在宅訪問サービスの継続要因および訪問リハビリテーションが要介護高齢者に与える影響 :cluster randomization trialによる検討  [in Japanese] Factors Associated with Continuous Home Care Services and Effects of Home-Visit Rehabilitation Service in Older Individuals Requiring Home Care : a Cluster Randomization Trial  [in Japanese]

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Abstract

【目的】在宅訪問サービスの継続要因および訪問リハビリテーションが要介護高齢者に与える影響について検証することを目的とした。【方法】対象者は,訪問リハビリテーションを利用する要介護高齢者33名(訪問リハ群),および訪問看護または訪問介護を利用しており訪問リハビリテーションを利用していない要介護高齢者13名(非訪問リハ群)とし,3か月間のサービス継続前後で運動機能,生活機能,活動状況の変化を比較した。【結果】30%以上の対象者が3か月後には訪問サービスを中止または終了しており,訪問リハ群では脱落者のvitality indexが継続者よりも有意に低かった。訪問リハ群では運動習慣を有する者が多く,離床時間の増大に対して良好な結果を示した。運動機能や生活機能は,有意な変化を認めなかった。【結論】訪問リハビリテーションの継続には,意欲が関与することが示され,訪問リハビリテーションは運動習慣の確立や離床時間の増大へ良好な影響を与える可能性が示唆された。

<b>Purpose</b>: The purpose of this study was to determine the factors associated with continuous home care services and effects of home-visit rehabilitation service in older individuals requiring home care. <br><b>Methods</b>: Five facilities were randomly assigned to home-visit rehabilitation service and home-visit nursing or care service groups. The home-visit rehabilitation group included 33 older individuals (mean 78.8 ± 6.2 years) who participated in our study. Thirteen older individuals (mean 82.9 ± 7.5 years) who used home-visit nursing or care services constituted the control group. Older for three months and were assessed for grip strength, chair-stand test, functional independence measure, bedside mobility scale, vitality index, and the amount of time out of bed at baseline and after three months. <br><b>Results</b>: In both groups, over 30% participants dropped out after 3 months. In the home-visit rehabilitation group, vitality index in participants who could not continue the home-visit rehabilitation were significantly lower as compared to individuals continued using home-visit rehabilitation. Assessment of interactions between time and group by repeated measure ANOVA adjusted for age and sex revealed a significant difference for the amount of time out of bed per day (p < 0.05). However, differences between two groups for physical functions, daily living functions, bedside mobility performance and caregiver burden were not significant. <br><b>Conclusion</b>: These results suggested that the vitality was one of factors associated with continuous home-visit rehabilitation services. The home-visit rehabilitation might contribute to providing habitual exercise and increase the amount of time out of bed.

Journal

  • Physical Therapy Japan

    Physical Therapy Japan 36(7), 382-388, 2009

    Japanese Society of Physical Therapy

References:  12

Cited by:  1

Codes

  • NII Article ID (NAID)
    110007505001
  • NII NACSIS-CAT ID (NCID)
    AN10146032
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0289-3770
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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