老年住院患者衰弱与健康促进行为的相关性

金燕萍; 王静茹; 杨守钦; 崔亮; 孙林芳

doi:10.16766/j.cnki.issn.1674-4152.004218

老年住院患者衰弱与健康促进行为的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004218

上海交通大学医学院附属第六人民医院护理部，上海 200233

基金项目:

上海市卫生健康委员会科研项目 202140042

详细信息

通讯作者:
孙林芳，E-mail：13916873449@163.com

中图分类号: R592
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出版历程
- 收稿日期: 2025-03-11

The correlation between frailty and health promoting behavior in the elderly inpatients

Department of Nursing, the Sixth People' s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China

摘要

摘要: 目的分析老年住院患者衰弱状况及其与健康促进行为的相关性，并探讨患者衰弱的影响因素，为临床老年衰弱的防治提供理论参考。方法选取2022年1月—2023年12月上海交通大学医学院附属第六人民医院收治的246例老年住院患者为研究对象，收集基础资料、FRAIL衰弱量表及健康促进生活方式量表(HPLP-Ⅱ)得分，应用SPSS 26.0统计学软件进行分析。结果 246例老年住院患者中，FRAIL得分为(1.72±0.35)分，衰弱发生率为30.49%(75/246)；HPLP-Ⅱ得分为(130.17±24.69)分，得分最高、最低维度分别为营养、体育运动。Logistic回归分析显示，学历(OR=0.536，P=0.003)、居住情况(OR=8.989，P=0.004)、用药种类(OR=3.174，P=0.013)、营养不良(OR=5.995，P=0.004)、体育锻炼时间(OR=0.387，P=0.010)、健康促进行为(OR=3.575，P=0.002)均为老年住院患者衰弱的影响因素。Spearman相关性分析显示，老年住院患者FRAIL得分与HPLP-Ⅱ总分呈负相关关系(r=-0.481，P＜0.05)。结论老年住院患者衰弱与健康促进行为呈负相关关系，临床需尽早进行综合干预，提升患者的健康促进行为，改善衰弱状况。
- 衰弱 /
- 老年 /
- 健康促进行为 /
- 相关性
Abstract: Objective To analyze the correlation between frailty and health-promoting behavior in elderly inpatients, and to explore the influencing factors of frailty to provide a theoretical reference for clinical frailty prevention and treatment. Methods A total of 246 elderly inpatients admitted to the Sixth People' s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were selected as the research objects. Basic data, the FRAIL frailty scale and health-promoting lifestyle scale (HPLP-Ⅱ) scores were collected and analyzed using SPSS 26.0 statistical software. Results Among 246 elderly inpatients, FRAIL score was (1.72±0.35) points, with an incidence of 30.49% (75/246); The score of HPLP-Ⅱ was (130.17±24.69) points, and the highest and lowest scores were nutrition and physical exercise; Logistic regression analysis showed that educational background (OR=0.536, P=0.003), living condition (OR=8.989, P=0.004), medication type (OR=3.174, P=0.013), malnutrition (OR=5.995, P=0.004), physical exercise time (OR=0.387, P=0.010), and health-promoting behavior (OR=3.575, P=0.002) were the related factors affecting the frailty of elderly inpatients. Spearman correlation analysis showed that the FRAIL score of elderly inpatients was negatively correlated with the total score of HPLP-Ⅱ (r=-0.481, P < 0.05). Conclusion There is a negative correlation between frailty and health-promoting behavior in elderly inpatients. Comprehensive intervention is needed as early as possible to improve patients' health-promoting behaviors and improve frailties.
- Frailty /
- Elderly /
- Health promoting behavior /
- Correlation
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表 1 老年住院患者健康促进行为状况(x±s，分)

Table 1. Health-promoting behaviors in older adult inpatients(x±s, points)

项目	条目数	总分	条目均分
HPLP-Ⅱ	52	130.17±24.69	2.50±0.54
体育运动	8	18.09±4.13	2.26±0.31
健康责任	9	20.41±5.28	2.27±0.33
压力管理	8	20.57±5.36	2.57±0.59
营养	9	25.11±5.82	2.79±0.62
人际关系	9	24.19±5.75	2.69±0.60
精神成长	9	21.80±5.51	2.42±0.50

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表 2 影响老年住院患者衰弱的单因素分析

Table 2. Univariable analysis of factors associated with frailty in older adult inpatients

