医养结合背景下失能老人社区支持服务需求及影响因素研究
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摘要
目的了解医养结合背景下城市失能老人社区支持服务需求情况,并分析其影响因素。方法采用Barthel指数评定量表及失能老人社区支持服务需求调查问卷对杭州市3个主城区各1家共3家街道社区卫生服务中心的298名失能老人进行调查。结果失能老人社区支持服务需求总分为(112.12±11.28)分,专业医疗护理维度需求最高。多元逐步回归分析结果显示,月收入、年龄、希望养老方式与城区GDP为失能老人社区支持服务需求的影响因素(P<0.01或P<0.05)。结论医养结合背景下失能老人社区支持服务有较大需求,迫切需要得到医疗、护理、康复支持,应关注高龄、生活经济困难的失能老人需求,完善医养结合建设与社区支持力度,加强政府职能,推进失能老人照护体系构建,保障失能老人的照护需求与生活质量。
Objective To investigate the community support service demand of urban disabled elderly of combination of medical and health care,and to explore its influencing factors.Methods A total of 298 disabled elderly from 3 community health service centers in Hangzhou were investigated using the Barthel Index( BI) and Disabled Elderly Community Support Service Demand Questionnaire.Results The total score of community support service demand in disabled elderly was( 112.12±11.28),and the demand for professional medical care was the highest dimension.Multiple stepwise regression analysis revealed that the monthly income,age,endowment models and district gross domestic product were influencing factors of elderly demands( P<0.01 or P< 0.05). Conclusion The disabled elderly were in greater need of community support services with combination of medical and health care.They urgently need medical care,nursing,and rehabilitation support.Medical staff should pay attention to the needs of disabled elderly with advanced-age and difficulties in living.The combination of medical and health care construction and community support efforts should be improved.And strengthen government functions and promote the construction of the elderly care system for the disabled elderly to protect their care demands and quality of life.
Objective To investigate the community support service demand of urban disabled elderly of combination of medical and health care,and to explore its influencing factors.Methods A total of 298 disabled elderly from 3 community health service centers in Hangzhou were investigated using the Barthel Index( BI) and Disabled Elderly Community Support Service Demand Questionnaire.Results The total score of community support service demand in disabled elderly was( 112.12±11.28),and the demand for professional medical care was the highest dimension.Multiple stepwise regression analysis revealed that the monthly income,age,endowment models and district gross domestic product were influencing factors of elderly demands( P<0.01 or P< 0.05). Conclusion The disabled elderly were in greater need of community support services with combination of medical and health care.They urgently need medical care,nursing,and rehabilitation support.Medical staff should pay attention to the needs of disabled elderly with advanced-age and difficulties in living.The combination of medical and health care construction and community support efforts should be improved.And strengthen government functions and promote the construction of the elderly care system for the disabled elderly to protect their care demands and quality of life.
引文
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[15]孔令磷,赵梦遐,鲍翠玉,等.咸宁市社区老年人居家护理服务供需调查及原因分析[J].护理管理杂志,2016,16(11):761-763.
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[18]齐芳.住院空巢老人焦虑抑郁和主观幸福感现状及影响因素研究[J].护理管理杂志,2016,16(6):385-387.
[19]Liu YH,Chang HJ,Huang CC.The unmet activities of daily living(ADL)needs of dependent elders and their related factors:An approach from both an individual-and arealevel perspective[J].Int J Gerontol,2012,6(3):163-168.
[20]Szebehely M,Trydegrd GB.Home care for older people in Sweden:A universal model in transition[J].Health Soc Care Community,2012,20(3):300-309.DOI:10.1111/j.1365-2524.2011.01046.x.
[21]李钰勤,张仙强,代亚丽.乌鲁木齐市养老机构老年人主观幸福感现状及影响因素分析[J].护理管理杂志,2017,17(3):167-170.
[22]Hussein S,Ismail M.Ageing and elderly care in the Arab region:Policy challenges and opportunities[J].Ageing Int,2017,42(3):274-289.DOI:10.1007/s12126-016-9244-8.
[23]Singh A,Bairwa M,Goel S,et al.Prevalence and predictors of unmet needs among the elderly residents of the rural field practice area of a tertiary care centre from northern India[J].Malays J Med Sci,2016,23(5):44-50.
[24]郑丽秀,庞书勤,李绵利,等.居家高龄老人自理能力及照护需求的调查[J].护理管理杂志,2016,16(7):476-478.
[25]胡慧秀,王志稳,李颖堃,等.养老机构老人对护士关怀行为感知的研究[J].护理管理杂志,2014,14(12):847-849.
[26]Tareque MI,Tiedt AD,Islam TM,et al.Gender differences in functional disability and self-care among seniors in Bangladesh[J].BMC Geriatr,2017,17(1):177.
[27]赵雅宜,丁亚萍,崔焱,等.不同养老方式老年人能力状况及养老方式选择的影响因素研究[J].护理管理杂志,2017,17(3):163-166.
