上海市某社区老年人生活质量及影响因素研究
摘要
[目的]为了解社区老年人的生活质量并分析其影响因素,在此基础上结合文献回顾,提出改善社区老年人生活质量的对策建议。
[方法]采取分层整群抽样的方法,在上海市静安区石门二路社区的13个居委中按照居住情况和经济条件状况分别抽取2个条件较好和2个相对较差的居委,结合户籍资料及居委会的人口登记资料,由石门二路社区卫生服务中心的社区医生,经统一培训后对所有常住于本区域的60岁以上老年人,进行项目为封闭式的现场问卷调查。调查表整理后进行数据录入到SPSS13.0数据库,采用频数分析、T检验、单因素分析、多元逐步回归等进行统计分析。
[结果]得出上海市石门二路社区老年人96.42%生活自理,靠自己照顾自己,经济状况尚可,95.55%的老年人表示生活开支够用,79.3%的老人受到家人支持,91.5%的老人有城镇医疗保险,测量的平均生活质量中等偏上,60.2%的老年人生活质量良好;但社区老年人慢性病患病率很高,患一种及以上慢性病者占88.7%;老年人抑郁症状发生率较高,达到17.2%;社区老年人生活质量的影响因素包括性别、年龄、婚姻、居住情况、家庭人均收入、日常开支、日常生活自理能力、主要照顾给予者、业余爱好、家人支持、参与社区活动情况、躯体患慢性病的数目、患病严重程度、抑郁症状患病、患糖尿病,与文化程度、退休前职业、医疗保险情况、配偶患病严重程度无关。
[结论]建议从社区卫生服务、家庭、社会三个方面努力,多做工作,不断提高社区老年人的生活质量。社区卫生服务要更加重视慢性病管理工作,要重视老年人的精神卫生教育和心理干预;家庭要给予老年人多一些支持与关注,让老年人保持经济上的独立和支配权,并落实好患病老年人的照顾问题;社会方面要不断提高老年人的经济收入,扩大对无经济收入老年人的保障范围和力度,创造支持性的社会环境和积极的生活氛围,并重视非正式支持。
[Objective] The study aims to investigate the quality of life of the elderly in community and analyze influencing factors. Then the recommendations have been put forward to improve the quality of old people's life in community based on this investigation as well as document review.
[Methods] Stratified cluster sampling method was employed for this research. 4 communities among 13 communities in Shi Men Er Road area, Jing'an Direction of Shanghai were selected according to living and economical conditions. With information of official household registration and communities' population record, and after related training, community doctors from Shi Men Er Road community health service center made a questionnaire survey among residents over 60-year-old in these communities. Survey data was put into SPSS data base, and analyzed by using frequency analysis, T test, single-factor analysis, multi-regression, and other statistical analysis. [Results] Survey results showed that most old people in Shanghai Shi Men Er Road Community can be self-help and take care of themselves. Their economical conditions were good, most of them reported medical expenditure was acceptable and their families provided support for them. Most old people had health insurance coverage. Measured average life quality of these old people was quite good and above society's average. However, the rate of having chronic diseases among these old people was relately very high. Ratio of suffering from one kind of chronic disease was about 88.7%; up to 17.2 % for melancholia. Factors affecting old people's life's quality included gender, age, marriage, living condition, family member's average incoming, daily expenses, ability of daily living independence, main care provider, hobby, family support, status of taking part in community activities, chronic disease number and severity degree, whether having melancholia and diabetes. But there's no relationship with education degree, career before retire, health insurance coverage, disease severity degree of consort.
[Conclusion] The study proposes to work hard to improve quality of old people's life in community step by step from following aspects: community health services, family and society. For community health services, we should pay more attention to chronic diseases management, old people's spirit health indoctrination and psychology interventions. Family should offer more support and attention to old people, provide them independence and control right on economy, and make it clear how to take care of old people. For society, it should improve old people's economic income step and step, enlarge the range and improve the degree of security for old people without income. Meanwhile, it is important to provide a supportable society environment and an active living atmosphere, and pay attention to informal support.
