养老机构失能老年人长期照护需求影响因素结构方程模型构建研究

Research on the construction of structural equation model of factors affecting the long-term care needs of the disabled elderly in elderly care institutions

目的探讨养老机构失能老年人长期照护需求影响因素的作用机制,为采取有针对性的护理干预提供依据。方法于2018年7—11月,采用便利抽样法选取保定市10家养老机构的508名失能老年人为研究对象,采用一般资料调查表、Barthel指数、养老机构失能老年人长期照护需求问卷、养老机构失能老年人长期照护需求影响因素问卷对其长期照护需求现状及影响因素进行横断面调查。采用SPSS 21.0进行相关性分析、多元线性回归分析,采用AMOS 24.0进行模型拟合、路径及中介效应分析。结果养老机构失能老年人长期照护需求总分为(105.04±21.68)分;个体内、人际、个体外因素得分分别为(16.93±5.20)、(10.51±3.39)、(19.80±6.24)分。个体内因素、人际因素、个体外因素及照护需求两两均呈正相关(r值为0.222~0.645,均P<0.05)。个体内、人际和个体外因素均能直接影响失能老年人的长期照护需求(β=0.455、0.527、0.403);个体内、人际因素在个体外因素与失能老年人长期照护需求间的单独中介及个体内因素-人际因素链式中介效应显著,效应值分别为0.078、0.095及0.023,分别占总效应的15.15%、18.45%及4.47%。结论各影响因素对失能老年人长期照护需求具有较强的预测和解释能力,护理人员可针对不同的影响因素来满足失能老年人的照护需求。

Objective To explore the mechanism of factors affecting the long-term care needs of disabled elderly in elderly care institutions,and provide basis for taking targeted nursing intervention.Methods From July to November 2018,convenience sampling method was used to conduct cross-sectional survey of the current situation and influencing factors of long-term care needs of 508 disabled elderly people in 10 elderly care institutions in Baoding City by general information questionnaire,Barthel index,the Long-term Care Needs of the Disabled Elderly in elderly care institutions,the Questionnaire on the Factors Affecting the Long-term Care Needs of the Disabled Elderly in elderly care institutions.SPSS 21.0 was used for correlation analysis and multiple regression analysis,and AMOS 24.0 was used for model fitting,path and mediation effect analysis.Results The score of long-term care needs of the disabled elderly in elderly care institution was(105.04±21.68)points;the scores of intra-personal,interpersonal,and extra-personal factors were(16.93±5.20)points,(10.51±3.39)points,(19.80±6.24)points,respectively.Intra-individual factors,interpersonal factors,extra-individual factors and care needs were all positively correlated(r values were 0.222-0.645,P<0.05).Intra-individual,inter-personal and extra-individual factors could directly affect the long-term care needs of the disabled elderly(β=0.455,0.527,0.403);intra-individual and inter-personal factors had independent mediating effects and chain mediating effects between extra-individual factors and the long-term care needs of the disabled elderly,and the effects were significant,with effect value of 0.078,0.095 and 0.023,accounting for 15.15%,18.45%and 4.47%of the total effect,respectively.Conclusions Each influencing factor has a strong ability to predict and explain the long-term care needs of the disabled elderly,and nursing staff could meet the care needs of the disabled elderly according to different influencing factors.