The Elder Health Information Technology Framework for Geriatric Care in Rural India: A Policy Initiative

Healthcare monitoring and analysis of healthcare parameters is a reality to reduce costs and increase access to specialist and experts that holds the future for geriatric care in India. This paper proposes distinct methods towards the implementation of rural elder health information technologies (IT), which includes electronic medical records, clinical decision support, mobile medical applications, and software driven medical devices used in the diagnosis or treatment of disease for the older adult population in the villages of India. The purpose is online patient satisfaction at the microlevel (village panchayat) through methods accessible and affordable by establishing a common standard of operations at the village primary care units giving way to early disease detection and routine screening among the aged population avoiding institutionalization. The rural elder health IT framework is of great interest for all stakeholders in the field, as it benefits the investors and the consumers, adding to the technological infrastructure, thereby opening new avenues of research in health informatics, telemedicine and enhancing the scope of geriatric research, which in turn enhances the health-related quality of life for the rural older adults in the remote villages of the nation.

Investigation and Countermeasures on the Health-Promoting Lifestyle of the Disabled Elderly in a Rural Area

Objective： To investigate the level of health-promoting lifestyle in the disabled elderly in a rural area and to provide useful countermeasures for health care workers and the government to improve the elderly＇ s lifestyle behaviors. Methods： A total of 446 disabled elderly people were recruited and examined using the General Questionnaire and Health-Promoting Lifestyle Profile II. Results： The mean score of the health-promoting lifestyle was 109.73（ SD = 16.80）, in which 90.6 percent of the disabled elderly demonstrated unhealthy lifestyle behaviors. The average score for each of the subscales includedthe following： interpersonal relations, stress management, nutrition, self-actualization, health responsibility, and sports activity. Conclusions： The health-promoting lifestyle of the disabled elderly needs to be improved; health care workers and the government should pay more attention to the countermeasures that can improve the lifestyle behaviors and promote the health of the disabled elderly.

Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease （COPD）. The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states （POMS） evaluation were performed. In the forest group,

Problems of elderly health care and welfare arrangement --Case study of demand on elder care in northeastern of Thailand

This research attempted to explain the problems of elderly health care, the problems and suggestion in elder welfare arrangement and the demand on elder care. The survey underlying this study was conducted in Muang district, Khon Kaen province, Thailand. Eighteen subdistricts were interviewed in the study area. Data were collected in two areas of Khon Kaen province, that are, the city of Khon Kaen and the outside Thesaban Nakhon Khon Kaen. The random sample consisted of 386 elders： 112 elders lived in the city of Khon Kaen and 234 elders lived outside Thesaban Nakhon Khon Kaen, Muang district, Khon Kaen. The analysis of the demand on elderly welfare gave an interesting result that the elders demanded on monthly income to support living cost and medical services at high level; The demand on housing was at low level; The demand on education, religion and culture the demand on club, sport and entertainment, and the demand on job and art were at the moderate level; The main problem of elderly welfare arrangement was the scarcity of budget support, the weakness of elder health, and activities announcement. The analysis of pattern of elder welfare： The case study of elder care identified that 31.87 percent of the elders had demand on elder care. Price of the elder care at 100 Baht per day was mostly selected about one-fourth of all the case occurred. Female elder selected the elder care at 100 Baht per day, while male elder choose at a higher price level, which were 200 Baht per day and 150 Baht per day respectively. The female elder care was the most popular. The elder care age between 30-39 years was mostly selected. Finally, most of elders purposed the working day of the elder care depend on their appointment.

Assessment of Comprehensive Health Care of the Elderly in Primary Health Care

Objective: To assess comprehensive care in the elderly population, as well as the quality of care in Primary Health Care. Methods: This is an exploratory descriptive study with a quantitative approach, conducted from July to December 2012, in the city of Santa Cruz, Rio Grande do Norte, Brazil. A sample of 130 subjects chosen by drawn was calculated, and data collection was performed at their homes. Results: There were interviewed 130 people, 92 (70.8%) women and 38 men (29.2%), with a minimum age of 60 and maximum of 96 years, with a mean of 72.8, median of 72.0 and a standard deviation of 8.3. Regarding the quality of care ratings of the PHC team, 48.5% (n = 63) of respondents stated this to be good, while 32.3% (n = 42) rated this as fair. Conclusions: In this perspective, one of the most appreciated meanings that were given to comprehensive care by health care professionals refers to holistic knowledge of each patient, resulting in the non-fragmentation of care. Thus, it is noticed that comprehensiveness has some weaknesses that need to be corrected, which shows the need for education and training of professionals assigned to primary health care services.

