基于因子分析的五保老人生命质量评价研究
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摘要
目的:了解五保老人生命质量评价现状,分析影响因素,为其生命质量提高、五保政策改进落实及保障制度完善提供参考。方法:应用WHOQOL-26量表及自编问卷,采取分层、随机、定额抽样,抽取山东某地级市≥60岁五保老人873例作为研究对象,以探索性因子分析法评价生命质量。结果:生命质量评价经因子分析归纳为生理、心理、环境、社会关系4个维度,生理领域评分最高(10.23±1.60),环境领域评分最低(8.53±1.40)。单因素分析显示,年龄、文化程度、健康自评、经济自评、住院次数对生命质量各维度评分有显著影响(P<0.05)。相对居家养老,机构养老五保老人生理、环境、社会关系领域评分较高,但心理领域评分差异无统计学意义(P>0.05)。多元回归分析显示,影响生理、环境、社会关系、心理领域评分的因素依次为健康自评、经济自评、住院次数;养老模式只对前3个领域评分有显著影响(P<0.05)。结论:应落实五保政策,强化疾病筛查、健康管理,完善机构养老及医疗照护体系,从而全面提升五保老人生命质量。
Objective To evaluate the quality of life among thefive guarantees elderly,andanalyze theinfluencingfactors,thusproviding references for improving the implementation of the five guarantees policy and perfecting the guarantee system.Methods Using WHOQOL-26 scale and self-designed questionnaire,873 target elders aged 60 or older from a prefecture-level city in Shandong Province were selected by stratified,random,quota sampling method,and then we evaluate thequality of life by exploratory factor analysis.Results By factor analysis,the life quality evaluation was divided into 4 dimensions: physiology,psychology,environment and social relations,physiological domain score was the highest( 10.23 ± 1.60),environmental field scorewas the lowest( 8.53 ± 1.40).Univariable analysis showed age,education level,self-rated health,economic self-evaluation,and number of hospitalization all had significant effects on each dimension ofthe quality of life scores( P < 0.05).Relative to home care,the five guarantees elderly inpension agency had higher scores in physiological,environmental,and social relations domains,but there was no significant difference in psychological field score( P > 0.05).Multivariable regression analysis showed the factors influencing physical,environmental,social and psychological scores were self-rated health,economic self-evaluation,number of hospitalization,pension pattern only had significant impacts on the former 3 fields( P < 0.05).Conclusion we should implement the five guarantees policy,strengthen disease screening and health management,perfect institutional pension and health care system,in order to comprehensively improve the quality of life among the five guarantees elderly.
Objective To evaluate the quality of life among thefive guarantees elderly,andanalyze theinfluencingfactors,thusproviding references for improving the implementation of the five guarantees policy and perfecting the guarantee system.Methods Using WHOQOL-26 scale and self-designed questionnaire,873 target elders aged 60 or older from a prefecture-level city in Shandong Province were selected by stratified,random,quota sampling method,and then we evaluate thequality of life by exploratory factor analysis.Results By factor analysis,the life quality evaluation was divided into 4 dimensions: physiology,psychology,environment and social relations,physiological domain score was the highest( 10.23 ± 1.60),environmental field scorewas the lowest( 8.53 ± 1.40).Univariable analysis showed age,education level,self-rated health,economic self-evaluation,and number of hospitalization all had significant effects on each dimension ofthe quality of life scores( P < 0.05).Relative to home care,the five guarantees elderly inpension agency had higher scores in physiological,environmental,and social relations domains,but there was no significant difference in psychological field score( P > 0.05).Multivariable regression analysis showed the factors influencing physical,environmental,social and psychological scores were self-rated health,economic self-evaluation,number of hospitalization,pension pattern only had significant impacts on the former 3 fields( P < 0.05).Conclusion we should implement the five guarantees policy,strengthen disease screening and health management,perfect institutional pension and health care system,in order to comprehensively improve the quality of life among the five guarantees elderly.
引文
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[9]李新辉,巩存涛,郑昆亮,等.新疆农村维吾尔族老年人生命质量及其影响因素调查研究[J].中国全科医学,2014,(16):1884-1888.
[10]刘玲,张枭,王春辉,等.农村中老年高血压患者生活质量及影响因素分析[J].中国公共卫生,2011,27(2):155-157.
[11]夏泓.Y县农村五保集中供养困境及出路研究[D].湘潭大学,2014.
[12]赵怀娟.城市失能老人机构照护需要及需要满足研究——以南京市调查为例[J].中国卫生事业管理,2013,30(4):315-319.
[13]董小燕.山西省城乡老年人生命质量及影响因素的研究[D].山西医科大学,2014.
[14]贺斌.农村留守老人社会支持、应对方式与心理健康现状调查[J].中国卫生事业管理,2013,30(9):703-706.
[15]王芳,朱晓丽,丁雪.我国基层卫生人力资源配置现状及公平性分析[J].中国卫生事业管理,2012,29(2):108-110.
[2]李侗桐,方任飞,谢铮.北京市老年人生命质量的社会决定因素[J].北京大学学报:医学版,2014,46(3):450-454.
[3]朱军红,王鹏,汪文新,等.湖北农村福利院五保老人生活质量状况调查[J].中国心理卫生,2009,23(12):895-897.
[4]丁玲,吴炳义,郑晓瑛,等.山东省老年人心理健康状况及影响因素分析[J].中国卫生事业管理,2014,31(12):948-951.
[5]孟琴琴,张拓红.老年人健康自评的影响因素分析[J].北京大学学报医学版,2010,42(3):258-263.
[6]宗纪勇,徐志伟,刘玲,等.农村地区高血压患者生命质量及其影响因素[J].中国卫生事业管理,2010,27(9):630-630.
[7]Wilcox V L,Kasl S V,Idler E L.Self-rated health and physical disability in elderly survivors of a major medical event.[J].The Journals of Gerontology:Series B,1996,51(2):S96-104.
[8]张琳,宁艳花,姚丽,等.银川市老年人生活质量状况及影响因素分析[J].中国公共卫生,2011,27(2):162-164.
[9]李新辉,巩存涛,郑昆亮,等.新疆农村维吾尔族老年人生命质量及其影响因素调查研究[J].中国全科医学,2014,(16):1884-1888.
[10]刘玲,张枭,王春辉,等.农村中老年高血压患者生活质量及影响因素分析[J].中国公共卫生,2011,27(2):155-157.
[11]夏泓.Y县农村五保集中供养困境及出路研究[D].湘潭大学,2014.
[12]赵怀娟.城市失能老人机构照护需要及需要满足研究——以南京市调查为例[J].中国卫生事业管理,2013,30(4):315-319.
[13]董小燕.山西省城乡老年人生命质量及影响因素的研究[D].山西医科大学,2014.
[14]贺斌.农村留守老人社会支持、应对方式与心理健康现状调查[J].中国卫生事业管理,2013,30(9):703-706.
[15]王芳,朱晓丽,丁雪.我国基层卫生人力资源配置现状及公平性分析[J].中国卫生事业管理,2012,29(2):108-110.