Factors associated with the use of wheelchairs by institutionalized elderly people

Abstract Due to the high prevalence of wheel-chair use by institutionalized elderly people, the scope of this research was to verify whether factors involving gender, age, education, length of institutionalization, comorbidities, cognition and functionality are associated with the use of such equipment, as well as ascertain the reasons for use according to the perceptions of the elderly. It is a cross-sectional descriptive study that included 55 elderly people subdivided into G1 (locomotion without assistance) and G2 (wheelchair users). Analysis of the profile in medical records, cognition and functionality by the Mini-Mental State Examination and Barthel index was conducted. Wheelchair users asked about the factors that lead to wheelchair use were recorded: 33 (60%) of the elderly were in G1 and 22 (40%) in G2. There were differences between the groups with respect to functionality (p = 0.005). The elderly who have not suffered a stroke are less likely to use a wheelchair (OR: 0.09; 95% CI: 0.02 to 0.36). Elderly wheelchair users reported: fear of falling, pain, tiredness, weakness in the legs, difficulty walking and lack of assistance in walking. Strokes and functionality are associated with wheelchair use. Knowledge of these factors and the reasons reported by the elderly may enable alternatives of prevention to be defined.

摘要 鉴于养老机构入住老年人使用轮椅的比例较高，本研究旨在验证性别、年龄、受教育程度、入住机构时长、共病情况、认知状态与功能状态等相关因素是否与该辅助器具的使用存在关联，并结合老年人的主观自述明确其使用轮椅的具体原因。本研究为横断面描述性研究，共纳入55名老年人，将其分为G1组（无需辅助即可自主行动）与G2组（轮椅使用者）。研究人员通过梳理医疗档案、采用简易精神状态检查表（Mini-Mental State Examination）及巴氏指数（Barthel index）对受试者的基线特征、认知水平与功能状态进行评估，并对G2组老年人开展轮椅使用诱因的访谈记录工作。本次研究中，G1组共33名老年人，占比60%；G2组共22名，占比40%。两组受试者在功能状态方面存在显著统计学差异（p=0.005）。未发生过脑卒中的老年人使用轮椅的概率显著更低（优势比OR：0.09；95%置信区间CI：0.02~0.36）。轮椅使用者自述的使用原因包括：跌倒恐惧、肢体疼痛、疲劳、下肢乏力、行走困难及无人协助行走。研究结果显示，脑卒中病史与功能状态与轮椅使用存在显著关联。明确上述影响因素及老年人自述的使用原因，可为制定针对性预防策略提供科学依据。