中国老年人口健康状况及其家庭照料需求预测

中国人口老龄化快速发展,失能、半失能老年人口规模迅速扩大,老年照料需求快速增加。科学预测不同失能状况老年人口规模及其照料服务需求是推动老年照护服务体系建设的重要基础。文章基于中国老年健康影响因素跟踪调查(CLHLS)数据,使用Markov模型测算中国分性别、分年龄段老年人口健康状况转移矩阵,运用队列要素预测法、多元回归法等预测得到2020—2035年中国不同失能状况老年人口规模及其照料服务人员需求规模、家庭照料经济成本。预测结果显示:中国失能老年人口规模呈现增长态势,从2020年的1946万人增至2035年的3424万人,失能老年人口的比例从2020年的7.4%小幅增至2035年的7.9%,且中重度失能老年人口增幅更快,2035年时轻度失能老年人口规模相比2020年增加66%,中重度失能老年人口规模相比2020年增加92%。女性失能老年人口规模增速快于男性,80岁及以上老年人口失能比例增长更快,2035年男性70~79岁、80~89岁、90+岁三个年龄组失能老年人口规模分别为2020年的1.53倍、1.92倍、1.94倍;2035年女性三个年龄组失能老年人口规模分别为2020年的1.72倍、2.29倍、2.52倍。老年家庭照料需求将呈现快速增长态势,家庭照料服务人员需求量从2020年的2795万人增至2035年的4863万人,增长74%。2020—2035年健康老年人口的照料服务人员需求量占总需求量的比例在57%左右,中重度失能老年人口需求量占比在24%左右,轻度失能老年人口需求量占比在19%左右。60~69岁老年人口所需的照料服务人员占比最高,90岁及以上年龄组对照料服务人员的需求量增长更快。老年人口家庭照料经济成本从2020年的3027亿元增至2035年的11676亿元,将增长近3倍。中重度失能老年人口所需的家庭照料现金成本相比2020年增长3.1倍,轻度失能老年人口所需的家庭照料现金成本相比2020年增长2.6倍。男性老年人口所需家庭照料现金成本低于女性老年人口,且增速也低于女性老年人口。本研究基于定量预测结果提出积极推进健康老龄化,加大促进生育的政策支持力度,尽快推广长期照护保险制度,以赋能家庭为着力点加强失能老年人口的支持体系建设,大力发展老年护理服务业,大力发展养老护理职业教育等政策建议。

农村二孩家庭男孩偏好对长姐体质健康的影响研究

基于资源分配理论,选用中国家庭追踪调查(CFPS)2010-2018年数据,考察了农村二孩家庭中男孩偏好对长姐体质健康的影响及内在机制。研究发现:男孩偏好对长姐体质健康具有显著负向影响,相比有妹妹,有弟弟的长姐身高Z评分将降低0.254个单位,表现出发育迟缓和消瘦的概率比正常组将分别提高5%和2%,但与肥胖不存在显著关联。性别平等感知在男孩偏好与长姐体质健康关系中发挥调节效应,父母感知到的社会性别平等越弱,男孩偏好对长姐体质健康的不利影响越强。男孩偏好对长姐体质健康的影响存在异质性,长姐处于学龄期、二孩处于学龄前和父亲出生队列较早时,男孩偏好对长姐体质健康将产生更不利的影响。未来应结合我国农村地区重男轻女的社会环境,在保证儿童福利有效供给的基础上,发展以家庭为核心的福利政策,全面构建普惠型儿童福利支持体系。

健康中国背景下智慧康养困境及策略研究

《“健康中国2030”规划纲要》对老年人健康管理工作提出了一系列要求,但在实践工作中,仍面临多种困境。智慧康养对解决健康服务困境有重要的意义与价值,同时面临着社会心理、伦理、开发和运作成本等方面的挑战。本文提出构建综合式智慧型健康专业指导服务产品、搭建智慧康养的多主体协同合作框架、促进智慧康养嵌入社区养老与康复服务、加强对智慧康养相关应用的监督管理等策略,实现智慧康养助力健康服务升级。

面向老年友好型社会的老龄化地理学研究

在我国老龄化程度快速加深、经济社会转型和城乡空间重构的特殊时期,地理学与社会学、老年学等学科交叉的需求日益凸显,老龄化地理学正成为重要的研究领域。当前,地理学对老龄化的研究聚焦于人口老龄化的时空特征和驱动因素、人口老龄化的空间效应、老年人健康与环境的关系、老年人的空间行为、养老服务的空间组织与规划等方面,在一定程度上为应对老龄化社会的挑战提供了有力支撑。但是从老年友好型社会建设的实际需求出发,一些基础性概念仍然需要辨析,以便深入理解老年人口区别于其他人口的特征。立足于老龄化语境下人、社会与环境所构成的地域系统,从人口、健康、社会等维度重新剖析老龄化和老年人的特征,结合社会需求探讨老龄化地理学研究的未来方向。

Cross Cultural Exploration of the Perceived Health Competence Scale

The eight-item Perceived Health Competence Scale (PHCS) is a measure of self-efficacy in general health management that is used to predict health outcomes and behaviors. The PHCS has been shown to be a reliable and valid instrument but has been used in primarily white European Americans. The PHCS is positively correlated to health status and coping abilities. Younger, healthier populations score higher on the PHCS compared to elderly who are managing chronic illness. This study examined the PHCS in three Midwestern samples: African American elders which revealed two separate factors in PHCS;Native Americans who evaluated the PHCS as a single construct;and a Spanish speaking sample. In the latter sample, findings suggest health competence may be a multi-dimensional construct. Further evaluation of the Spanish version of the PHCS and population characteristics are needed to measure health competence beliefs.