[2]潘金洪,帅友良,孙唐水,等.中国老年人口失能率及失能规模分析-基于第六次全国人口普查数据[J].南京人口管理干部学院学报,2012,28(4):3-6.DOI:10.3969/j.issn.1007-032X.2012.04.001.
[3]马姗伊,李阳.医养结合养老服务模式与中国养老现实的契合[J].税务与经济,2016,38(6):25-29.
[4]Park JM.Equity of access under Korean national long-term care insurance:Implications for long-term care reform[J].Int J Equity Heal,2015,14(1):1-9.DOI:10.1186/s12939-015-0210-y.
[5]李倩,袁忻忻,冷茂华.我国医养结合模式的发展现状研究[J].劳动保障世界,2016,28(23):10-11.DOI:10.3969/j.issn.1007-7243.2016.23.006.
[6]俞帼英,乐嘉宜,练媛媛,等.探索构建社区“医养结合”服务模式下的老年人健康管理的可行性[J].上海医药,2016,37(2):47-49.
[7]唐志红,于卫华,饶晓岚,等.医养结合-四元联动整合照护模型的实践[J].中华护理杂志,2017,52(1):40-43.DOI:10.3761/j.issn.0254-1769.2017.01.008.
[8]杭州统计信息网.各区、县(市)资料[EB/OL].(2017-02-18)[2017-10-24].http://tjj.hangzhou.gov.cn.
[9]李立明.老年保健流行病学[M].北京:北京医科大学中国协和医科大学联合出版社,1996:99.
[10]郭飏,王丽娟,付雪连,等.社区失能老人健康管理现状调查[J].护理学杂志,2014,29(7):73-75.DOI:10.3870/hlxzz.2014.07.073.
[11]Casado BL,Vulpen KS,Davis SL.Unmet needs for home and community-based services among frail older Americans and their caregivers[J].J Aging&Heal,2010,23(3):529-530.DOI:10.1177/0898264310387132.
[12]郝晓宁,薄涛,刘建春,等.北京市失能老人照料现状及需求影响因素研究[J].中国卫生经济,2015,34(8):59-62.DOI:10.7664/CHE20150817.
[13]陈颖,马丽霞,黎玉莲,等.郑州市不同失能程度居家老年人生活护理项目现况与需求调查[J].广东医学,2016,37(3):425-428.
[14]史薇.城市老年人健康对居家养老服务需求的影响[J].老龄科学研究,2014,2(8):68-77.DOI:10.3969/j.issn.2095-5898.2014.08.010.
[15]孔令磷,赵梦遐,鲍翠玉,等.咸宁市社区老年人居家护理服务供需调查及原因分析[J].护理管理杂志,2016,16(11):761-763.
[16]Evans T,Akporuno O,Owens KM,et al.Using Maslow's hierarchy to highlight power imbalances between visiting health professional student volunteers and the host community:An applied qualitative study[J].Educ Health(Abingdon),2017,30(2):133-139.DOI:10.4103/efh.Ef H_175_16.
[17]Donovan R,Williams A,Stajduhar K,et al.The influence of culture on home-based family caregiving at end-of-life:A case study of Dutch reformed family care givers in Ontario,Canada[J].Soc Sci Med,2011,72(72):338-346.DOI:10.1016/j.socscimed.2010.10.010.
[18]齐芳.住院空巢老人焦虑抑郁和主观幸福感现状及影响因素研究[J].护理管理杂志,2016,16(6):385-387.
[19]Liu YH,Chang HJ,Huang CC.The unmet activities of daily living(ADL)needs of dependent elders and their related factors:An approach from both an individual-and arealevel perspective[J].Int J Gerontol,2012,6(3):163-168.
[20]Szebehely M,Trydegrd GB.Home care for older people in Sweden:A universal model in transition[J].Health Soc Care Community,2012,20(3):300-309.DOI:10.1111/j.1365-2524.2011.01046.x.
[21]李钰勤,张仙强,代亚丽.乌鲁木齐市养老机构老年人主观幸福感现状及影响因素分析[J].护理管理杂志,2017,17(3):167-170.
[22]Hussein S,Ismail M.Ageing and elderly care in the Arab region:Policy challenges and opportunities[J].Ageing Int,2017,42(3):274-289.DOI:10.1007/s12126-016-9244-8.
[23]Singh A,Bairwa M,Goel S,et al.Prevalence and predictors of unmet needs among the elderly residents of the rural field practice area of a tertiary care centre from northern India[J].Malays J Med Sci,2016,23(5):44-50.
[24]郑丽秀,庞书勤,李绵利,等.居家高龄老人自理能力及照护需求的调查[J].护理管理杂志,2016,16(7):476-478.
[25]胡慧秀,王志稳,李颖堃,等.养老机构老人对护士关怀行为感知的研究[J].护理管理杂志,2014,14(12):847-849.
[26]Tareque MI,Tiedt AD,Islam TM,et al.Gender differences in functional disability and self-care among seniors in Bangladesh[J].BMC Geriatr,2017,17(1):177.
[27]赵雅宜,丁亚萍,崔焱,等.不同养老方式老年人能力状况及养老方式选择的影响因素研究[J].护理管理杂志,2017,17(3):163-166.