上海市某辖区居民养老服务需求评估维度开发的德尔菲法研究

Study on assessment dimensions of community-based elderly care service with Delphi method

目的 从供需方角度出发,厘定辖区养老服务需求评估维度,并评估各维度对养老服务需求的贡献程度.方法 通过文献回顾和课题小组讨论,初步设立患病情况、生活自理能力、视力、跌倒风险、老年人自我意愿/信息的表达能力、老年人对他人表达的意愿/信息的理解能力、抑郁情况、焦虑情况、家属照护提供能力、自我养老意愿、家属养老意愿11个养老服务需求评估维度,由护理院、养老机构、日托中心的管理层和执行层、镇政府以及村/居委会的37位代表,于2016年4-8月,采用两轮德尔菲法咨询对评估维度进行再确认和赋权.结果 两轮咨询的专家积极性、权威程度均良好,且最后一轮咨询获得了专家很强的认可.最终确定了12个评估维度,其中经第1轮咨询新增的＂老年人经济状况＂仅作为养老补贴参考,不参与老年人健康状况评估,因此也不参与评估维度权重计算;11个评估维度中,以＂患病情况＂的权重最高,为0.11,以＂视力＂和＂焦虑情况＂的权重最低,为0.07.结论 该养老服务需求评估维度的可信性较高,对现阶段社区居民养老困境的解决提供参考.

Objective To define the assessment dimensions of community-based elderly care service.Methods Firstly 11 assessment dimensions of elderly care service needs were teased out through literature review and group discussion, these were illness, self-care ability, vision, risk of falls, willingness/information self-expression ability, the comprehension in others＆#39; willingness/information, depression, anxiety, family care ability, self-desires for old-age support, family-desires for old-age support.Then 37 experts were invited to reconfirm and empower theose assessment dimensions with two rounds of Delphi method.Results Results showed that the enthusiasm and authority degree of experts were favorable in two rounds, and the results from the second round showed strong opinion coordination.Finally, 12 assessment dimensions were confirmed, in which financial situation of the aged added and used for reference.After weight calculation, illness was weighted the highest （0.11）, while vision and the degree of anxiety were weighted lowest in 11 dimensions （0.07）.Conclusion The reliability of the assessment dimensions of the aged service needs is high.This study had positive significance on the solution of the dilemma in elderly care at the present stage.