Investigation of self-care ability and frailty of daily living activities in elderly hemodialysis patients and risk factor assessment
Objective:To evaluate the self-care ability of activity of daily living(ADL)and weakness of elder-ly patients with maintenance hemodialysis(MHD),and to explore dialysis-related risk factors.Methods:A total of 228 elderly MHD patients from the Blood Purification Center of China-Japan Friendship Hospital were in-cluded.Cross-sectional survey was conducted using the assessment scale of self-care ability and frailty screen-ing scale of the elderly,and correlation analysis,univariate and multivariate regression analyses were carried out.Results:The mean age of the patients was 70.9±7.2 years,among them 51％were males,and 23.70％had various degrees of dependence on daily life(eating,personal hygiene,dressing,toileting and excretion and movement).Univariate analysis showed that age,dialysis blood flow,unplanned dismounting and events of con-cern(fracture,cardiovascular events,outpatient emergency hospitalization)were statistically significant between different ADL ability groups(P＜0.05).The incidence of frailty was as high as 85％,and the correlation coeffi-cient with ADL capacity was 0.503(P＜0.01).The multi-classification logistic regression equation showed that frailty(OR=0.22,0.124,P＜0.01)and age(OR=1.104,OR=1.117,P＜0.01)were risk factors for mild and moderate dependence of ADL in ADL self-care patients.Dialysis age(OR=1.151,P=0.014)was an independent risk fac-tor for ADL who could take care of themselves.Conclusion:Self-care of daily living in elderly MHD patients was strongly associated with prevalent frailty,and that progression of frailty exponentially increased the risk of declining self-care.The occurrence of clinical events,setting a lower blood flow,increasing dialysis age and having unplanned off-board behavior were associated with a decline in self-care in daily life.Attention should be given in clinical care to early recognition of declining ADL in elderly hemodialysis patients and early nursing intervention.
maintenance hemodialysiselderly patientsactivity of daily livingfrailty
万方数据
维普
