安徽省两市社区居家老人心理健康照顾服务需求———利用研究

Study on Demand-utilization about Mental Health Care Service of Home-based Elderly in Two Cities of Anhui Province

目的了解安徽省两市社区居家老人心理健康照顾服务需求———利用现状及其影响因素,为提升社区老年人心理健康水平和社区老年人心理健康服务水平提供参考。方法根据ADL量表、SRHMS量表相关条目自行设计问卷,采用多阶段分层抽样的方法随机抽取安徽省合肥市、阜阳市65岁以上的老年人进行问卷调查。采用EpiData 3.1对数据进行双录入,SPSS 25.0进行统计描述,卡方检验和logistic回归分析。结果共计调查两市社区居家老人534人,有效应答500人,有效应答率93.6%。共有259人(51.8%)需要心理健康照顾服务,而实际接受过心理健康照顾服务的仅为99人(19.8%),多因素分析结果显示,合肥地区(OR=1.646,95%CI:1.128~2.401)、受教育年限越长(OR=1.066,95%CI:1.024~1.110)、自评精神状况越差(OR=1.508,95%CI:1.118~2.034)、近两周患病(OR=1.881,95%CI:1.153~3.069)的社区居家老人更容易对心理健康照顾服务产生需求。合肥地区(OR=1.903,95%CI:1.196~3.026)、月可支配收入越高(OR=1.360,95%CI:1.099~1.682)、自评精神状况越差(OR=1.602,95%CI:1.187~2.163)的社区居家老人更多地利用了心理健康照顾服务。结论两市社区居家老年人对心理健康照顾服务的需求与实际利用存在着较大差异,对心理健康照顾服务的实际利用不足,应提高老年人对心理健康的重视度,提高社区心理健康服务水平。

Objective To understand the status quo of need-utilization of mental health care services for home-based elderly in communities in Anhui Province and its influencing factors,so as to provide reference for the improvement of mental health level of elderly in communities and mental health service level of elderly in communities.Methods Questionnaires were designed by themselves according to the relevant items of ADL scale and SRHMS scale,and a multistage stratified sampling method was adopted to randomly select the elderly over 65 years old in Hefei and Fuyang of Anhui province for questionnaire survey.EpiData3.1 was used for double entry of data,SPSS 25.0 for statistical description,chi square test and logistic regression analysis.Results A total of 534 people in the two cities were investigated,and 500 people responded effectively,with an effective response rate of 93.6%.A total of 259 persons(51.8%)needed mental health services,whereas only 99 persons(19.8%)actually received mental health services.According to the results of multivariate analysis,home-based elderly residents in hefei(OR=1.646,95%CI:1.128~2.401),with longer years of education(OR=1.066,95%CI:1.024-1.110),with lower self-rated mental status(OR=1.508,95%CI:1.118~2.034),and with illness in recent two weeks(OR=1.881,95%CI:1.153~3.069)are more likely to have a demand for mental health care services.Elderly residents in Hefei(OR=1.903,95%CI:1.196~3.026),with higher monthly disposable income(OR=1.360,95%CI:1.099~1.682),and with lower self-rated mental status(OR=1.602,95%CI:1.187~2.163)made more use of mental health care services.Conclusion There is a big difference between the needs and actual utilization of mental health care services for the elderly in the community in the two cities,and the actual utilization of mental health care services is insufficient,so the importance of mental health among the elderly should be enhanced and improve the level of community mental health services.