基于日常生活能力评估的老年人长期护理服务需求分析

Survey on the demand for long-term care services by elderlies with different activity of daily living

目的了解不同日常生活能力(activity of daily living,ADL)老年人的养老意愿及长期护理服务需求状况。方法2017年8—9月,采用多阶段分层整群随机抽样的方法抽取山东省3个城市60岁及以上老年人群7070人。通过自制问卷和ADL量表对其一般社会人口学特征、养老意愿及ADL进行调查。采用秩和检验、多元logistic回归模型分析老年人一般情况与日常活动能力之间的关系以及不同ADL老年人长期护理服务需求的影响因素。结果根据ADL评分将调查对象分为无受损、能力下降和明显障碍3组,分别有5467人(77.3%)、1283人(18.2%)和320人(4.5%)。不同ADL老年人的养老意愿不同,差异有统计学意义(Z=8.704,P<0.05)。不同ADL老人长期护理服务需求影响因素不同:养老意愿为3组老年人长期护理服务需求的共同影响因素;无受损组老人年龄、居住方式与服务需求显著相关,能力下降组老人服务需求与居住方式、慢性病状况显著相关,明显障碍组老人需求与文化程度、自评经济状况显著相关。结论不同ADL老人长期护理服务需求及其影响因素不同,应根据老年人ADL状况,有针对性地提供长期护理服务。

Objective To explore the aging care willingness and requirements for long-term care services among elderlies with different activity of living(ADL).Methods 7070 elderlies aged 60 years and above were subject to a questionnaire survey using stratified multistage random cluster sampling in three municipalities of Shandong province from August through September,2017.Data information was obtained by a customized questionnaire and ADL scale.Rank sum test and multivariate logistic regression were used for statistical analysis.Results According to the ADL scoring,the participants were divided into 3 groups:normal,decreased function,and dysfunction,with 5467(77.3%),1283(18.2%),and 320(4.5%)people respectively.Elderlies with different ADL had different aging care willingness,and the difference was statistically significant(Z=8.704,P<0.05).The factors influencing long-term care services need varied with the degree of ADL.The willingness was a common factor for long-term care services needs of the three elderly groups.The age and living arrangements were factors among the normal ADL group.The living arrangements and chronic diseases were those among the decreased function group,and the education and self-rated economic status were those among the dysfunction group.Conclusions The demand for long-term care service were diversified with the degree of ADL.Targeted interventions should be taken to meet the needs of elderlies of different ADL.