A Study On The Current Situation Of Ability Of Daily Living And Its Influencing Factors Of Mild-to-moderate Disabled Elderly In Home-based Setting In Guiyang

Objective: Evaluate the activities of daily living;Analyze the main influence factors of activities of daily living(ADL)among the mild-to-moderate disabled elderly to improve the ability of independent living and further provide some scientific basis to establish the long-term care system in community providing for the disabled elderly.Methods: This was a cross-sectional study that questionnaire research was conducted among 1905 elderly adult in home-based setting in eight communities of Guiyang city by Stratified and cluster random sampling to screen the mild-to-moderate disabled elderly and family caregivers.The instrument for disabled elderly consisted of general information,Katz's Index,Activities of Daily Living scale(ADL),General Self-Efficacy Scale(GSES),the Family concern index(APGAR),the MOS 36 item short from health survey(SF-36).The instrument for family caregivers consisted of general information,Zarit caregiver Burden Interview(ZBI),Epidata 3.1 was used for data entry and SPSS19.0 was adopted to analyzed the data using a descriptive analysis,independent sample t test,one-way analysis of variance,multiple comparison by the Least-significant Difference(LSD),Pearson correlation coefficient,Multiple Liner Regression(MLR)at a 5% significance level.Results:(1)1905 valid questionnaire was received and 234 each from mild-tomoderate disabled elderly and family caregivers was screened;(2)174(74.36%)mild disabled elderly and 70(25.64%)moderate disabled elderly of the total 234 mild-to-moderated disabled elderly.The dependency rate of instrumental activities of daily living scale(IADL)exceeded the physical self-maintenance scale(PSMS).The dependency rate of PSMS was decreasing as bathing,continence,walking,dressing,eating,toileting.The dependency rate of IADL was decreasing as travelling,household tasks,preparing a meal,shopping,grooming,using the telephone,financial management,managing medications.The rate of having chronic diseases among these people was 96.15%,and 51.28% more than two kinds.The top-five:high blood pressure,diabetes,rheumatic arthritis,coronary heart disease.(3)The mean score of self-efficacy was 19.18±5.90,and 64.10% elderly presented low self-efficacy.The mean score of family function was 5.60±2.72,and 20.51% elderly presented a high level of family dysfunction.The disabled elderly had low physical health and mental health combined score compared with normal elderly,difference was statistically significant(P<0.05).(4)60.26% family caregivers presented a high level of care burden.(5)The attitude on self-care of disabled elderly:67.09% elderly thought that try to perform ADL by themselves.The attitude on replacement care of family caregivers:38.46% caregivers thought that let elderly perform ADL by themselves,34.62% caregivers would have performed it for them.(6)The main influence factors of ADL of the mild-to-moderate disabled elderly were elderly' literacy,gender,monthly income,the number of children,family function,mental status and family caregivers' opinion on the possibility of functional recovery in the elderly,replacement care.Conclusions:(1)The mild-to-moderate disabled elderly's PSMS,IADL had a certain dependence in home-based setting in Guiyang.Family caregivers had a high level of care burden,the authorities should pay attention to not only disabled elderly but also family caregivers.(2)Most of disabled elderly was willing to perform ADL by themselves,however,some family caregivers would do it for them so that aggravated the dependency rate of ADL of disabled elderly.(3)According to the influence factors of ADL,targeted intervening measures should be worked out to decrease the dependency of ADL and further improve the quality of life for disabled elderly,ease family and society's care burden.