self-determination and autonomy. Only a few studies have approached the underlying factors of a living will document among older long-term care recipients.</p><p><strong>Objectives: </strong>To explore how common having a living will was among older persons receiving home care or round-the-clock long-term care, as well as to evaluate associations between socio-demographical factors and functional capacity with a living will.</p><p><strong>Design: </strong>The study population consisted of older persons receiving long-term care in Finland in 2016-2017. Data were collected <i>via</i> individual assessments at home or at a care facility. The questions in the assessment covered health, functional capacity, service use, and social support.</p><p><strong>Methods: </strong>Primary outcome 'living will' and associated factors were identified for each person aged 65 or older from RAI-assessment data (Resident Assessment Instrument, RAI). Cross-tabulations with χ²-tests and adjusted binary logistic regression models were performed to evaluate the association between the factors and a living will.</p><p><strong>Results: </strong>Of the 10,178 participants, 21% had a living will - a greater proportion were female (22%) than male (18%), and a greater proportion of residents in assisted living (25%) and residential care homes (20%) compared with home care residents (15%) had a living will. Female gender (<i>p</i> < 0.001), having a proxy decision-maker (<i>p</i> = 0.001), increasing age (<i>p</i> = 0.003), impairing functional capacity (activities of daily living hierarchy <i>p</i> < 0.001, Cognitive Performance Scale <i>p</i> < 0.001), instability of health status (Changes in Health, End-Stage Disease and Signs and Symptoms <i>p</i> < 0.001), and closeness of death (<i>p</i> < 0.001) were significantly associated with a living will among older persons. Extensive differences in results were found between home care clients and clients of round-the-clock long-term care.</p><p><strong>Conclusion: </strong>Preparedness for the future with a living will varies according to services and on individual level. To reduce inequalities in end-of-life care, actions for advance care planning with appropriate timing are warranted.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":"17 ","pages":"26323524231212513"},"PeriodicalIF":2.7000,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687943/pdf/","citationCount":"0","resultStr":"{\"title\":\"Factors associated with living will among older persons receiving long-term care in Finland.\",\"authors\":\"Paula Andreasen, Leena Forma, Ilkka Pietilä\",\"doi\":\"10.1177/26323524231212513\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A living will document is known to be an important tool for preparing for future care together with healthcare professionals. A living will supports an older person's self-determination and autonomy. Only a few studies have approached the underlying factors of a living will document among older long-term care recipients.</p><p><strong>Objectives: </strong>To explore how common having a living will was among older persons receiving home care or round-the-clock long-term care, as well as to evaluate associations between socio-demographical factors and functional capacity with a living will.</p><p><strong>Design: </strong>The study population consisted of older persons receiving long-term care in Finland in 2016-2017. Data were collected <i>via</i> individual assessments at home or at a care facility. The questions in the assessment covered health, functional capacity, service use, and social support.</p><p><strong>Methods: </strong>Primary outcome 'living will' and associated factors were identified for each person aged 65 or older from RAI-assessment data (Resident Assessment Instrument, RAI). Cross-tabulations with χ²-tests and adjusted binary logistic regression models were performed to evaluate the association between the factors and a living will.</p><p><strong>Results: </strong>Of the 10,178 participants, 21% had a living will - a greater proportion were female (22%) than male (18%), and a greater proportion of residents in assisted living (25%) and residential care homes (20%) compared with home care residents (15%) had a living will. Female gender (<i>p</i> < 0.001), having a proxy decision-maker (<i>p</i> = 0.001), increasing age (<i>p</i> = 0.003), impairing functional capacity (activities of daily living hierarchy <i>p</i> < 0.001, Cognitive Performance Scale <i>p</i> < 0.001), instability of health status (Changes in Health, End-Stage Disease and Signs and Symptoms <i>p</i> < 0.001), and closeness of death (<i>p</i> < 0.001) were significantly associated with a living will among older persons. Extensive differences in results were found between home care clients and clients of round-the-clock long-term care.</p><p><strong>Conclusion: </strong>Preparedness for the future with a living will varies according to services and on individual level. To reduce inequalities in end-of-life care, actions for advance care planning with appropriate timing are warranted.</p>\",\"PeriodicalId\":36693,\"journal\":{\"name\":\"Palliative Care and Social Practice\",\"volume\":\"17 \",\"pages\":\"26323524231212513\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2023-11-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687943/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Palliative Care and Social Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/26323524231212513\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Palliative Care and Social Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/26323524231212513","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

