OBJECTIVE To investigate the use of home nursing by community-dwelling older women to determine the nature of services required by those living alone. DESIGN A retrospective cohort study using routinely collected data. SETTING AND PARTICIPANTS Women aged 55 years and older living in metropolitan Melbourne who received an episode of nursing care from a large community home-based nursing service provider between January 1, 2006 and December 31, 2015. METHODS Descriptive and inferential statistical analyses were used to examine the relationship between client- and service-related factors and use of community nursing services. The primary outcome of interest was the hours of service received in a care episode. RESULTS A total of 134,396 episodes of care were analyzed, in which 51,606 (38.4%) episodes involved a woman who lived alone. The median hours of care per episode to women who lived alone was almost 70% more than that for women who lived with others. Multivariable regression identified factors influencing the amount of service use: living alone status, cognitive health status, and number of required home nursing activities. After adjusting for confounding and interactions, living alone was associated with at least 13% more hours of care than is provided to those not living alone. Compared with women who lived with others, women living alone required almost double the amount of assistance with medication management and were 30% more likely to experience a deterioration in their condition or be discharged from home nursing care into an acute hospital. From 2006 to 2015, for all women there was a trend toward fewer hours of nursing service provided per episode. CONCLUSIONS AND IMPLICATIONS Community-dwelling older women who live alone have greater service needs and higher rates of discharge to hospital. This knowledge will help guide provision of services and strategies to prevent clinical deterioration for this population.

中文翻译：

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社区老年妇女：独居与使用家庭护理服务之间的关联

目的 调查居住在社区的老年妇女使用家庭护理的情况，以确定独居者所需服务的性质。设计 一项使用常规收集数据的回顾性队列研究。地点和参与者 居住在墨尔本市区的 55 岁及以上女性，她们在 2006 年 1 月 1 日至 2015 年 12 月 31 日期间接受了一家大型社区家庭护理服务提供商的护理。检查客户和服务相关因素与社区护理服务使用之间的关系。感兴趣的主要结果是护理事件中接受的服务时间。结果 共分析了 134,396 次护理事件，其中 51,606 (38.4%) 次事件涉及一名独居女性。独居女性每集的平均护理时间比与他人同住的女性多近 70%。多变量回归确定了影响服务使用量的因素：独居状态、认知健康状态和所需的家庭护理活动数量。在对混杂因素和相互作用进行调整后，与非独居者相比，独居者提供的护理时间至少多出 13%。与与他人同住的女性相比，独居女性需要几乎两倍的药物管理帮助，并且病情恶化或从家庭护理出院进入急症医院的可能性高出 30%。从 2006 年到 2015 年，对于所有女性来说，每集提供的护理服务时间都有减少的趋势。结论和意义 居住在社区的独居老年妇女有更多的服务需求和更高的出院率。这些知识将有助于指导提供服务和策略，以防止该人群的临床恶化。