残疾老人辅具使用和配套服务利用对其照顾者压力的影响

Study on the Impact of Assistive Device Use and Complementary Service Utilization in the Elderly with Disabilities on Caregiver Stress

目的:了解残疾老人辅具使用和配套服务利用对其照顾者压力的影响,为提高残疾老人照顾者生活质量提供依据。方法:立意抽样选取湖北、陕西、北京和上海1个主城区和1个郊区或贫困区(县)正在使用辅具的残疾老人为调查对象,描述残疾老人辅具使用与其照顾者压力现状;运用二元logistic回归模型分析残疾老人辅具使用和配套服务利用对其照顾者压力的影响。结果:1093例样本中,79.87%的残疾老人照顾者压力有所减轻。存在辅具使用困难的残疾老人照顾者压力减轻的可能性更低(OR=0.629,P=0.012);残疾老人对辅具质量越满意,其照顾者压力减轻的可能性越高(OR=2.710,P<0.001);接受过辅具咨询和维修更换服务的残疾老人照顾者压力减轻的可能性是未接受过相关服务残疾老人的1.764倍和2.576倍。结论:残疾老人的辅具使用极大减轻了其照顾者压力,辅具配套服务的利用对减轻残疾老人照顾者压力有重要作用,残疾老人家庭经济状况与残疾程度显著影响其照顾者压力。低收入家庭、中重度残疾老人照顾者的压力应重点关注;提高辅具使用率,降低辅具使用难度,加强辅具质量管理,推广辅具配套服务是减轻残疾老人照顾者压力的重要途经。

Objective To explore the impact of assistive device use and complementary service utilization on caregiver stress in the elderly with disabilities,and provide a reference for improving the quality of life of caregivers of the elderly with disabilities.Methods The elderly with disabilities who were using assistive devices in one main urban area and one suburban area or poor area in Hubei,Shaanxi,Beijing and Shanghai were selected by purposive sampling to describe the current situation of assistive device utilization of the elderly with disabilities and their caregiver stress.A binary logistic regression model was used to analyze the effects of assistive device use and complementary service utilization on caregiver stress in the elderly with disabilities.Results 79.87% of the 1093 cases showed a reduction in stress among caregivers of the elderly with disabilities.Older adults with disabilities who had difficulty in using assistive devices were less likely to have reduced caregiver stress(OR=0.629,P=0.012).The more satisfied with the quality of the assistive device of the older adults with disabilities were,the more likely they were to have reduced caregiver stress(OR=2.710,P<0.001).Caregiver stress was 1.764 and 2.576 times more likely to be reduced in older adults with disabilities who received assistive device counseling services or repair and replacement services than in older adults with disabilities who did not receive related services.Conclusion The use of assistive devices for the elderly with disabilities greatly reduced the stress of their caregivers,and the utilization of complementary services for assistive devices played an important role in reducing the stress of caregivers of the elderly with disabilities.The economic status and the degree of disability of the elderly with disabilities significantly affect their caregiver stress.Low-income families and caregivers of the elderly with moderate to severe disabilities should be given priority attention.Increasing the use of assistive devices,reducing the difficulty of using assistive devices,strengthening the quality management of assistive devices,and promoting assistive device services are important ways to reduce the pressure on caregivers of the elderly with disabilities.