[方法]采取分层整群抽样的方法,在上海市静安区石门二路社区的13个居委中按照居住情况和经济条件状况分别抽取2个条件较好和2个相对较差的居委,结合户籍资料及居委会的人口登记资料,由石门二路社区卫生服务中心的社区医生,经统一培训后对所有常住于本区域的60岁以上老年人,进行项目为封闭式的现场问卷调查。调查表整理后进行数据录入到SPSS13.0数据库,采用频数分析、T检验、单因素分析、多元逐步回归等进行统计分析。
[结果]得出上海市石门二路社区老年人96.42%生活自理,靠自己照顾自己,经济状况尚可,95.55%的老年人表示生活开支够用,79.3%的老人受到家人支持,91.5%的老人有城镇医疗保险,测量的平均生活质量中等偏上,60.2%的老年人生活质量良好;但社区老年人慢性病患病率很高,患一种及以上慢性病者占88.7%;老年人抑郁症状发生率较高,达到17.2%;社区老年人生活质量的影响因素包括性别、年龄、婚姻、居住情况、家庭人均收入、日常开支、日常生活自理能力、主要照顾给予者、业余爱好、家人支持、参与社区活动情况、躯体患慢性病的数目、患病严重程度、抑郁症状患病、患糖尿病,与文化程度、退休前职业、医疗保险情况、配偶患病严重程度无关。
[结论]建议从社区卫生服务、家庭、社会三个方面努力,多做工作,不断提高社区老年人的生活质量。社区卫生服务要更加重视慢性病管理工作,要重视老年人的精神卫生教育和心理干预;家庭要给予老年人多一些支持与关注,让老年人保持经济上的独立和支配权,并落实好患病老年人的照顾问题;社会方面要不断提高老年人的经济收入,扩大对无经济收入老年人的保障范围和力度,创造支持性的社会环境和积极的生活氛围,并重视非正式支持。
[Objective] The study aims to investigate the quality of life of the elderly in community and analyze influencing factors. Then the recommendations have been put forward to improve the quality of old people's life in community based on this investigation as well as document review.
[Methods] Stratified cluster sampling method was employed for this research. 4 communities among 13 communities in Shi Men Er Road area, Jing'an Direction of Shanghai were selected according to living and economical conditions. With information of official household registration and communities' population record, and after related training, community doctors from Shi Men Er Road community health service center made a questionnaire survey among residents over 60-year-old in these communities. Survey data was put into SPSS data base, and analyzed by using frequency analysis, T test, single-factor analysis, multi-regression, and other statistical analysis. [Results] Survey results showed that most old people in Shanghai Shi Men Er Road Community can be self-help and take care of themselves. Their economical conditions were good, most of them reported medical expenditure was acceptable and their families provided support for them. Most old people had health insurance coverage. Measured average life quality of these old people was quite good and above society's average. However, the rate of having chronic diseases among these old people was relately very high. Ratio of suffering from one kind of chronic disease was about 88.7%; up to 17.2 % for melancholia. Factors affecting old people's life's quality included gender, age, marriage, living condition, family member's average incoming, daily expenses, ability of daily living independence, main care provider, hobby, family support, status of taking part in community activities, chronic disease number and severity degree, whether having melancholia and diabetes. But there's no relationship with education degree, career before retire, health insurance coverage, disease severity degree of consort.
[Conclusion] The study proposes to work hard to improve quality of old people's life in community step by step from following aspects: community health services, family and society. For community health services, we should pay more attention to chronic diseases management, old people's spirit health indoctrination and psychology interventions. Family should offer more support and attention to old people, provide them independence and control right on economy, and make it clear how to take care of old people. For society, it should improve old people's economic income step and step, enlarge the range and improve the degree of security for old people without income. Meanwhile, it is important to provide a supportable society environment and an active living atmosphere, and pay attention to informal support.
引文
[1]孙永英,曾慧等.我国人口老龄化现状与护理对策.护理学杂志,2006,21(21):76-78.
[2]杨玉娟.人口老龄化与社区健康保健.护理研究,2003,17(9):1005-1006.
[3]李增金,时秋宽,吕锡珠.老龄化社会的挑战.中国健康教育,1999,15(2):5-6.
[4]陶国枢.北京市老年人生活质量相关因素分析.中国老年学杂志,1997,17(8):197-198.
