福州城市社区空巢老人生存质量及对社区护理需求的调查分析
|
摘要
目的:(1)了解空巢老人、非空巢老人的一般情况是否存在差别。
(2)明确空巢、非空巢老人的生存质量和对社区护理服务需求情况及其影响因素。
(3)提出改进社区护理的对策以提高老人生存质量的措施。
方法:选择福州4 个社区60 岁以上的老人作为研究对象。使用自制的社区护理需求调查问卷以及生存质量综合评定量表(GQOLI-74),对其生存质量状况、社区护理需求情况及影响因素等进行调查研究。采用卡方检验、方差分析、逐步回归、相关分析等确定生存质量和社区护理需求的情况和影响因素及其相互关系。
结果:1、一般情况:(1)平均年龄为68.80±7.16 周岁,空巢老人共占老人总数的29.8%。(2)空巢老人和非空巢老人在年龄构成、婚姻状况、性别比、文化程度、职业、月收入上均没有差别。(3)独居和夫妇空巢之间、有无配偶非空巢之间在年龄构成、性别比、职业构成比较上存在差别,各组在文化程度、月收入上没有差别。
2、社会学资料:(1)调查对象中患1 种以上疾病的老人占71.9%。在所患疾病中,居前3 位的是高血压、关节炎、心血管疾病。(2)所有老人中与子女同住的老人占64.7%(3)大部分老人所面临的最主要问题集中在经济问题和健康问题,孤独和经济问题是独居空巢老人所担心的。
3、社区护理需求:(1)认为社区护理对其生活有帮助和很有帮助的老人占41.7%,40.8%的老人选择到社区卫生服务站接受服务,老人不接受社区护理的最主要原因是费用问题。(2)老人对社区护理需求处在中等水平,最需要的护理项目集中在健康宣教方面。(3)影响社区护理需求的主要因素是对社区护理的认识、患病数目、年龄等。
4、老人的生存质量:独居空巢、夫妇空巢、有无配偶非空巢老人在社会功能和总分的差别有显著意义;空巢、非空巢老人在生存质量个领域和总分上没有差别。影响老人生存质量的主要因素是患病数目、经济状况、文化程度、职业、婚姻状况、年龄等。
Objective:
(1) To investigate the general conditions of the old empty-nest and non-empty-nest people and the differences between them .
(2) To investigate the empty-nest and non-empty-nest old people’s QOL and theirdemanding community nursing care and the affected factors.
(3)To put forward some perfect measures for improving the old people’s QOL.
Methods:
A total of 363 old people over 60 years old are selected from 4 communities in Fuzhou,Fujian. Their QOL and community nursing needs are assessed by using a self-designedinvestigation questionnaire besides the GQOLI-74. The statistics methods used includeschi-square test、ANOVA、step linear regression、correlation analysis, and so on.
Results:
1、General conditions: The mean age of the old people is 68.80±7.16. The old empty-nestpeople make up 29.8% of the total. There is no significant difference in the constitution ofage、marriage、sex rate、education degree、occupation and income between the empty-nest andnon-empty-nest old people. There are significant differences existing in the constitution of age、sex、occupation among the 4 groups-single and couple old empty-nest people, spouse andnon-spouse old non-empty people. But the difference in education and income are insignificant。
2、Sociological materials:(1) 71.9% old people of all are suffering from a certain kind ofdisease. The three most disease they suffer from are hypertension 、arthritis andcardiac-vascular diseases. (2) 64.7% old people live together with their children. (3) The mostimportant problems up what they are facing focus on financial and healthy problem.
3、Community nursing needs:(1)41.7% old people believe that community nursing arehelpful or extremely helpful to their life. 40.8% of them choose to receive services fromcommunity nursing stations. The main reason that the old people refuse to receive communitynursing is the problem of cost. (2) The average needs of community nursing are at a mediumlevel and mostly focus on healthy education. (3) The main factors affecting community nursingare knowledge about community nursing, disease numbers and age, etc. 4、QOL: There are significant differences in social function and total scores among the 4groups, but there is no significant difference in all domains and total scores between the empty-nestand non-empty-nest groups. The main factors are disease numbers, economic situation, educationdegree, marriage condition and age, etc. 5、The relationship between QOL and community nursing needs : All domains of QOL aremainly reverse associating with that of community nursing needs, except the material function ofQOL with the health promoting of community nursing needs. Conclusions: The differences in QOL and community nursing needs between the empty-nest andnone-empty-nest are almost insignificant. QOL is mainly reverse associating with communitynursing needs. We must take different measures to different old people.
