主动健康视角下养老机构失能老年人“给予式照护”困境的质性研究

A qualitative study on dilemma of“Giving Care”for the disabled elderly in nursing homes from perspective of active health

目的从主动健康视角出发,探析养老机构失能老年人“给予式照护”困境的形成原因。方法采用目的抽样法,2022年7月—12月选取重庆某养老机构的失能老年人及照护人员为研究对象。采用一对一深入访谈、Colaizzi 7步分析法进行资料收集及分析。结果确定了4个主题:①“给予”照护理念主导,包括以孝为本的文化思想、被动接受的照护特征、购买服务的用尽心理;②参与照护能力不足,包括主动健康的知识缺乏、参与照护的技能弱化;③转型照护模式受阻,包括人力资源的客观限制、适老环境的匹配滞后;④利用内在能力减退,包括潜在风险的过度规避、照护人员的工作超负荷、个性照护的质量欠佳。结论养老机构失能老年人“给予式照护”形成原因受到社会背景、服务体系、供给资源、管理模式等多重影响。将失能老年人从“给予式被动照护”转型到“参与式主动健康”,是实现积极健康老龄化理念的重要举措。

Objective This study aims to explore the formation of the dilemma of“giving care”for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi’s 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the“giving”care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient“participation”care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to“transformation”of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and④the decline in“utilization”of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of“giving care”for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of“passive giving care”to“active participation in their health”is an important measure to realize the concept of positive aging and healthy aging.