项目	例数	衰弱		统计量	P值	项目	例数	衰弱		统计量	P值
项目	例数	是	否	统计量	P值	项目	例数	是	否	统计量	P值
年龄[例(%)]				2.328^a	0.020	冠心病[例(%)]				2.473^b	0.116
60~69岁	105	23(30.67)	82(47.95)			有	129	45(60.00)	84(49.12)
70~79岁	87	32(42.67)	55(32.16)			无	117	30(40.00)	87(50.88)
≥80岁	54	20(26.67)	34(19.88)			慢性阻塞性肺疾病[例(%)]				2.328^b	0.127
性别[例(%)]				3.740^b	0.053	有	48	19(25.33)	29(16.96)
男性	118	29(38.67)	89(52.05)			无	198	56(74.67)	142(83.04)
女性	128	46(61.33)	82(47.95)			以往工作性质[例(%)]				3.706^b	0.157
学历[例(%)]				3.082^a	0.002	脑力为主	64	15(20.00)	49(28.65)
初中及以下	122	47(62.67)	75(43.86)			体力为主	122	44(58.67)	78(45.61)
高中或中专	80	22(29.33)	58(33.92)			脑力体力兼有	60	16(21.33)	44(25.73)
大专及以上	44	6(8.00)	38(22.22)			家庭人均月收入[例(%)]				1.950^a	0.051
体质指数[例(%)]				0.450^a	0.653	＜2 000元	85	29(38.67)	56(32.75)
＜18.5	91	29(38.67)	62(36.26)			2 000~5 000元	91	33(44.00)	58(33.92)
18.5~23.9	68	21(28.00)	47(27.49)			＞5 000元	70	13(17.33)	57(33.33)
＞23.9	87	25(33.33)	62(36.26)			最近1年住院次数[例(%)]				2.196^a	0.028
居住地[例(%)]				0.094^b	0.954	1次	39	7(9.33)	32(18.71)
农村	47	15(20.00)	32(18.71)			2次	95	27(36.00)	68(39.77)
城镇	75	22(29.33)	53(30.99)			≥3次	112	41(54.67)	71(41.52)
城市	124	38(50.67)	86(50.29)			用药种类(x±s，种)		5.84±1.35	4.61±1.02	7.857^c	＜0.001
婚姻状态[例(%)]				4.620^b	0.099	医保类型[例(%)]				0.680^b	0.409
未婚	5	3(4.00)	2(1.17)			职工医保	118	33(44.00)	85(49.71)
已婚	149	39(52.00)	110(64.33)			新农合/居民医保	128	42(56.00)	86(50.29)
丧偶、分居或离婚	92	33(44.00)	59(34.50)			营养不良[例(%)]				13.742^b	＜0.001
居住情况[例(%)]				8.632^b	0.003	是	92	41(54.67)	51(29.82)
独居	82	35(46.67)	47(27.49)			否	154	34(45.33)	120(70.18)
未独居	164	40(53.33)	124(72.51)			住院时长[例(%)]				1.897^b	0.168
高血压[例(%)]				0.221^b	0.639	＜7 d	74	18(24.00)	56(32.75)
有	182	54(72.00)	128(74.85)			≥7 d	172	57(76.00)	115(67.25)
无	64	21(28.00)	43(25.15)			体育锻炼时间[例(%)]				5.213^a	＜0.001
糖尿病[例(%)]				0.445^b	0.505	从不	39	25(33.33)	14(8.19)
有	94	31(41.33)	63(36.84)			1~30 min/d	137	41(54.67)	96(56.14)
无	152	44(58.67)	108(63.16)			31~59 min/d	41	5(6.67)	36(21.05)
						≥60 min/d	29	4(5.33)	25(14.62)
						健康促进行为(x±s，分)		92.85±15.32	146.54±27.58	15.811^c	＜0.001
注：^a为Z值，^b为χ²值，^c为t值。

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表 3 影响老年住院患者衰弱的多因素分析

Table 3. Multivariable analysis of factors associated with frailty in older adult inpatients