(2)明确空巢、非空巢老人的生存质量和对社区护理服务需求情况及其影响因素。
(3)提出改进社区护理的对策以提高老人生存质量的措施。
方法:选择福州4 个社区60 岁以上的老人作为研究对象。使用自制的社区护理需求调查问卷以及生存质量综合评定量表(GQOLI-74),对其生存质量状况、社区护理需求情况及影响因素等进行调查研究。采用卡方检验、方差分析、逐步回归、相关分析等确定生存质量和社区护理需求的情况和影响因素及其相互关系。
结果:1、一般情况:(1)平均年龄为68.80±7.16 周岁,空巢老人共占老人总数的29.8%。(2)空巢老人和非空巢老人在年龄构成、婚姻状况、性别比、文化程度、职业、月收入上均没有差别。(3)独居和夫妇空巢之间、有无配偶非空巢之间在年龄构成、性别比、职业构成比较上存在差别,各组在文化程度、月收入上没有差别。
2、社会学资料:(1)调查对象中患1 种以上疾病的老人占71.9%。在所患疾病中,居前3 位的是高血压、关节炎、心血管疾病。(2)所有老人中与子女同住的老人占64.7%(3)大部分老人所面临的最主要问题集中在经济问题和健康问题,孤独和经济问题是独居空巢老人所担心的。
3、社区护理需求:(1)认为社区护理对其生活有帮助和很有帮助的老人占41.7%,40.8%的老人选择到社区卫生服务站接受服务,老人不接受社区护理的最主要原因是费用问题。(2)老人对社区护理需求处在中等水平,最需要的护理项目集中在健康宣教方面。(3)影响社区护理需求的主要因素是对社区护理的认识、患病数目、年龄等。
4、老人的生存质量:独居空巢、夫妇空巢、有无配偶非空巢老人在社会功能和总分的差别有显著意义;空巢、非空巢老人在生存质量个领域和总分上没有差别。影响老人生存质量的主要因素是患病数目、经济状况、文化程度、职业、婚姻状况、年龄等。
Objective:
(1) To investigate the general conditions of the old empty-nest and non-empty-nest people and the differences between them .
(2) To investigate the empty-nest and non-empty-nest old people’s QOL and theirdemanding community nursing care and the affected factors.
(3)To put forward some perfect measures for improving the old people’s QOL.
Methods:
A total of 363 old people over 60 years old are selected from 4 communities in Fuzhou,Fujian. Their QOL and community nursing needs are assessed by using a self-designedinvestigation questionnaire besides the GQOLI-74. The statistics methods used includeschi-square test、ANOVA、step linear regression、correlation analysis, and so on.
Results:
1、General conditions: The mean age of the old people is 68.80±7.16. The old empty-nestpeople make up 29.8% of the total. There is no significant difference in the constitution ofage、marriage、sex rate、education degree、occupation and income between the empty-nest andnon-empty-nest old people. There are significant differences existing in the constitution of age、sex、occupation among the 4 groups-single and couple old empty-nest people, spouse andnon-spouse old non-empty people. But the difference in education and income are insignificant。
2、Sociological materials:(1) 71.9% old people of all are suffering from a certain kind ofdisease. The three most disease they suffer from are hypertension 、arthritis andcardiac-vascular diseases. (2) 64.7% old people live together with their children. (3) The mostimportant problems up what they are facing focus on financial and healthy problem.
3、Community nursing needs:(1)41.7% old people believe that community nursing arehelpful or extremely helpful to their life. 40.8% of them choose to receive services fromcommunity nursing stations. The main reason that the old people refuse to receive communitynursing is the problem of cost. (2) The average needs of community nursing are at a mediumlevel and mostly focus on healthy education. (3) The main factors affecting community nursingare knowledge about community nursing, disease numbers and age, etc. 4、QOL: There are significant differences in social function and total scores among the 4groups, but there is no significant difference in all domains and total scores between the empty-nestand non-empty-nest groups. The main factors are disease numbers, economic situation, educationdegree, marriage condition and age, etc. 5、The relationship between QOL and community nursing needs : All domains of QOL aremainly reverse associating with that of community nursing needs, except the material function ofQOL with the health promoting of community nursing needs. Conclusions: The differences in QOL and community nursing needs between the empty-nest andnone-empty-nest are almost insignificant. QOL is mainly reverse associating with communitynursing needs. We must take different measures to different old people.
