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首页> 外文期刊>Journal of Health Services Research & Policy >Locomotor disability: meaning, causes and effects of interventions
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Locomotor disability: meaning, causes and effects of interventions

机译：运动障碍：干预措施的含义，原因和影响

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This paper provides a synopsis of a long-term programme of MRC-funded work on locomotor disability in older people. Specifically it describes the meaning and experience of disability, examines the risk factors for disability and systematically reviews the evidence from randomized trials of complex interventions for disability. We undertook a national prospective study of a representative sample of 999 people aged 65 years or more plus in-depth interviews with a small subsample and a selected sample obtained from hospital sources. Secondary analysis of several large prospective studies was carried out and a systematic review and meta-analysis of published randomized controlled trials of the effects of complex interventions for disability. Very few participants subscribed to the constructs of longstanding illness, disability or infirmity that surveys often use. A wide range of social and psychological factors, independently of chronic diseases, were strongly associated with disability. People with greater functional reserve capacity and those with greater self-efficacy were generally less likely to suffer from catastrophic decline in ability and had better quality of life in the face of disability. In reviewing 89 trials (over 97,000 participants) of complex interventions for disability, evidence of benefits was found although no relationship with intensity of intervention was apparent. nnOur findings on the meaning and experience of disability suggest the need for modifications to routinely used survey questions and for different ways of understanding the need for and receipt of care among older people with disabilities. The diverse risk factors for disability suggest that novel approaches across social, psychological as well as more traditional rehabilitation and behavioural risk factor modification would be worth exploring. Complex interventions appeared to help older people to live independently and limit functional decline irrespective of age and health status.
机译：本文概述了由MRC资助的老年人运动障碍的长期计划。具体来说，它描述了残疾的含义和经历，检查了残疾的危险因素，并系统地审查了复杂的残疾干预措施随机试验的证据。我们进行了一项全国性前瞻性研究，对999名65岁或65岁以上人群的代表性样本进行了深入访谈，并对其中的一个小样本和从医院获得的样本进行了深入访谈。对几项大型前瞻性研究进行了二级分析，并对已发表的有关复杂干预措施对残疾的影响的随机对照试验进行了系统的综述和荟萃分析。很少有参与者赞成调查经常使用的长期疾病，残疾或虚弱的结构。独立于慢性疾病的各种社会和心理因素与残疾密切相关。具有较高功能储备能力的人和具有较高自我效能的人通常较少遭受灾难性的能力下降，并且面对残疾时生活质量更好。在审查89项针对残疾的复杂干预措施的试验（超过97,000名参与者）时，发现了获益的证据，尽管与干预强度没有明显关系。 nn我们对残疾的含义和经历的发现表明，有必要对常规使用的调查问题进行修改，并需要以不同的方式来理解老年人的护理需求和接受护理的方式。残疾的各种危险因素表明，应探索跨社会，心理以及更传统的康复和行为危险因素修正的新颖方法。无论年龄和健康状况如何，复杂的干预措施似乎都可以帮助老年人独立生活并限制功能下降。

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