三联护理服务模式对居家空巢老人生存质量和社会支持度的影响

Effects of combined model with contract signing, team cooperation and telehealth care on social support and quality of life for empty nest elders at home

目的 探讨签约式管理,团队合作和远距离照顾三联服务模式对居家空巢老人社会支持度和生存质量的影响.方法 将朝晖街道已建卡的320名空巢老人随机分为两组,每组160名.对照组实施常规护理服务,观察组实施包括签约式服务、团队合作服务、远距离照顾在内的三联护理服务模式.干预1年后,采用社会支持量表（SSRS）及生存质量量表（SF-36）比较干预效果.结果 干预后,观察组与对照组SRSS三个维度得分分别为主观支持（21.4±4.2）和（18.4±3.7）分、客观支持（7.0±1.6）和（6.0±2.3）分、支持利用度（7.6±2.2）和（6.1±2.5）分;观察组与对照组SF-36八个维度得分分别为生理功能（74.8±14.9）和（66.3±l5.6）分、生理职能（72.3±15.8）和（65.9±14.7）分、躯体疼痛（71.3±19.8）和（62.4±15.0）分、总体健康（54.2 ± 13.0）和（47.8±13.1）分、精力（58.4±17.4）和（50.2±13.9）分、社会功能（58.0±17.9）和（48.8±21.3）分、情感职能（74.0±18.9）和（64.8±18.0）分、精神健康（59.5±12.8）和（50.1±11.3）分;观察组与对照组高血压规范管理率分别为97.0％和86.1％,高血压控制率分别为72.3％和61.7％,糖尿病控制率分别为85.4％和64.7％,两组各指标相比差异均具有统计学意义（P＜0.05）.结论 应用三联服务模式能够提高空巢老人的社会支持度、生存质量,提高高血压、糖尿病的控制率.

Objective To evaluate the effects of combined model of contract signing,team cooperation and telehealth care on social support and quality of life for empty nest elders at home.Methods A total of 320 empty nest elders at home were randomly divided into experimental group and control group.The elders in experimental group received contract signing,team cooperation and telehealth care for 1 year; For control group,routine nursing model was implemented.The elders were examined with social support （SSRS） and quality of life （SF-36） before and after intervention.Results Mter intervention,the scores of SSRS for experiment and control groups in subjective support 21.4 ±4.2 and 18.4 ±3.7,objective support 7.0 ± 1.6 and 6.0 ± 2.3,social support availability 7.6 ± 2.2 and 6.1 ± 2.5 ; the scores of SF-36 between experiment and control groups in physical functioning 74.8 ± 14.9 and 66.3 ± 15.6,role-physical 72.3 ±15.8 and 65.9 ± 14.7,bodily pain 71.3 ± 19.8 and 62.4 ± 15.0,general health 54.2 ± 13.0 and 47.8 ±13.1,vitality 58.4 ± 17.4 and 50.2 ± 13.9,social functioning 58.0 ± 17.9 and 48.8 ± 21.3,roleemotional 74.0 ± 18.9 and 64.8 ± 18.0,mental health 59.5 ± 12.8 and 50.1 ± 11.3 ; the rate of standard management of hypertension between experiment and control groups were 97.0% and 86.1%,the control rate of hypertension between experiment and control groups 72.3% and 61.7%,the control rate of diabetes between experiment and control groups 85.4% and 64.7,there were significant inter-group differences in all the above indicators （P 〈 0.05）.Conclusion The combined model of contract signing,team cooperation and telehealth care can significantly improve social support and quality of life for elders.