Sense of coherence (SOC) : social and psychological factors in the homebound elderly in a community / 日本プライマリ・ケア連合学会誌

<b>Objective</b> : Although current preventative care policies consider the issue of the homebound elderly to be important, effective means of intervention have not been established. Therefore, it is necessary to elucidate the relevant causes of the poorly understood “homebound” problem. As little expertise exists on the social and psychological factors of those who are homebound, this study focuses on the sense of coherence (SOC) —a new estimate of the psychosocial factors involved in being homebound—and examines the connection between being homebound and SOC.<br><b>Methods</b> : A mail survey was conducted among 1,895 elderly adults, none of whom had been issued a Certification of Long-Term Care Need. Survey items included basic attributes, physical characteristics, psychological and socioenvironmental characteristics, and the condition of being homebound. Furthermore, SOC was investigated as part of the psychosocial and environmental evaluation. The 853 respondents chosen for the analysis were divided into three groups depending on their level of homeboundedness, and an ordered logistic regression analysis was conducted using homeboundedness as the dependent variable.<br><b>Results</b> : The following items were found to have a significant association with homeboundedness : age, sex, low motor function, depressive tendencies, low SOC, and the low TMIG Index of Competence.<br><b>Discussion</b> : This study identified a relation between being homebound and SOC, suggesting that in addition to interventions for depression and motor function, new SOC focused aid must be considered in the prevention of homeboundedness.

An examination of lifestyle of community-dwelling frail elderly people using an activity monitoring evaluation system (A-MES) / 日本プライマリ・ケア連合学会誌

<b>Purpose</b> : The purpose of this study was to examine quantitative activity and determine characteristics using an activity meter in community-dwelling frail elderly people.<br><b>Methods</b> : We monitored 25 community-dwelling elderly of support-requiring condition level1 and 2 by attaching activity monitoring evaluation system (A-MES) and measured physical activity (PA) over 24 hours as well as body information, care information, everyday life function.<br>We examined according to sex / care category using obtained results.<br><b>Results</b> : Women's standing position time and walk time were significantly longer, and men's daytime lying position and sitting position time were significantly longer.<br>Also, in persons of support-required condition level 2 there was a significantly higher number of posture changes from sitting position to daytime lying position.<br>It was suggested that a quantitative evaluation of the PA could lead to discovery of activity decrease in home life in association with each PA item and low rank criteria of the functional independence measure (FIM).<br>Securing of enough walk time and shortening of the lying position time in the daytime tend to be important for self-care ability and maintenance of locomotiveness.<br><b>Conclusion</b> : It was suggested that the evaluation of shortening the lying position time in the daytime and increasing the amount of position changes will supplement a decrease of the PA, which is related to preventing decrease in activity.