[5]曾毅,顾大男.老年人生活质量研究的国际动态.中国人口科学,2002(5)
[6]徐涛,姜宝法.社区老年人生活质量评价及评定方法.中国公共卫生,2003,2(19):244-246
[7]刘红波,张曦等.SF-36问卷应用于老年人群生命质量的研究.中国慢性病预防控制,2002,1(10):26-28.
[8]张磊,邵晨等.苏州市老年人生活质量的评估.中国老年学杂志,2003(23):272-274.
[9]瓮学清,郭爱民,张洁等.北京市社区老年人生活质量影响因素分析.中国全科医学,2002,5(6):471-473.
[10]国立霞,王春梅等.天津市和平区354名老年人生活质量调查分析.白求恩军医学院学报,2003,1(1):29-31.
[11]余桂珍,曾琨等.社区老年人生活质量调查.中华护理杂志,2005,40(9):711-713.
[12]郑玉仁,柯雪梅,柯朝晖等.老年人生活质量及影响因素分析.中国公共卫生,2006,22(6):746-747.
[13]秦虹云,季建林等.社区门诊中老年慢性病患者的生活质量调查.中国临床康复,2004,8(18):3433-3435.
[14]Hideto Okazaki MD,PhD,Shigeru Sonoda MD.Evaluation of Use of the Medical Outcome Study 36-Item Short Form Health Survey and Cognition in Patients with Stroke.Journal of Stroke and Cerebrovascular Diseases,2008,5(17):276-280.
[15]胡善联.卫生经济学.复旦大学出版社,2004,289-299.
[16]韦懿芸,颜艳,王多劳等.中文版SF-36在社区老年人生存质量评价中的应用.中南大学学报,2006,31(2):184-188.
[17]张磊,徐德忠,黄久仪等.SF-36量表中文版的应用及分级截断点选择的研究.中华流行病学杂志,2004,25(1)69-73.
[18]陈敏.创建社区文化,提高老年人生活质量.科技信息,2007,29:175-176.
[19]庞连智,章亚萍.上海市闸北区临汾社区老年人健康状况调查.中国全科医学,2004,7(5),342-343.
[20]李亚萍,叶芸.杭州社区老年人慢性病调查分析.浙江临床医学,2003,5(6),477-478.
[21]黄茂盛,洪震,曾军等.上海市城乡老年人慢性病患病率现况调查.中华老年医学杂志,2001,20(4),287-289.
[22]董宣,高俊娜.天津市253名离休人员生活质量研究.中国公共卫生,2000,16(8):757-758.
[23]李晓惠,李天霖,王滨燕.不同职业老年人生活质量的影响因素研究.中华流行病学杂志,1998,19(1):57.
[24]张玉银,郑军,范平.居住方法对老年人生活质量的影响.中国疗养医学,2007,16(4):222-223.
[25]黄丽玲.老年人生活质量与社区卫生服务.广西医学,2003,2(25):323-324.
[26]陈琪尔.提高老年人的生活质量是实现“健康老龄化”的根本保证.实用医学杂志,2000,8(16):707.
[27]王庆华,段晓明,宋荣荣等.老年人生活质量与心理状况的研究.护理研究,2007,21(11):3025-3026.
[28]高之旭,盛建华.加强心理保健,提高社区老年人的生活质量.老年医学与保健,2004,4(10):193-194.
[29]沈兵明,应风其,王冠华.如何提高社区老年人生活质量.人口研究,1998,6(22):50-52.
[30]林奕,王凤卿.如何提高社区老年人的生活质量.中国初级卫生保健,2001,15(4):55-56.
[31]姚远.重视非正式支持,提高老年人生活质量.人口与经济,2002(5):46-48.
[1]王艳梅,冯蕾.老年人生活质量的研究进展.新疆医科大学报.2007,30(12):1433-1435.
[2]陶国枢.北京市老年人生活质量相关因素分析.中国老年学杂志,1997,17(8):197-198.
[3]徐涛,姜宝法.社区老年人生活质量评价及评定方法.中国公共卫生,2003,2(19):244-246
[4]张磊,邵晨等.苏州市老年人生活质量的评估.中国老年学杂志,2003(23):272-274.
