北京市社区失能老年人的照护需求及其影响因素

The demand for care and its influencing factors in community-dwelling disabled elderly in Beijing

目的探讨北京市社区失能老年人的照护需求及其影响因素。方法采用多阶段随机抽样法,对北京市4个区8个社区的1 158名老年人进行问卷调查,采用老年人生活活动能力量表筛选失能老年人,使用自行编制的社区失能老年人照护需求调查问卷对其照护服务需求内容进行调查,分析照护需求的影响因素。结果调查对象中共有220名失能老年人,失能率为19%,其中轻度失能90名(40.9%),中度失能68名(30.9%),重度失能62名(28.2%)。失能老年人存在多方面的照护需求,排序前3位的身体照护服务需求是:上下楼梯、洗澡和室内行走;排序前3位的日常生活照护需求是:家务助理、代购和陪同;排序前3位的居家护理服务需求是:吸氧、口腔护理和鼻饲喂养;其他服务需求的前3位是:紧急救护、康复治疗和小饭桌。多元线性回归分析结果显示,年龄、慢性病的种类、自评健康状况、失能程度、慢性疼痛、跌倒经历是失能老年人照护需求的影响因素。结论北京市60岁及以上失能老年人照护需求迫切,其中身体照护需求最高,影响该人群照护需求的因素呈多元化。

Objective To investigate the demand for care in community-dwelling disabled elderly and its influencing factors in Beijing. Methods With multi-stage random sampling method,a questionnaire survey was conducted among 1158 older adults in eight communities from four districts in Beijing. The elderly activities of daily living scale was used to screen the disabled elderly. Self-designed questionnaire of demand for care was used to in- vestigate care demand among community-dwelling disabled elderly. Multiple liner regression analysis was conducted to examine the influencing factors. Results There were 220 （19.0%） disabled older adults. There were 90 older adults with mild disability（40.9%）,68 with moderate disability（30.9%）,and 62 with severe disability（28.2%）. Disabled older adults had many kinds of demands for care services. For physical care service needs ,the top three care services were：walking up and down the stairs,taking a bath,and walking indoor; for daily life care demands,the top three care services were：domestic helper,purchasing,and accompanying; for home care services demands,the top three care demands included：oxygen therapy,oral care,and nasogastric tube feeding; the top three other service demands were：emergency care,rehabilitation therapy and delivery service with a small dining table. Multiple liner regression showed that age,chronic disease,healthy status,disability severity,chronic pain,and fall history were associated with care service demands of disabled older adults. Conclusion The community-dwelling disabled elderly aged 60 years or over in Beijing had urgent demand for care services. The demand for physical care service was the highest,and the influencing factors of demand were diversified.