基于健康生态学模型社区居家医养结合老年人多重慢性病影响因素分析

Analysis of influencing factors of multiple chronic diseases in elderly taking community home-based integrated medical and elderly care service based on health ecology model

目的:以健康生态学模型为基础,系统了解居家医养结合老年人多重慢性病的影响因素。方法:采用多阶段分层整群抽样的方法于广州、苏州、青岛抽取1380名老年人进行问卷调查,有效样本量为1113,对其基本情况进行分析,采用Logistic回归分析居家医养结合老年人多重慢性病的影响因素。结果:年龄70~95岁(以60~<70岁为参照,OR=2.677,95%CI为1.955~3.666)、不吸烟(以吸烟为参照,OR=0.434,95%CI为0.276~0.682)、夜晚睡眠时间≥6 h(以<6 h为参照,OR=0.312,95%CI为0.234~0.418)、外出频率(以≥30次/月为参照,4~<30次/月,OR=2.353,95%CI为1.486~3.726;<4次/月,OR=1.905,95%CI为1.215~2.986)、婚姻状况已婚(以未婚/离异/丧偶为参照,OR=1.997,95%CI为1.486~2.684)、工作情况以前无工作(以以前有工作为参照,OR=0.431,95%CI为0.259~0.716)、人均年收入≥6万元(以<6万元为参照,OR=0.535,95%CI为0.382~0.748)是居家医养结合老年人多重慢性病的影响因素。结论:个人行为特征、人际网络、生活和工作条件对于居家医养结合老年人多重慢性病的影响重大,且其影响因素是多层次、多方面的。

Aim:Based on the health ecology model,the factors affecting multiple chronic diseases in the elderly accepting home-based integrated medical and elderly care were explored.Methods:A total of 1380 elderly people were selected from Guangzhou,Suzhou,Qingdao by multi-stage stratified cluster sampling for questionnaire survey,with an effective sample size of 1113.Descriptive statistical analysis was conducted on their basic information.The influencing factors of multiple chronic diseases in the elderly were analyzed by Logistic regression.Results:Age of 70 to 95 years(taking age of 60 to<70 years as reference,OR=2.677,95%Cl was 1.955-3.666),no smoking(taking smoking as reference,OR=0.434,95%CI 0.276-0.682),night sleep duration≥6 hours(<6 hours as reference,OR=0.312,95%CI was 0.234-0.418),frequency of going out(≥30 times/month as reference,4-<30 times/month,OR=2.353,95%CI 1.486-3.726;<4 times/month,OR=1.905,95%CI 1.215-2.986),marital status married(unmarried/divorce/bereft of spouse as reference,OR=1.997,95%CI was 1.486-2.684),no previous employment(previous employment as reference,OR=0.431,95%CI was 0.259-0.716),annual per capita income≥60000 yuan(using<60000 yuan as reference,OR=0.535,95%CI was 0.382-0.748)were the influencing factors for the multiple chronic diseases in the elderly accepting home-based integrated medical and elderly care.Conclusion:Personal behavior characteristics,interpersonal network,living and working conditions have significant impact on the multiple chronic diseases in the elderly with home medical care combination,and the influencing factors are multi-level and multifaceted.