少数民族地区农村经济困难老年人失能现状多因素分析

A Multi-factor analysis of the current state of disability among economically disadvantaged older people in rural ethnic minority areas

目的 分析甘肃省临夏回族自治州60岁以上经济困难老年人自理能力现状。方法 使用多阶段分层抽样,2021年12月—2022年5月于该地区康乐县调查3 724名老年人,根据《老年人能力评估规范(征求意见稿)》,使用多分类无序logistic回归分析探究自理能力的影响因素。结果 能力完好44人(1.2%),轻度失能2 316人(64.0%),中度失能828人(22.8%),中重度失能320人(8.8%),重度失能116人(3.2%);性别、民族、宗教信仰、婚姻状况、疾病诊断、肥胖程度、年龄段、跌倒、噎食、压疮、关节活动度、伤口情况、牙齿缺损松动、吞咽困难、清理呼吸道无效、能力等级变更依据对老年人能力最终等级有影响(均P<0.05);多分类无序logistic回归分析显示,婚姻状况(重度失能:OR=0.269,95%CI:0.091~0.793)、疾病诊断(重度失能:OR=0.283,95%CI:0.125~0.643)、肥胖程度(重度失能:OR=5.867,95%CI:1.443~23.862)、年龄段(重度失能:OR=6.036,95%CI:2.488~14.643)、关节活动度(重度失能:OR=17.337,95%CI:5.067~59.320)、牙齿缺损松动(重度失能:OR=3.678,95%CI:1.487~9.096)、压疮(重度失能:OR=43.535,95%CI:1.273~1 488.906)是老年人能力最终等级的影响因素。结论 甘肃省临夏回族自治州60岁以上经济困难老年人失能率达98.8%,对其养老服务与健康需求应高度重视。

Objective To analyze the current status of self-care ability of economically disadvantaged older adults over 60 years old in Linxia Hui Autonomous Prefecture,Gansu Province.Methods Using multistage stratified sampling,3724 older adults were surveyed in Kangle County of the region from December 2021 to May 2022,and the influencing factors of self-care ability were explored using multi-classified unordered logistic regression analysis according to the Specification for the Assessment of Elderly People's Ability(Draft for Public Comments).Results Ability was intact in 44(1.2%),mildly disabled in 2316(64.0%),moderately disabled in 828(22.8%),moderately severely disabled in 320(8.8%),and severely disabled in 116(3.2%).Gender,ethnicity,religious beliefs,marital status,diagnosis of disease,obesity level,age group,falls,choking,pressure sores,joint mobility,wound condition,missing loose teeth,dysphagia,ineffective airway clearance,and basis for change in competency class had an effect on the final class of competency of the elderly(all P<0.05).Multi-classified unordered logistic regression analysis showed that marital status(severe disability,OR=0.269,95%CI:0.091-0.793),disease diagnosis(severe disability,0R=0.283,95%CI:0.125-0.643),degree of obesity(severe disability,OR=5.867,95%CI:1.443-23.862),age group(severe disability,OR=6.036,95%CI:2.488-14.643),joint mobility(severe disability,0R=17.337,95%CI:5.067-59.320),loose tooth defect(severe disability,OR=3.678,95%CI:1.487-9.096),pressure ulcer(severe disability,OR=43.535,95%CI:1.273-1488.906)were the influencing factor of the final level of the ability of the elderly.Conclusion The incapacity rate of economically disadvantaged older people over 60 years old in Linxia Hui Autonomous Prefecture,Gansu Province,reaches 98.8%,and great attention should be paid to their elderly care services and health needs.