老年慢性病患者出院护理需求及影响因素分析

Influencing factors of nursing needs in discharged elderly patients with chronic diseases

目的探讨老年慢性病患者出院护理的需求及影响因素，为制订针对性的出院指导提供依据。方法 选取2015年1-6月在上海市嘉定区真新社区卫生服务中心各类老年慢性病出院患者232例，采用自制调查问卷，内容包括疾病护理与预防、健康促进2个维度共20个条目，共分为20-100分。结果232例患者护理需求总分为（63．87±17．5）分。20个条目中，排在前5位的分别是出现紧急情况时医护人员的救护、定期提供体检、安全用药指导、上门提供护理及慢性病的长期护理。经单因素分析，年龄、有无配偶、文化程度、体育活动频率与护理需求总分比较差异有统计学意义（P〈0．05）。高龄、无配偶、小学及以下程度老人和大专及以上老人、从不参加体育活动者护理需求总分最高。经多重线性回归分析，影响老年慢性病患者出院护理需求的主要因素有年龄、文化程度、独居与否、体育活动频率、疾病对日常生活影响、有无后遗症以及首要住院原因（高血压）（P〈0．05）。结论 老年慢性病患者出院的护理需求是多方面的，护士在实施出院护理时，重点应关注患者不同护理需求，特别是高龄、无配偶、独居的患者，并有针对性地做好出院指导，满足老年慢性病患者的护理需求。

Objective To investigate the nursing needs of the discharged elderly patients with chronic diseases and the related influencing factors, and to provide corresponding discharge instructions. Methods A total of 232 elderly patients with chronic diseases discharged from Zhenxin Community Health Services Center, Jiading District, Shanghai, from January to June 2015 were involved. A self-designed questionnaire on the nursing needs was used including disease nursing and prevention, health promotion, etc. Results The top 5 nursing needs were cares provided by the physicians and nurses in case of emergency, regular physical examinations, instructions for medicine safety, home care, and long-term nursing of chronic diseases. The single-factor analysis showed that the nursing needs were influenced by the following factors： age, presence of a spouse or not, education background frequency of physical activity （P 〈 0.05）. The multiple linear regression analysis showed that the nursing needs were mainly influenced by age, education background , living alone or not, frequency of physical activity, influence of disease on daily living activity, sequelae and primary cause of hospitalization （hypertension） Conclusion The elderly patients with chronic diseases have diverse nursing needs after discharge. Nurses should pay more attention to those patients with aging, no spouse, and living alone.