引文
1、韩少梅,张承训.我国城乡独居老年人生活状况分布.中国老年学杂志,1999,19(1)。
2、张欣文,郝建华.社区独居老人健康和生活状况调查.同济大学学报(医学版),2002,23(1):25-27。
3 、Bruno Lunenfeld. The aging male: demographics and challenges[J].World Journal of Urology,2002,20(1):11-16.
4、齐麟.析“空巢家庭”――一个值得全社会关注的社会问题.南方人口,1999,4:18-20。
5、俞志新.关于“空巢”现象的分析与思考.杭州科技,2002,3:32-34。
6、李德明,陈天勇,李贵芸.空巢老人心理健康状况研究.中国老年学杂志,2003,23(7):405-407。
7、穆光宗.中国都市社会的养老问题:以北京为个案.中国人民大学学报,2002,2.
8、李鲁.社会医学.北京.人民卫生出版社.2003.8,第二版.
9、张玉梅、冯正仪、夏海鸥、王蓓玲.社区护理需求和工作内容的调查分析.中华护理杂志,2003,38(3):232-234.
10、Stanhope M. Lancaster J. Community health: promoting health of aggregates, families, and individuals. 4th edition. St. Louis: the C.V. Mosby company,1996.2.
11、李凌江,郝伟,杨德森.社区人群生活质量研究:问卷编制.中国心理卫生杂志,1995,9(5):227-231.
12、顾大男.老年人年龄界定和重新界定的思考.中国人口科学,2000,3:42-51。
13、倪宗瓒.卫生统计学..北京.人民卫生出版社.2001.1,第四版。
14、于普林.老年医学.北京.人民卫生出版社.2002.8,第一版,4.
15、王瑄.浅析城市“空巢家庭”老人的基本特征.城市问题.1995,3:19～24。
16、赵芳,许芸.城市空巢老人生活状况和社区支持体系分析.南京师大学报(社会科学版).2003,3:61-67。
17、赵芳.家庭中的亲子关系与养老方式的选择.江海学刊,2001,1。
18、梁雯,袁亚英,田俊英.社区空巢老人健康状况调查分析.护理研究.2004,18(6):1051-1052.
19、陈晓敏,杨柳.现代化进程中的空巢家庭.中华女子学院学报.2004,16(1):35-38,48.
20、王珣.浅析城市“空巢家庭”老人的基本特征.城市问题.1995,2:19-24
21、熊汉富.空巢家庭:一个应当关注的老年群体.人口研究.1998,22(3):51-53.
22、王方刃,石剑锋,杨艺明.福建省城镇老人健康和生活状况调查分析.学会. 1999,2:54-47.
23.、李迎春,胡传来,陶兴永等.社区中老年人慢性病及卫生服务需求情况调查.实用全科医学.2005,3(1):61-62.
24、王德文,林维文,周天枢.福州市老年人慢性病现状调查.中国公共卫生.2004,20(10):1242-1243.
25、傅东波,沈贻谔,夏昭林等.上海市社区老年人服务利用与需求情况调查.中国老年学杂志.1999,19(9):259-261.
26、汤哲,方向华,项曼君等.北京市老年人卫生服务需求研究.中华医院管理杂志.2004,20(8):464-469.
27、吕探云,曹育玲,杨英华等.社区老人长期护理需求的调查和护理探讨.护士进修杂志.2001,16(6):418-421.
28、王方刃,邓永岳.老年人社区卫生服务意愿和影响因素.中国卫生资源.2001,4(1):35-36.
29、Peto V Jenkinson C et al. Quality of life Research ,1995,4:241-248.
30、Walter J, James ,Shannon A. Quality of life .USA: University of Chicago Press ,1990.
31、Edited by G-Teeting Simth: Measuring Health : A practice approach , John Wiley and Sons LTD ,1988.
32 、Dempster, -M; Donnelly, -M Selecting a measure of health related quality of life , Soc-Work-Health-Care,2000;21(1):45-46.
