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背景旨在评估一种新型计算机辅助健康与社会风险评估体系在社区医疗机构应用的可行性、范围及所需成本,以有效改善日益增长的老龄化人群健康和幸福感。方法随机抽取英国伦敦伊林以及赫特福德郡的5个社区医疗机构的65岁以上人群。采用老年人多维风险评估体系(MRA-O)进行干预,包括:问卷涉及健康、生活方式、社会及环境领域的内容;基于问卷结果,由软件系统生成个性化的含有促进个人健康及幸福的建议反馈报告;对于有新的或者复杂需求的研究对象,由全科医生或社区护士给予随访。评估项目:使用MRA-O开展调查的可行性;研究对象的幸福状况、行为能力、生活质量、社会需求、健康风险、潜在的生活方式的改变;开展调查所需费用。结果共有1 550例研究对象参加调查,有效应答率为34%(526/1 550)。86%(454/526)完成MRA-O评估。研究对象存在的主要问题有:一周内有躯体疼痛(失访16例,269/438),活动量不足(失访1例,173/453),缺少运动(失访7例,174/447),跌倒(失访15例,117/439),失禁(失访13例,111/441),视力下降(失访3例,116/451),听力下降(失访23例,145/431),抑郁(失访3例,71/451),记忆力下降(失访1例,44/444),脱离社会(失访5例,46/449),孤独感(失访12例,31/442)。71.4%(失访17例,312/437)自评健康情况好/很好,生活质量及幸福感稍高于同龄人群常模标准。应用此评估体系开展调查所花费用不高。结论应用此计算机辅助风险评估体系能调查出老年人中存在的与健康和社会相关的问题以及个体需求。然而,样本量较少,尤其是高龄、特别穷困,以及外裔老年人数量较少,可能不能表明各种老龄化人群使用此系统的机会是均等的。
The purpose of this study is to assess the feasibility, scope and cost of applying a new computer-assisted health and social risk assessment system to community health institutions in order to effectively improve the health and well-being of the growing aging population. Methods A random sample of people aged 65 and over was collected from Ehling, London, England, and five community health facilities in Hertfordshire. Interventions using multidimensional risk assessment system for the elderly (MRA-O) include: questionnaires related to health, lifestyle, social and environmental aspects; based on the questionnaire results, the software system generates personalized recommendations that promote personal health and well-being Feedback reports; follow-up by general practitioners or community nurses for subjects with new or complex needs. Assessment of project: feasibility of using MRA-O to carry out the survey; study of the state of happiness, capacity, quality of life, social needs, health risks, potential changes in lifestyles; Results A total of 1 550 subjects participated in the survey. The effective response rate was 34% (526/1 550). 86% (454/526) completed the MRA-O assessment. The main problems were as follows: physical pain in one week (16 cases lost in follow-up, 269/438 cases), lack of activity (1 case lost in 173 cases, 453 cases lost), lack of exercise (7 cases lost to follow-up, 174/447) (15 cases lost, 117/439 lost), incontinence (13 cases lost, 111/441 lost), decreased vision (3 lost, 116/451 lost), decreased hearing (23 lost, 145/431 lost) , Memory loss (1 case, 44/444 cases lost), depression (5 cases lost, 46/449 cases lost), loneliness (12 cases missing, 31/442 ). 71.4% (17 cases lost, 312/437) Self-rated health status is good / very good, quality of life and happiness is slightly higher than the norm of the same age group of norm. It is not expensive to conduct a survey using this assessment system. Conclusion Using this computer-assisted risk assessment system can investigate health and social-related problems and individual needs among the elderly. However, the small sample size, especially older age, particularly poor people and the small number of older persons of foreign descent may not be able to show that all kinds of aging population have equal access to the system.