武汉市养老院老年人生存质量现况、影响因素及对策研究

Quality of life, its influencing factors and countermeasures among nursing home residents in Wuhan

目的：调查武汉市养老院老年人的生存质量，并分析影响养老院老年人生存质量的相关因素，为改善养老院老年人的生存质量提供相应对策。方法2012年9月—2013年8月，便利抽取武汉市内22所养老院的292名老年人进行问卷调查。问卷主要包括改良版生存质量量表（ QOLC-E）以及简短心理状况评估量表（ SPMSQ）。统计老年人慢性病和损伤程度得分、老年人生存质量6个维度得分及不同影响因素的老年人生存质量总分及各维度得分。结果共257名（88%）老年人患慢性疾病，其主要功能障碍主要是来自心肺系统（51.0%）、感觉系统（43.2%）、肌肉骨骼皮肤系统（37.0%）与神经系统（32.9%）。养老院老年人生存质量总得分为（3.02±0.61）分，其中身体不适度、饮食、关心和支持、负面情绪、压力及价值观6个维度得分分别为（3.49±0.47），（2.87±0.82），（3.13±0.53），（3.13±1.11），（3.16±1.14），（2.33±1.36）分。影响养老院老年人生存质量的主要因素为慢性病、社会支持（自觉经济负担、被遗忘感、社会接触）、丧偶。无慢性病、社会支持较高或非丧偶老年人，生存质量得分较高。结论武汉市养老院老年人的生存质量尚需进一步提高，影响养老院老年人生存质量的因素是多方面的，养老机构、家庭、社会需从多方面采取相应的措施来帮助提高养老院老年人的生存质量。

Objective To investigate the quality of life and its related factors and countermeasures for nursing home residents in Wuhan, to provide constructive advice for promoting quality of life of residents in nursing home. Methods A convenient sample of 292 nursing home residents from 22 nursing homes was enrolled in Wuhan from September 2012 to August 2013. Several questionnaires were used in this survey including demographic data such as modified version of the quality-of-life concerns in the end of life questionnaire （QOLC-E） and short portable mental status questionnaire （SPMSQ）. Results A total of 257 （88%） elderly acquired chronic disease, and the main disorder resulted from heart and lung system （51. 0%）, sensory system （43. 2%）, musculoskeletal and skin system （37. 0%）, and nervous system （32. 9%）. The total score of life quality was （3. 02 ± 0. 61）, of which discomfort level of body, diet, care and support, negative mood, stress and sense of worth were （3. 49 ± 0. 47）, （2. 87 ± 0. 82）, （3. 13 ± 0. 53）, （3. 13 ± 1.11）, （3.16 ±1.14） and （2.33 ±1.36） respectively. The main influencing factors contained chronic disease, social support （ self-feeling of financial burden, feeling of passing into silence, social contact ） , and widowed. Elderly without chronic disease history, with high social support and non-widowed obtained a high score of life quality. Conclusions It is necessary for us to improve the quality of life for nursing home residents in Wuhan. Several factors affect the elderly quality of life, so the faculty of nursing homes, family members as well as the community workers should have responsibility to take appropriate and corresponding measures in many ways to help elderly improve their life quality.