Investigation And Analyses Of Activities Of Daily Living, Social Activities, Cognition And Complication Among The Bedridden Elderly

Background:With the coming of the senile society, owing to caducity and disease, the number of the bedridden elderly patients gradually increased. The manpower and material resources are added into the society and family. At present, the research for the bedridden elderly patients is commonly limited to the long time interrupted bedridden elderly patients, or short time bedridden elderly in hospital and long time bedridden single case report and incidence of a disease to the long term hospitalized bedridden elderly patients, there is little investigation and research about activities of daily living, cognition, social activity and complication for the long term hospitalized bedridden elderly patients. By using objective methods, an investigation and analyses about above problems is developed. The results will be used to guide the clinical geriatric nursing, which is important to the old patients and their relatives.Objectives:1. To describe the generating states of activities of daily living, social activities, cognition and complication of the bedridden elderly patients in hospital.2. To ascertain the relationship among the bedridden time and activities of daily living, social activities, cognition and complication chaos of the bedridden elderly patients in hospital.3. To explore the relationship among the bedridden classification and the other items including Activities of Daily Living, social activities, cognition chaos and complication of the bedridden elderly patients in hospital. Object and Methods:Object: The hospitalized bedridden elderly patients from the elderly patients or cadre section of 5 hospitals in ChengDu are extracted for investigation and research according to the bedridden time exceeding 1 month.Methods: By referring literatures, evaluating by experts and pre-researching for modifying the list《The inquisitions for the elderly patients bedridden rest》. The questionnaire include the general population characteristics, the correlative bedridden characteristics, complications, social activity scale, Activities of Daily Living list edited by Lawton and Brody, the ability of cognition scale. Those scales had better reliability and availability by using to the correlative research of the elderly patients and the bedridden. We developed a description-correlation study in our research, and adopt convenient sampling method owing to the limitation in different source of patient. We studied the items including the activities of daily living, social activities, and cognition and of the 151 bedridden elderly patients whose bedridden time is longer than 1 month. Process: Testing the reliability and validity of activities of daily living, social activities, cognition and complications; issuing the questionnaire face to face, collecting and handling the data, adopting the software package of SPSS10.0 to analyze the data.Results:1. The bedridden elderly patients have the problems of lower in the daily life ability, deficiency in social activities, obstacles in cognition and more complications.2. The diversity of activities of daily living, social activities, cognition, complication of the elderly patients having different persistent bedridden timeThere are differences in activities of daily living with different in the elderly bedridden time (P=0.001), the longer the bedridden time is, the more obvious the obstacle in activities of daily living is; There are differences in social activities with different in the elderly bedridden time (P=0.0001), the longer the bedridden time is, the more obvious the deficiency in social activities is; There are differences in cognition with different in the elderly bedridden time (P=0.0001), the longer the bedridden time is , the more obvious the obstacle in cognition is; There are differences in occurring of complication with different in the elderly bedridden time(P=0.0001), the longer the bedridden time is, the more the complication of patient is.3. The correlation among the bedridden time and other items including activities of daily living, social activities, cognition, and complicationThere is positive correlation between the grade of activities of daily living and bedridden time (r_s=0.340), i.e. with increasing of the bedridden time, the obstacle in activities of daily living is more serious; there is negative correlation between the grade of social activities and bedridden time (r_s=-0.348), i.e. with increasing of the bedridden time, the ability in social activities declined; there is positive correlation between cognition testingscore and bedridden time (r_s=0.496), i.e. with increasing of the bedridden time, the obstacle in cognition is more obvious; there is positive correlation between the grade of complication and bedridden time (r_s=0.741) , i.e. with increasing of the bedridden time, the number of complication added, all P=0.001.4. The correlations between the classification of the bedridden groups (including the one needing aids at most time of the day in indoor life and the one in bed all the day) and the others including activities of daily living, social activities, cognition, and complicationThere is positive correlation between the classification of the bedridden groups (including the one needing aids at most time of the day indoor life and the one lying the bed all the day) and activities of daily living (r_s=0.355), i.e. comparing with the one lying the bed all the day to the one needing aids at most time of the day, the mark in activities of daily living is higher, the obstacle in activities of daily living added; there is negative correlation between the classification of the bedridden groups and social activities (r_s=-0.282), i.e. comparing with the one lying the bed all the day to the one needing aids at most time of the day, the mark in social activities declined, the obstacle in social activities is more obvious; There is positive correlation between the classification of the bedridden groups and cognition (r_s=0.296), i.e. comparing with the one lying the bed all the day to the one needing aids at most time of the day, the mark in cognition is higher, the obstacle in cognition added , all P=0.0001; there is a positive correlation between the classification of the bedridden groups and complication, so being statistic meaning (r_s=0.186, p=0.022). , i.e. comparing with the one lying the bed all the day to the one needing aids at most time of the day, the occurring number of complication added. Conclusions:1. Conclusions and suggestions:(1) The bedridden elderly patients are in the states of lower in activity of daily living, lack in the social activities, having obstacles in cognition and several complications. The society, family and nurses should take more attentions to them.(2) The diversity of activities of daily living, social activities, cognition, and complication of the elderly patients having different persistent bedridden time is obvious.(3) With the bedridden time prolonging, the activities of daily living declining, social activities declining, having obstacle in cognition and the items of complication increasing. It is necessary to decrease the bedridden time of the elderly patients, improve activities of daily living, social activities and cognition and reduce complications.(4) There are correlations among the different classification of the bedridden groups (including the one needing aids at most time of the day indoor life and the one lying the bed all the day) and activities of daily living, social activities, cognition, and complication. Namely, from the one needing aids at most time of the day indoor life to the one in bed all the day, activities of daily living declining, cognition having obstacle and social activities declining, complication increasing. It indicated that we should decrease the bedridden time of the patients.2. Significance:(1) Making the clinic doctor, nurse and the patients' folks recognize the situations, which include the decreasing in activities of daily living, lack insocial activities, obstacles in cognition and the increasing in complications are caused by the long time bedridden, and making them think much of nursing in daily living of the bedridden elderly patients, and provide references for promoting in social activities, estimating in cognition and preventing occurrence in complications.(2) To provide reference for shortening the patients' bedridden time in clinic activities, and making changes from the persistent bedridden rest to interrupted bedridden rest, even not to have bedridden rest.(3) To provide reference for reducing the elderly patients' bedridden time, and change the time from all the day to partly time in bed.