33、江怀,周洁.关注空巢家庭现象.山西老年.2004,(1):4-5.
34、代爱英,顾湲,曹洁.空巢老人健康状况和社区卫生服务需求调查分析.中华全科医师杂志.2004,3(5):311.
35、吴雪,王克芳,娄凤兰等.空巢老人的生活质量的影响因素及对策.护理学杂志.2004,19(4):76-78.
36、Ashton ,-L Promoting the health and social care of older people : gaining a perspective from outside the UK.J-R-Soc-Health .2001 Sep 121(3):152-8.
37 、Drewnowski, -A; Evans –W-J, Nutrition , physical activity , and quality of life in older adults :summary .J-Gerontol-A-Biol-Sci-Med-Sci .2001 Oct; 56 Spec No 2.
38、Everard, -K-M et al Relation of relationship of activity and social support to the functional health of older adults. J-Geronto L-B-Psychol-Sci-Soc-Sci .2000 Jue ;55(4): S208-12
39、Guse,-L-W; Masemar, -M-A, Quality of life and successful aging in long term care : perceptions of residents. Issues-Health-Nurs. 1999 Nov-Doc;20(6):527.
40、Waber B, Burnier M, Brunner HR. How to improve adherence with prescribed treatment in hypertensive patients? J Cardiovasc Pharmacol 2000;35 Suppl 3: S23-6.
41、Burnier M. Long-term compliance with antihypertensive therapy: anthor facet of chrono therapeutics in hypertension. Blood Press Monit 2000;5 Suppl 1: S31-4.
42、林琳,米光明.社区健康教育.北京:中国医药科技大学出版社.1999.10.
43、Lan Darnton-Hill , Health aging and the quality of life , World Health Forum , Vol.16.1995.
44、杨瑞松等,社会生活环境与老年人健康关系研究,老年学杂志,1994,14(1):5.
45、北京西城区卫生局.社区护士心系社区、溶入社区、服务社区.中国护理管理.2004,4(5):34-36.
46、Cacciatore F et al. Gerontology ,1999,45(6):323.
47、Goldsmith I et al .J Heart Valve Dis , 1999, 8(6) :702.
48、戴静,刘协和,马渝根等.老年人生活质量影响因素调查分析.中国心理卫生杂志.2003,17(2):101-103, 100.
49、丁兆生.扬州市老年人生活质量调查及相关因素分析.江苏临床医学杂志.1998,2(6):541-54
2、张欣文,郝建华.社区独居老人健康和生活状况调查.同济大学学报(医学版),2002,23(1):25-27。
3 、Bruno Lunenfeld. The aging male: demographics and challenges[J].World Journal of Urology,2002,20(1):11-16.
4、齐麟.析“空巢家庭”――一个值得全社会关注的社会问题.南方人口,1999,4:18-20。
5、俞志新.关于“空巢”现象的分析与思考.杭州科技,2002,3:32-34。
6、李德明,陈天勇,李贵芸.空巢老人心理健康状况研究.中国老年学杂志,2003,23(7):405-407。
7、穆光宗.中国都市社会的养老问题:以北京为个案.中国人民大学学报,2002,2.
8、李鲁.社会医学.北京.人民卫生出版社.2003.8,第二版.
9、张玉梅、冯正仪、夏海鸥、王蓓玲.社区护理需求和工作内容的调查分析.中华护理杂志,2003,38(3):232-234.
10、Stanhope M. Lancaster J. Community health: promoting health of aggregates, families, and individuals. 4th edition. St. Louis: the C.V. Mosby company,1996.2.
11、李凌江,郝伟,杨德森.社区人群生活质量研究:问卷编制.中国心理卫生杂志,1995,9(5):227-231.
12、顾大男.老年人年龄界定和重新界定的思考.中国人口科学,2000,3:42-51。
13、倪宗瓒.卫生统计学..北京.人民卫生出版社.2001.1,第四版。
14、于普林.老年医学.北京.人民卫生出版社.2002.8,第一版,4.
15、王瑄.浅析城市“空巢家庭”老人的基本特征.城市问题.1995,3:19～24。
16、赵芳,许芸.城市空巢老人生活状况和社区支持体系分析.南京师大学报(社会科学版).2003,3:61-67。
17、赵芳.家庭中的亲子关系与养老方式的选择.江海学刊,2001,1。
18、梁雯,袁亚英,田俊英.社区空巢老人健康状况调查分析.护理研究.2004,18(6):1051-1052.