背景:众所周知,生前遗嘱文件是与医疗保健专业人员一起为未来护理做准备的重要工具。生前遗嘱支持老年人的自决和自主。只有少数研究接近了长期护理老年人的生活遗嘱文件的潜在因素。目的:探讨在接受家庭护理或全天候长期护理的老年人中,拥有生前遗嘱的普遍程度,并评估社会人口因素和功能能力与生前遗嘱之间的关系。设计:研究人群由2016-2017年在芬兰接受长期护理的老年人组成。数据是通过在家或在护理机构的个人评估收集的。评估中的问题包括健康、功能能力、服务使用和社会支持。方法:从RAI评估数据(居民评估工具,RAI)中确定每个65岁或以上的人的主要结局“生前遗嘱”和相关因素。采用χ 2检验和调整后的二元logistic回归模型进行交叉表列,以评估各因素与生前遗嘱之间的相关性。结果:在10,178名参与者中,21%的人有生前遗嘱,其中女性的比例(22%)高于男性(18%),在辅助生活院舍(25%)和住宿护养院(20%)的居民比在家护理院舍(15%)的居民有生前遗嘱。女性(p = 0.001),年龄增加(p = 0.003),功能能力下降(日常生活活动层次p p p p p p p结论:对未来生活的准备程度因服务和个人水平而异。为了减少临终关怀中的不平等,有必要采取适当时机的预先护理计划行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors associated with living will among older persons receiving long-term care in Finland.

Background: A living will document is known to be an important tool for preparing for future care together with healthcare professionals. A living will supports an older person's self-determination and autonomy. Only a few studies have approached the underlying factors of a living will document among older long-term care recipients.

Objectives: To explore how common having a living will was among older persons receiving home care or round-the-clock long-term care, as well as to evaluate associations between socio-demographical factors and functional capacity with a living will.

Design: The study population consisted of older persons receiving long-term care in Finland in 2016-2017. Data were collected via individual assessments at home or at a care facility. The questions in the assessment covered health, functional capacity, service use, and social support.

Methods: Primary outcome 'living will' and associated factors were identified for each person aged 65 or older from RAI-assessment data (Resident Assessment Instrument, RAI). Cross-tabulations with χ²-tests and adjusted binary logistic regression models were performed to evaluate the association between the factors and a living will.

Results: Of the 10,178 participants, 21% had a living will - a greater proportion were female (22%) than male (18%), and a greater proportion of residents in assisted living (25%) and residential care homes (20%) compared with home care residents (15%) had a living will. Female gender (p < 0.001), having a proxy decision-maker (p = 0.001), increasing age (p = 0.003), impairing functional capacity (activities of daily living hierarchy p < 0.001, Cognitive Performance Scale p < 0.001), instability of health status (Changes in Health, End-Stage Disease and Signs and Symptoms p < 0.001), and closeness of death (p < 0.001) were significantly associated with a living will among older persons. Extensive differences in results were found between home care clients and clients of round-the-clock long-term care.

Conclusion: Preparedness for the future with a living will varies according to services and on individual level. To reduce inequalities in end-of-life care, actions for advance care planning with appropriate timing are warranted.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Palliative Care and Social Practice
Palliative Care and Social Practice Nursing-Advanced and Specialized Nursing
CiteScore
2.90
自引率
0.00%
发文量
37
审稿时长
9 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信