基于健康生态学模型的失能老人家庭照护质量影响因素研究

Influencing factors of home care quality for disabled elderly based on health ecology model

目的基于健康生态学模型(health ecological model,HEM),分析失能老人家庭照护质量现状及影响因素,探讨改善失能老人家庭照护质量的可行路径。方法采用一般资料调查表、日常生活功能指数量表(activity of daily living scale,ADL)、失能老人家庭照护质量量表(family caregiver consequences inventory,FCCI)、慢性病病人健康素养量表、家庭关怀度指数量表(adaptation,partnership,growth,affection and resolve,APGAR)及社会支持量表(social support rating scale,SSRS)对新疆乌鲁木齐市810例失能老人家庭进行调查,以失能老人家庭照护质量为因变量,以HEM 5个层面的指标为自变量进行多元线性回归分析。结果失能老人家庭照护质量总得分为(45.12±3.45)分;不同年龄、婚姻状况、文化程度、月收入、是否经常锻炼、是否规律饮食、患慢性病数量、居住情况及失能程度的失能老人,其家庭照护质量差异均有统计学意义(P<0.05)。家庭功能、健康素养及社会支持与家庭照护质量呈正相关,失能程度与其呈负相关;年龄、家庭功能、健康素养、失能程度、社会支持、文化程度及患慢性病数量是失能老人家庭照护质量的主要影响因素(P<0.05)。结论失能老人居家照护质量处于中等水平,其家庭照护质量的影响因素是多维度、多层次的,应从个人、家庭、环境等多角度对居家失能老人进行综合干预,进而改善失能老人家庭照护质量。

Objective To analyze the status quo and influencing factors of the quality of family care for disabled elderly based on the health ecological model(HEM),so as to discuss the feasible path to improve the quality of family care for disabled elderly.Methods A total of 810 disabled elderly families in Urumqi,Xinjiang were investigated by general data,activity of daily living scale(ADL),family caregiver consequences inventory(FCCI),health literacy scale for chronic patients,adaptation,partnership,growth,affection and resolve(APGAR)scale,and social support rating scale(SSRS).Multiple linear regression analysis was carried out with the quality of home care for disabled elderly people as dependent variable and 5 levels of health ecology model as independent variables.Results The total score of home care quality for disabled elderly was(45.12±3.45)points;The quality of family care was statistically significant for disabled elderly with different ages,marital status,educational level,monthly income,regular exercise,regular diet,number of chronic diseases,living conditions,and degree of disability(P<0.05).Family function,health literacy,and social support were positively correlated with the quality of family care,while the degree of disability was negatively correlated with it;Age,family function,health literacy,disability degree,social support,education degree,and number of chronic diseases were the main influencing factors of family care quality for disabled elderly(P<0.05).Conclusion The quality of home care for disabled elderly people is at a medium level,and the influencing factors of family care quality are multi-dimensional and multi-level.Comprehensive intervention should be carried out to improve the quality of home care for disabled elderly people from multiple perspectives such as individuals,families,and environment.