الفهرس 
Health Profile of Older AdultsOnly 14 pages are availabe for public view
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Abstract
The aim of this study is to assess daily living activities among institutionalized older adults with chronic immobility through:
1. Assessing older adults’ knowledge regarding immobility.
2. Assessing older adults’ activities of daily living.
3. Assessing older adults’ degree of mobility.
Research Questions:
1- Is there a relation between socio-demographic characteristic of older adults and degree of mobility?
2- Is there a relation between socio-demographic characteristic older adult and daily living activities?
3- Is there a relation between older adults’ degree of mobility and their daily living activities?
Subjects and methods
Includes research design, setting, subject and tools for data collection.
Research design:
Descriptive analytical or correlational study to achieve the aim of this study.
Research setting:
This study was conducted at all institutionalized health care centers affiliated to the Ministry of Social Solidarity in Fayoum Governorate. There are four institutionalized health care centers namely, Dar Abou Bakr Elsedek, Dar Shafee, Dar Resala and Dar Esha Hassanien,
• Research subjects:
Convenience sample was used in the study included all older adult clients in institutionalized health care centers who had chronic immobility and over 60 years old. The total number was 150 elderly.
Institutionalized health care centers No of elderly
1 Dar Abou Bakr Elsedek 40 (25 female, 15 male)
2 Dar Shafee 30 (20 female, 10 male)
3 Dar Resala 30 (20 female, 10 male)
4 Dar Esha Hassanien 50 (30 female, 20 male)
Tools of the study:
Data of this study was collected through two tools as the following:
First tool: Interviewing structured questionnaire divided into five parts developed by the investigator. (Appendix I).
• Part I: Sociodemographic characteristics to assess age, sex, marital status, education, occupation, income. Q1 – Q6.
• Part II: Medical history as chronic diseases as cardiac diseases, diabetes mellitus, renal disease, neurological disease, hepatic disease, medication administration, past surgery, accidents, times and place of accidents, complication of accidents, smoking, periodic check up, sleep pattern, and types of sleep disorders . Q7- Q22.
• Part III: Knowledge of older adult regarding immobility: to assess older adults’ knowledge regarding immobility, it consisted of (26) multiple choice question divided into five dimensions older adults’ immobility (5 items), activities of daily living (5 items), changes (5 items), common diseases (7 items), healthy and safe environment (4 items).Q23 –Q48.
• Part IV: Elderly mobility scale (EMS): Adopted from Nolan, Remilton, Green, 2008. This tool provides a standardized mean to assess degree of mobility in older adults. There are 7 dimensions of functional performance evaluated, all of which refer to abilities that are supporting the performing of activities of daily living, it consisted of (7) multiple choice question, lying to sitting, sitting to lying, sitting to standing, standing process, gait, timed walk, and functional reach.
- 14 -20: Elderly is independent in basic activities of daily life and is generally safe at home, however, might require some help.
- 13-10: Elderly scores borderline independence in activities of daily life and requires some help with mobility maneuvers.
- 0 – 9: Elderly requires help with basic activities of daily life and is dependent of long-term care.
• Part V: Barthel Index of Activities of Daily Living. Adopted from Collin et al., 1988, to assess daily living activities of older adults. It consisted of 10 items of multiple-choice question, bowels (3 items), bladder (3 items), grooming (2 item), toilet use (3 items), feeding (3 items), transfer (4 items), mobility (4 items), dressing (3 items), stairs (3 items) bathing (2 item).
Scoring system:
Sum elderly scores for each item, total possible scores range from 0 – 20, with lower scores indicating increased disability. It was classified into two categories
- 0-9: Elderly consider dependent.
- 10-20: Elderly consider independent.
Second tool: Environmental assessment tool (EAT): (Appendix II) Adopted from Fleming, Forbes, Bennett, 2003. An observational checklist to assess safety of older adults’ environment. It consisted of 38 items divided into four dimensions:
1- Unobtrusively reduce risks (14 items),
2- Manage level of stimulation optimize helpful stimulation (9 items),
3- Support movement and engagement (9 items),
4- Create a familiar place (6 items).
Content and Face Validity
It was ascertained by a group of three experts in community health nursing. Their opinions elicited regarding the format, layout, consistency, accuracy and relevancy of the tools.
The present study revealed that:
The mean age of older adults were 67.45±7.23, one third of older adults, their age was ranged between 75 to 84 years old, 52.7% of them were males versus 47.3% were females, 44% of older adult were widow, 30.7% of them had basic educational level. 96% of them retired, and 50.7% of them had not enough income.
The present study results showed that, 58% of older adult had correct answer regarding meaning of immobility, 50% of them had correct answer regarding of causes of immobility. 61.3% of them had correct answer regarding risk factors of immobility. While, 46.0 of them had correct answer regarding a complicatins of immobility, 54.7% of them had correct answer regarding prevention of immobility.
Also, this study finding showed that, 69.3% of older adult had correct answer regarding meaning of daily living activities, 76.7% of them had correct answer regarding types of daily living activities, 78.7% of them had correct answer regarding factors that affect on daily living activities, while 76.7% of them had correct answer regarding benefits older adult’s daily living activities, 80.0% of them had correct answer regarding importance of daily living activities.
This study result finding showed that, 40.7% of older adults need help from one person from sleep to sitting, 42% of them not need help from sitting to sleep. While, 39.3% of them need help from one person from sitting to standing, 37.3% of them need help from one person during standing, 37.8% of older adult walk with help but not safe during walking, 54.7% of them need less than 15 sec during walking for certain time, 50% of them need more than 20 cm during functional reach.
There were more than half of older adult had satisfactory knowledge regarding immobility where about less than half of them had unsatisfactory knowledge regarding immobility.
However, more than three quarterly of older adult had satisfactory knowledge regarding daily living activities where about one quarter of them had unsatisfactory knowledge regarding daily living activities.
Also, the present study results concluded that, one third of older adults show independent level of mobility where about one quarter of them had borderline independent level and less than half of them had dependent mobility degree.
According to research question there was a statistically significant difference between sociodemographic characteristic of older adult and degree of mobility.
Also, there there were statistically significant different between sociodemographic older adult knowledge and daily living activities.
However, there there were statistically significant differences between degree of mobility of older adult and their daily living activities.