老年长期照护综合评价模型指标体系建立及实证研究

The establishment and empirical study of the index system for the comprehensive evaluation model of long term care for the elderly

目的构建适用于居家、社区及养老服务机构的老年长期照护综合评价模型指标体系并加以验证。方法在文献研究、理论析取、质性访谈、专家函询基础上建立初级评估指标体系,采用问卷调查法收集684份有效数据,以相关性分析法、极端组法、信效度检验法再次筛选指标并加以验证,形成最终模型指标体系。结果最终模型指标体系包括7个一级指标共计119个二级指标,Cronbach'sα系数0.782~0.986,重复测量Pearson相关系数0.917~0.980。其中,"日常生活能力""跌倒风险""压疮风险""认知能力"指标采用目前十分成熟的量表;"异常症状/表现""医疗护理项目""自我照护知识需求"指标为自主建立,Bartlett球形检验结果为0.745~0.883,探索性因子分析主成分分析萃取公因子依次为4个、3个、1个,对总方差累计贡献率分别达68.04%、59.49%、65.40%;经验证性因子分析,修正后公因子分别为4个、4个、3个。结论老年长期照护综合评价模型中7个一级指标均具有良好的信效度,均达到实际应用标准,可为后续进一步建立国内常模奠定前期研究基础。

Objective To establish and verify the index system of the comprehensive evaluation model that suitable for home,community and elder service institution of long term care for the elderly.Method To set up a primary evaluation index system on the basis of literature research,theoretical disjunctive,qualitative interview and expert consultation.A total of 684 valid data were collected by questionnairesurvey,three methods were used to screen and evaluate the model indexes again,such as correlation analysis,extreme group method,reliabilityand validity test,then formed the final model index system.Results The final model index system included 7 first level indicators,total of119 two level indicators,the Cronbach＇s α coefficient was 0.782～ 0.986,the pearson correlation coefficient was 0.917～ 0.980.Among them,the＂ daily life ability＂ ＂ falling risk＂ ＂ pressure sore risk＂ and ＂ cognitive ability＂ evaluation were using very mature scales,the ＂ abnormal performance / symptom＂ ＂medical care project＂ and ＂ self-care knowledge needs＂ evaluation were independently established in the study,Bartlett spherical test resulted was 0.745～ 0.883,the exploratory factor analysis principal component analysis were 4,3and 1,the cumulative contribution to the total variance were 68.04%,59.49% and 65.40%.After confirmatory factor analysis,the revised common factors were 4,4 and3.Conclusion By statistical analysis,seven first level indicators of the index system for the comprehensive evaluation model of long term carefor the elderly had good reliability and validity,the independent construction index for the study also reached the practical standard.The indexsystem can laid the foundation of establishing domestic norms for further research.