الفهرس 
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Abstract
Aging is a complex and dynamic process with intricately, interrelated and inseparable physiologic, psycho logic and sociologic components. It is a normal process that implies continued growth development and adaptation until death. Aging is a universal human experience that culminates in an end. It is a dynamic state of existence that changes with ones perspective. Moreover, aging is a time of confusion and vulnerability to certain risk taking behaviors, which may lead to serious complications as osteoarthritis or joint degenerative. Accordingly, there is an urgent need to focus more attention on elderly health both physical and functional mobility disability, (Tinetti, 2006).
The aim of the study was to assess the quality of life of older adult with mobility impairment, through:
1- Identifying the physical activity of daily living among older adults.
2- Determining the psychosocial state of older adults.
3- Assessing the functional capacity of older adults according to their activities.
4- Assessing the safety of adult’s home environment.
Research questions.
1- Is there a relation between the mobility impairment and psychosocial state of older adults?
2- What is the effect of impaired physical mobility on the daily living activities?
Subjects and methods: are described under the following four designs technical, operational, administrative, and statistical.
Design: This is descriptive study.
Setting: The study was carried out at the orthopedic clinic of the two selected setting (10th of Ramadan Insurance Hospital & Ain Shams Center for Geriatric Medicine). Subjects were followed at their homes for environmental assessment.
Subjects: It consisted of subjects attending the outpatient clinic in 10th of Ramadan Insurance Hospital. Attendants nearly (200) patients/year, 50% were taken randomly. As regards Ain Shames Center for Geriatric Medicine attendants were nearly (330) patients/year 30% will be taken randomly.
The sample was chosen according to the following inclusive criteria:
1- Older adults (Age 60 years or above)
2- Diagnosed mobility impairment.
3- Agreed of patient to participate in the study by written consent.
Tools: Three tools were used for data collection:
The first tool: A questionnaire to assess socio-demographic characteristic and medical history. The data were collected using a self administered questionnaire. The researcher designed the questionnaire based on literature review.
The second tool: An observation check list for home environment. Functional assessment, activities of daily living, and quality of life scales were adopted and modified by the researcher.
The third tool: Data collected from medical record: It included: Electrolytes, kidney function, Liver function, blood sugar, urine analysis etc.
Validity for the used tools was done through 5 experts from the Community Health Nursing field.
Data were collected over a period of eight months, from beginning of May 2009 to the end of December 2009.
The study results revealed the following:
- Older adults with mobility impairment mean age was 71.3±9.1, less than two thirds were females (63.3%) and 58.8% were illiterates
- Concerning history of older adults with mobility impairment (from hospital medical records). Investigations revealed that 52.3% of patients their hemoglobin was normal, most of patients (92%) their white blood cells investigation was high, and for more than half (56.5%) of the sample their serum calcium was high. Nearly one fourth of the sample (27.5% & 21%), their kidney functions were high serum urea & creatinin respectively. More than one fourth of patients (28%), their liver function was high (SGOT). All of the sample (100%) their E.S.R. was high.
- Concerning serum analysis for bone, the sample 96.5% were high in C.reactive protein
Almost half of the sample (50.2%) were disabled, while more than fourth of patients (27.6%) had positive joint movement and less than one fourth (22.2%) were passive joint movement.
- Approximately two thirds of patients (66.8%) were in pain all time, for half of patients (50%) knee was the site of pain, and 34.2% were taking medications regularly as doctor orders, while 59.8% were taking medication when feeling or experiencing sever pain in joint.
- Concerning daily living activities62.3% were unable to perform tasks of mobility impairment (home maintenance), stair ascending and descending (80.5%), and food preparation for the majority of cases (81.4%).
- Moderate help required to complete the tasks was observed in more than three quarters (78.9%) of mobility impairment of the older adults for bowel control, bathing self 77.9% and personal toilet (92%), while patients were fully independent in performing tasks as shopping (50.3 %) and using telephone (49.2%).
- Concerning functional capacity of the mobility impairment of the older adults, personal activity of mobility impairment was moderate for approximately half of cases (48.7%), as well as for dressing (51.3%), while less than half of cases were good in hearing.
- More than half of patients 55.3% were was some timing practiced shoulder exercise, while knee and hip exercises were practiced by 66.3%, by hip exercises 56.3%, hot and cold water exercises 62.3%.
- Concerning flexibility exercise, more than two thirds of elderly patients 67.8% were sometimes practicing flexibility, exercises while almost two fifths of the sample (40.2%) were regularly walking for 30 minutes/day.
- Concerning home environment it was generally moderate in almost all items. On the other hand, it was poor in (5%) especially for stairs and corridors, and 10% for toilet.
- Disability scores were significantly high among older adults with mobility impairment who were moderate in functional capacity (p<0.05).
Conclusion: Based on the findings and research questions, of the study it was concluded that building peoples confidence and self esteem is an important aspect of mobilization and nurses are part of a multi-disciplinary approach to the care and management of people with problems of mobility.