[5]瓮学清,郭爱民,张洁等.北京市社区老年人生活质量影响因素分析.中国全科医学,2002,5(6):471-473.
[6]田立霞,王春梅等.天津市和平区354名老年人生活质量调查分析.白求恩军医学院学报,2003,1(1):29-31.
[7]余桂珍,曾琨等.社区老年人生活质量调查.中华护理杂志,2005,40(9):711-713.
[8]郑玉仁,柯雪梅,柯朝晖等.老年人生活质量及影响因素分析.中国公共卫生,2006,22(6):746-747.
[9]秦虹云,季建林等.社区门诊中老年慢性病患者的生活质量调查.中国临床康复,2004,8(18):3433-3435.
[10]张向明.城市老年人健康相关因素初步探讨.实用老年医学杂志,1997,11(6):258.
[11]孙玉卫,姜宝法,徐涛.老年人生活质量调查表的信度和效度研究.实用预防医学,2003,10(4):476-478.
[12]朱诗林,何国平.老年人生活质量影响因素的研究现状.综述,2005,11(19):1604-1606.
[13]刘志荣,倪进发。合肥市离退休老年人生活质量的流行病学研究.中国公共卫生,2003,19(2):230-232.
[14]徐大麟,王瑞平,孙晋福,等.上海市中心城区社区老人生存质量调查与对比研究.老年医学与保健,2000,6(2):77.
[15]蒋志学,赵艳霞,刘丽.城市老年人生活质量分析.老年人口,2003,1(91):28-30.
[16]中华荪,肖柳红,李宗亮,等.广州城区老年人进行生活质量的调查研究.中华护理杂志,1998,33(6):314-317.
[17]赵晓华.苏州市老年人生活质量调查及对策探讨.中国健康教育,2000,16(4):225-227.
[18]吴思英.影响老年人生活质量的社会因素及提高对策.海峡预防医学杂志,2002,8(2):28-29.
[2]杨玉娟.人口老龄化与社区健康保健.护理研究,2003,17(9):1005-1006.
[3]李增金,时秋宽,吕锡珠.老龄化社会的挑战.中国健康教育,1999,15(2):5-6.
[4]陶国枢.北京市老年人生活质量相关因素分析.中国老年学杂志,1997,17(8):197-198.
[5]曾毅,顾大男.老年人生活质量研究的国际动态.中国人口科学,2002(5)
[6]徐涛,姜宝法.社区老年人生活质量评价及评定方法.中国公共卫生,2003,2(19):244-246
[7]刘红波,张曦等.SF-36问卷应用于老年人群生命质量的研究.中国慢性病预防控制,2002,1(10):26-28.
[8]张磊,邵晨等.苏州市老年人生活质量的评估.中国老年学杂志,2003(23):272-274.
[9]瓮学清,郭爱民,张洁等.北京市社区老年人生活质量影响因素分析.中国全科医学,2002,5(6):471-473.
[10]国立霞,王春梅等.天津市和平区354名老年人生活质量调查分析.白求恩军医学院学报,2003,1(1):29-31.
[11]余桂珍,曾琨等.社区老年人生活质量调查.中华护理杂志,2005,40(9):711-713.
[12]郑玉仁,柯雪梅,柯朝晖等.老年人生活质量及影响因素分析.中国公共卫生,2006,22(6):746-747.
[13]秦虹云,季建林等.社区门诊中老年慢性病患者的生活质量调查.中国临床康复,2004,8(18):3433-3435.
[14]Hideto Okazaki MD,PhD,Shigeru Sonoda MD.Evaluation of Use of the Medical Outcome Study 36-Item Short Form Health Survey and Cognition in Patients with Stroke.Journal of Stroke and Cerebrovascular Diseases,2008,5(17):276-280.
[15]胡善联.卫生经济学.复旦大学出版社,2004,289-299.
[16]韦懿芸,颜艳,王多劳等.中文版SF-36在社区老年人生存质量评价中的应用.中南大学学报,2006,31(2):184-188.
[17]张磊,徐德忠,黄久仪等.SF-36量表中文版的应用及分级截断点选择的研究.中华流行病学杂志,2004,25(1)69-73.
