老龄化背景下计划生育特殊家庭健康养老困境探析——以家庭功能为分析视角

Dilemmas in Elderly Care Faced by the Special Family under the Context of Population Aging:from a Perspective of Family Function

目的从家庭功能角度探析计划生育特殊家庭面临的健康养老困境及原因。方法于2018年9月—2019年8月采用定额抽样方法选取云南省4个市/县的122户计划生育特殊家庭作为调查对象,利用家庭功能评估量表(Family Assessment Device,FAD)和深入访谈对其家庭功能和养老现状进行调查。统计方法包括描述性分析、t检验、方差分析等。结果被调查家庭的整体功能欠佳(GF=2.37)。年龄是家庭问题解决(F=3.568,P=0.031)、情感反应(F=10.643,P<0.001)、行为控制(F=7.810,P<0.001)和总体功能维度(F=3.591,P=0.031)的影响因素;家庭月收入是家庭总体功能(F=3.087,P=0.030)、沟通(F=3.494,P=0.018)、情感反应(F=3.974,P=0.010)和行为控制维度(F=2.717,P=0.048)的影响因素;婚姻状况是家庭问题解决(F=4.438,P=0.005)和情感卷入功能(F=4.301,P=0.006)的影响因素;独生子女现状是家庭问题解决(F=2.934,P=0.004)、角色(F=-2.253,P=0.026)和情感卷入维度(F=-3.183,P=0.002)的影响因素。家庭功能的弱化使得计划生育特殊家庭面临经济、生活照料、心理和看病住院四个方面的养老困境。结论在加大社会支持力度以弥补家庭功能弱化的同时,应从经济、日常照料、心理和医疗四个层面精准施策,改善计划生育特殊家庭的养老困境。

Objective To explore the dilemmas in elderly care faced by parents who endured the loss or disability of only-child from the perspective of family function.Methods Using the quota sampling,a sample of 122 families who either experienced death or disability of only child were recruited from four cities or counties in Yunnan Pro-vince from September 2018 to August 2019,and used the standardized Family Assessment Device(FAD)questionnaire and in-depth interview to investigate their family function and pension status.Data analysis involved independent-samples T test and one-way ANOVA.Results The family function outcomes of these families were relatively poor(general functioning(GF)=2.37).Overall,older age was an influencing factor for problem solving(PS)(F=3.568,P=0.031),affective responsiveness(AR)(F=10.643,P<0.001),behavior control(BC)(F=7.810,P<0.001)and GF(F=3.591,P=0.031).Monthly family income was an influencing factor for communication(CM)(F=3.494,P=0.018),AR(F=3.974,P=0.010),BC(F=2.717,P=0.048)and GF(F=3.087,P=0.030).Being married was a risk factor for PS(F=4.438,P=0.005)and affective involvement(AI)(F=4.301,P=0.006).Status of only child was an influencing factor for PS(F=2.934,P=0.004),RL(F=-2.253,P=0.026)and AI(F=-3.183,P=0.002).Findings indicated that due to the weakness of family function,the parents in these families have to confront with the economical,physical,psychological,and health-seeking dilemmas.Conclusion There is a great need for targeted interventions to strengthen family function among these families through social support while providing more economic,emotional,daily care,and healthcare services.