变量	B	SE	Waldχ²	P值	OR值	95% CI
学历	-0.624	0.211	8.746	0.003	0.536	0.354~0.810
居住情况	2.196	0.749	8.596	0.004	8.989	2.071~39.019
用药种类	1.155	0.462	6.250	0.013	3.174	1.283~7.850
营养不良	1.791	0.612	8.564	0.004	5.995	1.807~19.896
体育锻炼时间	-0.950	0.369	6.628	0.010	0.387	0.188~0.797
健康促进行为	1.274	0.408	9.750	0.002	3.575	1.607~7.954
注：学历，初中及以下=1，高中或中专=2，大专及以上=3；居住情况，独居=1，未独居=2；用药种类为连续性变量，以实际值赋值；营养不良，是=1，否=2；体育锻炼时间，从不=1, 1~30 min/d=2，31~59 min/d=3，≥60 min/d=4；健康促进行为为连续性变量，以实际值赋值。

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表 4 老年住院患者衰弱与健康促进行为的相关性分析

Table 4. Correlation analysis between frailty and health promoting behavior in elderly inpatients

项目	r值	P值
体育运动	-0.410	＜0.001
健康责任	-0.362	0.001
压力管理	-0.308	0.009
营养	-0.315	0.007
人际关系	-0.357	0.003
精神成长	-0.306	0.010
HPLP-Ⅱ总分	-0.481	＜0.001

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参考文献(21)