[18]陈敏.创建社区文化,提高老年人生活质量.科技信息,2007,29:175-176.
[19]庞连智,章亚萍.上海市闸北区临汾社区老年人健康状况调查.中国全科医学,2004,7(5),342-343.
[20]李亚萍,叶芸.杭州社区老年人慢性病调查分析.浙江临床医学,2003,5(6),477-478.
[21]黄茂盛,洪震,曾军等.上海市城乡老年人慢性病患病率现况调查.中华老年医学杂志,2001,20(4),287-289.
[22]董宣,高俊娜.天津市253名离休人员生活质量研究.中国公共卫生,2000,16(8):757-758.
[23]李晓惠,李天霖,王滨燕.不同职业老年人生活质量的影响因素研究.中华流行病学杂志,1998,19(1):57.
[24]张玉银,郑军,范平.居住方法对老年人生活质量的影响.中国疗养医学,2007,16(4):222-223.
[25]黄丽玲.老年人生活质量与社区卫生服务.广西医学,2003,2(25):323-324.
[26]陈琪尔.提高老年人的生活质量是实现“健康老龄化”的根本保证.实用医学杂志,2000,8(16):707.
[27]王庆华,段晓明,宋荣荣等.老年人生活质量与心理状况的研究.护理研究,2007,21(11):3025-3026.
[28]高之旭,盛建华.加强心理保健,提高社区老年人的生活质量.老年医学与保健,2004,4(10):193-194.
[29]沈兵明,应风其,王冠华.如何提高社区老年人生活质量.人口研究,1998,6(22):50-52.
[30]林奕,王凤卿.如何提高社区老年人的生活质量.中国初级卫生保健,2001,15(4):55-56.
[31]姚远.重视非正式支持,提高老年人生活质量.人口与经济,2002(5):46-48.
[1]王艳梅,冯蕾.老年人生活质量的研究进展.新疆医科大学报.2007,30(12):1433-1435.
[2]陶国枢.北京市老年人生活质量相关因素分析.中国老年学杂志,1997,17(8):197-198.
[3]徐涛,姜宝法.社区老年人生活质量评价及评定方法.中国公共卫生,2003,2(19):244-246
[4]张磊,邵晨等.苏州市老年人生活质量的评估.中国老年学杂志,2003(23):272-274.
[5]瓮学清,郭爱民,张洁等.北京市社区老年人生活质量影响因素分析.中国全科医学,2002,5(6):471-473.
[6]田立霞,王春梅等.天津市和平区354名老年人生活质量调查分析.白求恩军医学院学报,2003,1(1):29-31.
[7]余桂珍,曾琨等.社区老年人生活质量调查.中华护理杂志,2005,40(9):711-713.
[8]郑玉仁,柯雪梅,柯朝晖等.老年人生活质量及影响因素分析.中国公共卫生,2006,22(6):746-747.
[9]秦虹云,季建林等.社区门诊中老年慢性病患者的生活质量调查.中国临床康复,2004,8(18):3433-3435.
[10]张向明.城市老年人健康相关因素初步探讨.实用老年医学杂志,1997,11(6):258.
[11]孙玉卫,姜宝法,徐涛.老年人生活质量调查表的信度和效度研究.实用预防医学,2003,10(4):476-478.
[12]朱诗林,何国平.老年人生活质量影响因素的研究现状.综述,2005,11(19):1604-1606.
[13]刘志荣,倪进发。合肥市离退休老年人生活质量的流行病学研究.中国公共卫生,2003,19(2):230-232.
[14]徐大麟,王瑞平,孙晋福,等.上海市中心城区社区老人生存质量调查与对比研究.老年医学与保健,2000,6(2):77.
[15]蒋志学,赵艳霞,刘丽.城市老年人生活质量分析.老年人口,2003,1(91):28-30.
[16]中华荪,肖柳红,李宗亮,等.广州城区老年人进行生活质量的调查研究.中华护理杂志,1998,33(6):314-317.
[17]赵晓华.苏州市老年人生活质量调查及对策探讨.中国健康教育,2000,16(4):225-227.
[18]吴思英.影响老年人生活质量的社会因素及提高对策.海峡预防医学杂志,2002,8(2):28-29.