How's Your Health at Home: Frail Homebound Patients Reported Health Experience and Outcomes

Pour notre sondage, nous avons utilise une methodologie mixte basee sur le Web (How's Your Health–Frail) pour examiner la sante des adultes fragiles (78% âges de 80 ans et plus) inscrits a un programme de soins primaires a domicile a Vancouver, au Canada. Soixante pour cent des repondants admissibles ont participe, representant plus d'un quart (92/350, 26,2%) de tous les individus qui recoivent le service. Malgre des niveaux eleves de co-morbidite et de dependance fonctionnelle, 50% ont juge leur sante aussi bonne, tres bonne ou excellente. Les ratios de cotes ajustes pour l'auto-evaluation de sa sante positive etaient de 7,50, 95 pour cent d'intervalle de confiance (IC) [1,09, 51,81] et 4,85, 95% CI [1,02, 22,95] pour l'absence de symptomes genants et le pouvoir de parler a la famille ou amis, respectivement. Des reponses narratives aux questions sur la fin de vie et la vie avec une maladie sont egalement decrites. Les resultats suggerent que l'accent mis sur la gestion des symptomes, et le soutien des contacts sociaux, peut ameliorer la sante des personnes âgees fragiles. ABSTRACT: We used a web-based mixed methods survey (HowsYourHealth–Frail) to explore the health of frail older (78% age 80 or older) adults enrolled in a home-based primary care program in Vancouver, Canada. Sixty per cent of eligible respondents participated, representing over one quarter (92/350, 26.2%) of all individuals receiving the service. Despite high levels of co-morbidity and functional dependence, 50 per cent rated their health as good, very good, or excellent. Adjusted odds ratios for positive self-rated health were 7.50, 95 per cent CI [1.09, 51.81] and 4.85, 95 per cent CI [1.02, 22.95] for absence of bothersome symptoms and being able to talk to family or friends respectively. Narrative responses to questions about end of life and living with illness are also described. Results suggest that greater focus on symptom management, and supporting social contact, may improve frail seniors' health.