[1]	曹成霖, 吴新春, 纪凯, 等. 老年衰弱研究进展[J]. 中国临床保健杂志, 2023, 26(2): 274-278. CAO C L, WU X C, JI K, et al. Research progress of frailty among older people[J]. Chin J Clin Healthcare, 2023, 26(2): 274-278.
[2]	吴敏婕, 吴申慧, 严玉茹. 老年综合评估在老年衰弱群体中的应用现状及思考[J]. 中国全科医学, 2023, 26(13): 1655-1660. WU M J, WU S H, YAN Y R. Comprehensive geriatric assessment in frail older people: thoughts on application[J]. Chinese Journal of General Practice, 2023, 26(13): 1655-1660.
[3]	黄宏燕, 戴曦, 胡蓉, 等. 多组分运动对老年衰弱患者营养状况和肌肉功能的影响[J]. 中国实用护理杂志, 2022, 38(7): 530-536. HUANG H Y, DAI X, HU R, et al. Effects of multicomponent training on nutritional status and muscle function in frail elderly adults[J]. Chin J Pract Nurs, 2022, 38(7): 530-536.
[4]	WARD D D, RANSON J M, WALLACE L M K, et al. Frailty, lifestyle, genetics and dementia risk[J]. J Neurol Neurosurg Psychiatry, 2022, 93(4): 343-350. doi: 10.1136/jnnp-2021-327396
[5]	ABELLAN VAN KAN G, ROLLAND Y M, MORLEY J E, et al. Frailty: toward a clinical definition[J]. J Am Med Dir Assoc, 2008, 9(2): 71-72. doi: 10.1016/j.jamda.2007.11.005
[6]	杨正霞, 罗彩凤, 迟晨汝, 等. 老年住院患者衰弱现状及影响因素分析[J]. 皖南医学院学报, 2023, 42(2): 177-180. YANG Z X, LUO C F, CHI C R, et al. Analysis on the current incidence of debilitation and influencing factors in elderly hospitalized patients[J]. Acta Acade Med Wannan, 2023, 42(2): 177-180.
[7]	RATHNAYAKE N, ALWIS G, LENORA J, et al. Applicability of health promoting lifestyle profile-Ⅱ for postmenopausal women in Sri Lanka; a validation study[J]. Health Qual Life Outcomes, 2020, 18(1): 122. DOI: 10.1186/s12955-020-01371-7.
[8]	董旭婷, 徐芳, 盛永红, 等. 健康促进行为与老年增殖型糖尿病视网膜病变患者衰弱的关系: 自我效能的中介作用及孤独感的调节效应[J]. 沈阳医学院学报, 2024, 26(1): 25-29, 94. DONG X T, XU F, SHENG Y H, et al. Mediating effects of self-efficacy and loneliness on health promoting behavior and frailty in elderly patients with proliferative diabetic retinopathy[J]. Journal of Shenyang Medical College, 2024, 26(1): 25-29, 94.
[9]	张瑛, 郑静, 管玉香, 等. 2型糖尿病患者衰弱与自我效能的关系及影响因素分析[J]. 中华全科医学, 2023, 21(7): 1153-1156. ZHANG Y, ZHENG J, GUAN Y X, et al. Correlation between frailty and self-efficacy in patients with type 2 diabetes and its influencing factors[J]. Chinese Journal of General Practice, 2023, 21(7): 1153-1156.
[10]	KRISHNAMOORTHY Y, VIJAYAGEETHA M, SAYA GK. Validation and reliability assessment of the mini-nutritional assessment-short form questionnaire among older adults in South India[J]. Indian J Community Med, 2021, 46(1): 70-74. doi: 10.4103/ijcm.IJCM_208_20
[11]	杨帆, 陈庆伟. 老年住院患者衰弱状态及其影响因素分析研究[J]. 中国全科医学, 2018, 21(2): 173-179. YANG F, CHEN Q W. Status and associated factors of frailty in older inpatients[J]. Chinese Journal of General Practice, 2018, 21(2): 173-179.
[12]	陈静, 王晓玲, 安康, 等. 老年衰弱与代谢综合征关系的研究进展[J]. 老年医学与保健, 2023, 29(6): 1374-1377. CHEN J, WANG X L, AN K, et al. Research progress on the relationship between senile frailty and metabolic syndrome[J]. Geriatr Health Care, 2023, 29(6): 1374-1377.
[13]	王湾湾, 李园园, 石小天, 等. 老年住院患者衰弱的影响因素分析及其与营养不良的相关性研究[J]. 中国全科医学, 2021, 24(6): 678-684. WANG W W, LI Y Y, SHI X T, et al. Frailty-related factors and degree of association of frailty with malnutrition in elderly inpatients[J]. Chinese Journal of General Practice, 2021, 24(6): 678-684.
[14]	张亚强, 关欣, 李晔, 等. 北京地区老年患者衰弱现状及中医证候调查[J]. 北京中医药, 2022, 41(8): 894-902. ZHANG Y Q, GUAN X, LI Y, et al. Investigation on the status quo of frailty and TCM syndromes of elderly patients in Beijing area[J]. Beijing Med J, 2022, 41(8): 894-902.
[15]	肖敏, 茆京来, 章晓君. 住院老年患者衰弱危险因素的横断面分析[J]. 中国综合临床, 2020, 36(4): 353-358. XIAO M, MAO J L, ZHANG X J. Cross-sectional analysis of frailty risk factors in hospitalized elderly patients[J]. Clin Med Chin, 2020, 36(4): 353-358.
[16]	李蕊, 吴越, 郑晓峰, 等. 老年共病住院患者衰弱风险预测模型的构建及验证[J]. 护士进修杂志, 2023, 38(11): 1006-1011. LI R, WU Y, ZHENG X F, et al. Construction of frailty risk prediction model for elderly inpatients with comorbidity and its validation[J]. J Nurs Train, 2023, 38(11): 1006-1011.
[17]	刘兰, 马文. 六盘水市社区老年衰弱的发生现状及其影响因素[J]. 贵州医科大学学报, 2024, 49(10): 1477-1483. LIU L, MA W. Study on the situation of senile frailty and its influencing factors in Liupanshui communities[J]. J Guizhou Med Univ, 2024, 49(10): 1477-1483.
[18]	赵婉越, 张伯煜, 孙婷, 等. 运动改善老年人衰弱状况的剂量效应Meta分析[J]. 中国慢性病预防与控制, 2023, 31(11): 860-866. ZHAO W Y, ZHANG B Y, SUN T, et al. Dose-effect meta-analysis of exercise to improve frailty in the elderly[J]. Chin J Prev Contr Chron Dis, 2023, 31(11): 860-866.
[19]	沈影, 王梅, 罗迎霞, 等. 基于能力-机会-动机-行为模型老年肺癌衰弱患者健康促进方案的构建[J]. 护理学报, 2022, 29(6): 65-70. SHEN Y, WANG M, LUO Y X, et al. Construction of health promotion program for elderly patients with debilitating lung cancer based on capability-opportunity-motivation-behavior model[J]. J Nurs Sci, 2022, 29(6): 65-70.
[20]	王水雨, 马丹, 位亚娟, 等. 郑州市二七区社区独居老年人衰弱与社会支持状况调查[J]. 实用预防医学, 2022, 29(2): 234-237. WANG S Y, MA D, WEI Y J, et al. Investigation on frailty and social support of elderly people living alone in Erqi District of Zhengzhou City[J]. Pract Prev Med, 2022, 29(2): 234-237.
[21]	DENG Y, ZHANG K, ZHU J, et al. Healthy aging, early screening, and interventions for frailty in the elderly[J]. Biosci Trends, 2023, 17(4): 252-261. doi: 10.5582/bst.2023.01204