19、陈晓敏,杨柳.现代化进程中的空巢家庭.中华女子学院学报.2004,16(1):35-38,48.
20、王珣.浅析城市“空巢家庭”老人的基本特征.城市问题.1995,2:19-24
21、熊汉富.空巢家庭:一个应当关注的老年群体.人口研究.1998,22(3):51-53.
22、王方刃,石剑锋,杨艺明.福建省城镇老人健康和生活状况调查分析.学会. 1999,2:54-47.
23.、李迎春,胡传来,陶兴永等.社区中老年人慢性病及卫生服务需求情况调查.实用全科医学.2005,3(1):61-62.
24、王德文,林维文,周天枢.福州市老年人慢性病现状调查.中国公共卫生.2004,20(10):1242-1243.
25、傅东波,沈贻谔,夏昭林等.上海市社区老年人服务利用与需求情况调查.中国老年学杂志.1999,19(9):259-261.
26、汤哲,方向华,项曼君等.北京市老年人卫生服务需求研究.中华医院管理杂志.2004,20(8):464-469.
27、吕探云,曹育玲,杨英华等.社区老人长期护理需求的调查和护理探讨.护士进修杂志.2001,16(6):418-421.
28、王方刃,邓永岳.老年人社区卫生服务意愿和影响因素.中国卫生资源.2001,4(1):35-36.
29、Peto V Jenkinson C et al. Quality of life Research ,1995,4:241-248.
30、Walter J, James ,Shannon A. Quality of life .USA: University of Chicago Press ,1990.
31、Edited by G-Teeting Simth: Measuring Health : A practice approach , John Wiley and Sons LTD ,1988.
32 、Dempster, -M; Donnelly, -M Selecting a measure of health related quality of life , Soc-Work-Health-Care,2000;21(1):45-46.
33、江怀,周洁.关注空巢家庭现象.山西老年.2004,(1):4-5.
34、代爱英,顾湲,曹洁.空巢老人健康状况和社区卫生服务需求调查分析.中华全科医师杂志.2004,3(5):311.
35、吴雪,王克芳,娄凤兰等.空巢老人的生活质量的影响因素及对策.护理学杂志.2004,19(4):76-78.
36、Ashton ,-L Promoting the health and social care of older people : gaining a perspective from outside the UK.J-R-Soc-Health .2001 Sep 121(3):152-8.
37 、Drewnowski, -A; Evans –W-J, Nutrition , physical activity , and quality of life in older adults :summary .J-Gerontol-A-Biol-Sci-Med-Sci .2001 Oct; 56 Spec No 2.
38、Everard, -K-M et al Relation of relationship of activity and social support to the functional health of older adults. J-Geronto L-B-Psychol-Sci-Soc-Sci .2000 Jue ;55(4): S208-12
39、Guse,-L-W; Masemar, -M-A, Quality of life and successful aging in long term care : perceptions of residents. Issues-Health-Nurs. 1999 Nov-Doc;20(6):527.
40、Waber B, Burnier M, Brunner HR. How to improve adherence with prescribed treatment in hypertensive patients? J Cardiovasc Pharmacol 2000;35 Suppl 3: S23-6.
41、Burnier M. Long-term compliance with antihypertensive therapy: anthor facet of chrono therapeutics in hypertension. Blood Press Monit 2000;5 Suppl 1: S31-4.
42、林琳,米光明.社区健康教育.北京:中国医药科技大学出版社.1999.10.
43、Lan Darnton-Hill , Health aging and the quality of life , World Health Forum , Vol.16.1995.
44、杨瑞松等,社会生活环境与老年人健康关系研究,老年学杂志,1994,14(1):5.
45、北京西城区卫生局.社区护士心系社区、溶入社区、服务社区.中国护理管理.2004,4(5):34-36.
46、Cacciatore F et al. Gerontology ,1999,45(6):323.
47、Goldsmith I et al .J Heart Valve Dis , 1999, 8(6) :702.
48、戴静,刘协和,马渝根等.老年人生活质量影响因素调查分析.中国心理卫生杂志.2003,17(2):101-103, 100.
49、丁兆生.扬州市老年人生活质量调查及相关因素分析.江苏临床医学杂志.1998,2(6):541-54