不同医养结合机构老年人总体幸福感调查及其影响因素研究

General Well-being and Associated Factors in Elderly People Receiving Integrated Medical and Nursing Care from Different Types of Institutions

目的调查不同医养结合机构老年人总体幸福感,分析其影响因素,为科学解决我国老龄化问题提供依据。方法 2016年2—5月,采用典型抽样与分层整群抽样相结合的方法,分别选取河南省老干部康复医院、郑州市中心医院(医院组),河南省老年公寓(养老院组)以及郑州市第九人民医院及其合作的养老机构(医院+养老院组)中所有接受医养结合服务的年龄≥60岁老年人为调查对象。调查个人基本情况、生活自理能力(ADL)、总体幸福感。结果不同性别、年龄、文化程度、有无配偶、有无慢性病老年人总体幸福感得分比较,差异无统计学意义(P>0.05);不同人均月收入、医养结合机构、ADL评分老年人总体幸福感得分比较,差异有统计学意义(P<0.05)。医院组老年人总体幸福感及对生活的满足维度得分均高于其他两组(P<0.05)。3类医养结合机构老年人总体幸福感得分与人均月收入、ADL评分呈正相关(P<0.05);医院组老年人总体幸福感得分与有无配偶呈正相关(P<0.05),即有配偶者总体幸福感较强;医院+养老院组老年人总体幸福感得分与有无慢性病呈负相关(P<0.05),即无慢性病者总体幸福感较强。多元线性回归分析结果显示,医养结合机构类型、有无配偶、人均月收入、ADL评分与老年人总体幸福感得分有回归关系(P<0.05)。结论国家和社会应努力提高老年人卫生保健水平,减轻其身体病痛,提高其ADL,提高收入水平,解除其看病住院的经济之忧,从而提高其总体幸福感及其生存质量。

Objective To investigate the general well-being and associated factors in elderly people receiving integrated medical and nursing care from different types of institutions,so as to provide a scientific basis for solving the problem of aging in China. Methods From February to May 2016,using typical sampling and stratified cluster sampling,we selected all the elderly persons aged 60 or over receiving integrated medical and nursing care from Henan Provincial Rehabilitation Hospital for Old Cadres and Zhengzhou Central Hospital（ hospital group）,Henan Provincial Apartment for the Aged（ beadhouse group） and the Ninth People＇ s Hospital of Zhengzhou and its cooperating elderly care institutions（ hospital ＋ beadhouse group）. The demographic data,ADL and general well-being of them were investigated by a questionnaire survey. Results Sex, age,educational attainment,marital status and prevalence of chronic diseases were not associated with the scores of general well-being（ P〈0. 05）. The scores of general well-being significantly varied by monthly income per capita, type of institution delivering integrated medical and nursing care and scores of ADL（ P〈0. 05）. The scores of general well-being and life satisfaction dimension of the elderly in the hospital group were higher than those in the other two groups（ P〈0. 05）. The scores of general well-being of the elderly were positively related to the monthly income per capita and the scores of ADL in all the groups（ P〈0. 05）. The scores of general well-being of the elderly in the hospital group were positively related to the marital status（ P〈0. 05）,specifically speaking,those who had a spouse showed a higher sense of happiness. The scores of general well-being of the elderly in hospital ＋ beadhouse group were negatively correlated with the prevalence of chronic diseases（ P〈0. 05）,that was,those who had no chronic diseases demonstrated higher subjective well-being. The results of multiple linear regression analysis showed that the type of institution delivering integrated medical and nursing care,marital status,monthly income per capita,and scores of ADL were significantly associated with the general well-being of the elderly（ P〈0. 05）.Conclusion In order to improve the wellbeing and quality of life of the elderly,national and social efforts should be made to increase their healthcare level,ADL and economic status,reduce their physical health problems and relieving the anxiety caused by medical and nursing care cost.