| Objective:The aging population situation in China is becoming increasingly severe,and the closely related issue of elderly frailty is also becoming increasingly prominent.In order to scientifically manage and effectively reverse frailty,this study aims to explore a comprehensive intervention based on the theory of healthy behavior process orientation,combined with multi-component exercise,nutrition education,medication guidance,and social support,to address the frailty,nutritional status,and depression status of elderly people in the community The occurrence of adverse events and the impact of inflammatory factors provide practical basis for the application of a comprehensive intervention plan for elderly frailty in the community.Methods:This study is a quasi experimental study,using the Elderly Weakness Index Scale to conveniently screen 160 elderly frail patients from two different communities in Xi’an.Using the method of grouping by place of residence,two different communities with similar elderly population proportion and infrastructure conditions and more than two blocks apart were divided into a control group and an intervention group,with 80 patients in each group.The control group received routine community care,while the intervention group received a comprehensive intervention plan based on the theory of health behavior process orientation for a period of 24 weeks.In the first two weeks of the intervention,a community health service center was selected nearby for group intervention,which included multi-component exercise training,nutrition education,medication guidance for the elderly,and social support.Afterwards,a weekly telephone follow-up and a monthly community visit were conducted,After the intervention for 24 weeks,the Chinese version of the frailty index scale,simplified nutrition assessment form,simplified version of the elderly depression scale,laboratory indicators,and self-made adverse event occurrence questionnaire were used to evaluate the effectiveness of comprehensive intervention.Using Epidata3.0 to establish a database and double entry,SPSS26.0 was used for statistical analysis.Among the general data of the two groups of research subjects,the counting data was described using frequency and percentage statistics;If the measurement data follow the normal distribution,the mean±standard deviation shall be used for statistical description;otherwise,the median(quartile)shall be used for description.The X~2 test and Fisher exact probability method were used for the balance comparison of baseline data and the inter group and intra group comparison counting data after intervention.The t-test was used for the measurement data that obeyed the normal distribution,and the Mann Whiteney U-rank sum test was used for the measurement data that did not obey the normal distribution.The difference between the test standards with P<0.05 is statistically significant.Results:During the study,the number of dropouts was 26,with 69 in the control group and 65 in the intervention group completing follow-up.With balanced and comparable baseline data,after 24 weeks of intervention,the total debilitating scores of the elderly in the intervention group were(5.42±2.81)points,lower than the(6.19±3.00)points in the control group and(6.97±1.83)points before intervention.Among them,the physical,psychological,and social debilitating scores in the intervention group were(2.43±1.56)points,(1.85±1.36)points,and(1.15±0.67)points,respectively,lower than the(2.88±1.88)points in the control group The difference between(2.01±1.30)and(1.29±0.97)was statistically significant(P<0.05).In terms of the incidence of weakness,the elderly in the intervention group decreased from 65 cases(100%)before the intervention to 41 cases(63.1%)after the intervention,while the elderly in the control group decreased from 69 cases(100.0%)before the intervention to 59 cases(85.5%)after the intervention,with a statistically significant difference(P<0.01).In terms of nutritional status,the elderly with nutritional risk in the intervention group decreased from 32 cases(49.2%)before the intervention to 23 cases(35.3%)after the intervention,with a statistically significant difference(P<0.05).In terms of the incidence of depression,after comprehensive intervention,the number of elderly patients with depression in the intervention group was 8(12.3%),lower than that in the control group(19(27.5%),with a statistically significant difference(P<0.05).In the incidence of adverse events,the incidence of falls(3.1%),limb dysfunction(4.6%),and emergency admission(0.0%)in the intervention group after intervention was significantly lower than the incidence of falls(15.4%),limb dysfunction(15.4%),and emergency admission(7.7%)before intervention,and lower than the incidence of falls(13.0%)and emergency admission(8.7%)in the control group,with significant differences(P<0.05)There was no statistically significant difference in the incidence of adverse events such as fractures and dysphagia(P>0.05).Among the laboratory indicators,vitamin D(25.26±8.32)in the intervention group after intervention was significantly higher than that in the control group(20.55±7.52)and before intervention(21.10±10.51),with a statistically significant difference(P>0.05).Conclusions:The comprehensive intervention combined with multi-component exercise,nutrition education,medication guidance and social support can improve the frailty of the elderly in the community,and its physical,psychological and social dimensions have been significantly improved,and the frailty of some elderly has been effectively reversed.The comprehensive intervention has a positive impact on the depression,nutritional status and vitamin D level of senile frail patients,and has played a certain role in reducing the risk of adverse events in the elderly,but has no significant impact on biochemical indicators such as albumin and inflammatory factors. |
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