乌市天山区空巢老人健康状况及卫生服务利用研究
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摘要
目的：了解乌市空巢老人分布特征、健康状况及影响因素和对社区卫生服务的需求、利用情况,便于社区更好地针对不同民族老年人特点开展健康保健与护理工作；有利于社区改善空巢老人健康状况,提高空巢老人生命质量。方法：在乌市天山区14个街道办事处随机抽取3个,每个街道内随机整群抽取2个社区,调查空巢老人的健康状况,包括空巢老人的一般状况、ADL、认知功能、慢性病患病情况、健康影响因素、卫生服务需求情况。结果：1)6个社区空巢老人总数为713人,其中男275人,占38.5%,女438人,占61.5%；少数民族250人,占35.1%；社区空巢老人最小年龄60岁,最大92岁；2)健康状况：慢性疾病对空巢老人生活自理能力有负向作用；慢性支气管炎、骨关节病、冠心病、哮喘、高血压病致空巢老人ADL功能障碍作用最强；按医疗费用支付方式分析,享有公费医疗的老年居民慢性病患病率最高,为94.1%,自费的老人患病率最低,为40.3%,不同医疗费用支付方式的空巢老人慢性病患病率差别有统计学意义(P<0.05)；性别、族别对认知功能的影响差别有统计学意义(P<0.05)；年龄(Beta=-0.142)对认知功能的影响最显著,其次为受教育程度(Beta=0.134)等；3)不同民族健康影响因素吸烟、饮酒、饮食习惯、体育锻炼差别有统计学意义(P<0.05)；4)社区卫生服务知晓程度汉族48.9%、少数民族37.6%,存在统计学差异；除预防服务外,不同民族在社区卫生服务利用方面存在统计学差异(P<0.05)；月收入501-1000元和知晓社区卫生服务功能对社区卫生服务的利用率要高,OR值分别为5.119、15.300。结论：不同医疗费用支付方式影响空巢老人慢性病的患病率；空巢老人的ADL又与慢性病的种类有关；空巢老人的认知功能与性别、族别、年龄、受教育程度等有关；社区卫生服务知晓程度、社区卫生服务利用率汉族优于少数民族,月收入、社区卫生服务知晓程度又影响着社区卫生服务利用率。
Objective:To find out the distribution characters, health status, influencing factors, health care demands and the demand-fulfilling status of health care services of the empty-nested elderly people in Urumqi, to help the community enhance the nursing and health care service particularly according to their ethnical character and improve the health condition and life quality of the empty-nested elderly people. Methods:random sampling 3 sub-district offices from 14 in Tianshan District of Urumqi city, then random sampling 2 communities from each sub-district office, survey the health condition of the empty-nested elderly people, including general information of their families, activity of daily living, cognitive function, the prevalence status of chronic diseases, daily care problem, financial sustainability problem, physical safety problem,the main factors influencing their health conditions and the utilization status of community health-care services.Results: 1) Totally 713 empty-nested elderly people of the 6 communities, including 275 male, accounting for 38.5% and 438 female,61.5%; 250 of ethnical minority, accounting for 35.1%; ages from 60 to 92.2) Health status:strong negative correlation between chronic diseases and daily self-care capability of empty-nested elderly people; chronic diseases such as chronic bronchitis, osteoarthritis, cardiovascular disease, chronic asthma and hypertension disease strongly construe this negative correlation especially for the ADL dysfunction of empty-nested elderly people; medical cost coverage:94.1% of the empty-nested elderly people who have full coverage by government or other social insurance have chronic diseases,40.3% of those who have no or limited coverage have chronic diseases, different medical cost coverages contrue the prevalence of chronic diseases of empty-nested elderly people and have statistically significance (p<0.05); gender and ethinical characters for the difference of cognitive capability have statistically significance (p<0.05); age (Beta=-0.142) is the strongest factor for cognitive capability, secondly is education ((Beta=0.134).3)Other factors influencing health status such as smoking, alcohol drinking, diet habbits and physical exercise have statistically significance (p<0.05).4) Knowledge for community health care services has statistically significance (p<0.05):48.9% for Han Chinese and 37.6% for ethnical minority Chinese; utilization of community health care services for different ethnical groups has statistically significance (p<0.05):monthly sallary level (501-1000 CNY per month) and the knowledge for community health care services are the main factors for the utilization, OR value 5.119 and 15;300.Conclusion:different medical cost coverage influence the prevalence of chronic diseases of empty-nested elderly people; ADL dysfunction of empty-nested elderly people correlates the kinds of chronic diseases; cognitive capability of empty-nested elderly people correlates the factors such as gender, age, ethnical group and education; for the knowledge and utilization for community health care services, Han Chinese outrats other ethnical minority Chinese, monthly sallary level and the the knowledge for community health care services influence the utilization of these services.
Objective:To find out the distribution characters, health status, influencing factors, health care demands and the demand-fulfilling status of health care services of the empty-nested elderly people in Urumqi, to help the community enhance the nursing and health care service particularly according to their ethnical character and improve the health condition and life quality of the empty-nested elderly people. Methods:random sampling 3 sub-district offices from 14 in Tianshan District of Urumqi city, then random sampling 2 communities from each sub-district office, survey the health condition of the empty-nested elderly people, including general information of their families, activity of daily living, cognitive function, the prevalence status of chronic diseases, daily care problem, financial sustainability problem, physical safety problem,the main factors influencing their health conditions and the utilization status of community health-care services.Results: 1) Totally 713 empty-nested elderly people of the 6 communities, including 275 male, accounting for 38.5% and 438 female,61.5%; 250 of ethnical minority, accounting for 35.1%; ages from 60 to 92.2) Health status:strong negative correlation between chronic diseases and daily self-care capability of empty-nested elderly people; chronic diseases such as chronic bronchitis, osteoarthritis, cardiovascular disease, chronic asthma and hypertension disease strongly construe this negative correlation especially for the ADL dysfunction of empty-nested elderly people; medical cost coverage:94.1% of the empty-nested elderly people who have full coverage by government or other social insurance have chronic diseases,40.3% of those who have no or limited coverage have chronic diseases, different medical cost coverages contrue the prevalence of chronic diseases of empty-nested elderly people and have statistically significance (p<0.05); gender and ethinical characters for the difference of cognitive capability have statistically significance (p<0.05); age (Beta=-0.142) is the strongest factor for cognitive capability, secondly is education ((Beta=0.134).3)Other factors influencing health status such as smoking, alcohol drinking, diet habbits and physical exercise have statistically significance (p<0.05).4) Knowledge for community health care services has statistically significance (p<0.05):48.9% for Han Chinese and 37.6% for ethnical minority Chinese; utilization of community health care services for different ethnical groups has statistically significance (p<0.05):monthly sallary level (501-1000 CNY per month) and the knowledge for community health care services are the main factors for the utilization, OR value 5.119 and 15;300.Conclusion:different medical cost coverage influence the prevalence of chronic diseases of empty-nested elderly people; ADL dysfunction of empty-nested elderly people correlates the kinds of chronic diseases; cognitive capability of empty-nested elderly people correlates the factors such as gender, age, ethnical group and education; for the knowledge and utilization for community health care services, Han Chinese outrats other ethnical minority Chinese, monthly sallary level and the the knowledge for community health care services influence the utilization of these services.
引文
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