Musical and Photographic Stimulations on the Symptomatology of Alzheimer’s Disease in Elderly

Background: Alzheimer’s disease is a progressive and neurodegenerative disorder characterized by deterioration of brain functions. Psychosocial interventions such as music and photographic stimuli may contribute to cognitive and sensory exercise or rehabilitation. Objective: Evaluate musical and photographic stimuli in elderly people with Alzheimer’s disease. Methods: It is an uncontrolled clinical trial, before-after type, eleven subjects composing the sample. Participants were submitted to Katz Index, Autobiographical Memory Test, GDS-15, Mini-Mental State Examination. The collection instruments were used on the first and last day of intervention, individually. There were 2 sessions in the week with duration of 50 minutes totaling 20 sessions. Data were analyzed by descriptive and inferential statistics and as variables expressed as mean standard deviation. Results: There was a significant effect of cognitive activity (P < 0.01), it was observed that a small advance (P = 0.05) of the daily life activities. With the analysis of GDS-15, it is verified that they are more effective for the increase of the previous self-estimation of the therapy (P = 0.94). In the application of the AMT, it is observed that there was a better recruitment of the memory for the neutral words. Conclusion: Musical and photographic stimuli had a positive effect on the cognitive level, daily life activities and autobiographical memory in seniors with Alzheimer’s disease.

乡村振兴背景下农村旅居康养的发展逻辑、限制与展望

农村退休迁移一度是西方多学科重点关注的研究话题,其兴起主要源自乡村生活价值重估、消费功能兴起以及老年人提高晚年生活质量的要求,但在国内学术界一直缺乏相应关注。伴随中国进入到城市化高速发展、乡村全面振兴的新发展阶段,珠三角、长三角等一些地方已开始出现与国外退休迁移相似的农村旅居康养动向。结合实地调查发现,相较于西方农村退休迁移的发展背景,国内农村旅居康养的产生是市场开发、政策引导、乡村建设和个体诉求共同作用的结果。鉴于国内农村旅居康养还存在全年段康养开发不足、医疗卫生基础薄弱、配套服务设施不完善、专业服务水平不高等问题,建议围绕城乡养老服务需求形成整合性框架,促进康养与旅游融合发展,引导乡村舒适驱动型发展,开展城乡互益性养老交流,建立城乡养老服务联合体,以实现城乡共建共享共富。

Evaluation of Quality Care for Senior Citizens in Primary Health Care

Objective: This study aimed to evaluate the quality care received by senior citizens in Primary Health Care (PHC) in the Unified Health System, with the objectives of contributing with the comprehensive implementation of humanized conduct and actions for this part of the population. Methods: This is a descriptive-exploratory study with a quantitative approach that was conducted in the city of Santa Cruz, which is located in the Brazilian state of Rio Grande do Norte, with a population of 130 senior citizens. The research was approved by the Committee for Ethics in Research at the Federal University at Rio Grande do Norte under protocol 152/2012. Results: In the results, the classification of the PHC services varied from good to reasonable. Regarding the assistance offered to the aging and comprehensive care, there were failures in accordance with how it’s recommended in the National Healthcare System. This concludes, through the perspective of the elderly user, the need for the reformulation of the activities which are offered to this population and therefore the implementation of conduct for better service in the area of Primary Health Care.

突发公共卫生事件下农村老人生活满意度及其提升路径——基于2017—2021年安徽民生调查数据的证据

关注突发公共卫生事件下农村老人生活满意度是我国积极老龄化战略实施和农村现代化治理的重要内容。2017—2021年安徽民生调查数据显示,在突发公共卫生事件的冲击下,农村老人总体生活满意度下降;医疗卫生焦虑大幅上涨,对基本生存问题的担忧超过了对养老服务的需求;人力资本质量、社会经济参与正向影响其总体生活满意度。提升农村老人生活满意度的重点在于精准回应生活需求,赋予低龄老人经济再造能力,依托自然禀赋嵌入互助养老组织,构建多级联动的危机治理格局,优化突发公共卫生事件应急机制。

健康老龄化:理念、体系、能力与评估

健康治理视角下,运用“理念-体系-能力-评估”分析框架研究发现,促进实现健康老龄化是理念转变引领体系重塑、能力变革,再到评估导向转型的过程。理念上,将人群的健康问题上升为国家战略;体系上,形成更加系统完备成熟的制度体系;能力上,提升全社会参与和全因素治理能力;评估上,构建以健康为导向的评估指标体系。最终,以提高全体老年人健康水平和生命质量为目标,最大限度地预防或延缓老年疾病发生。

农村康养产业发展的理论阐释、多元实践与政策协同

农村康养产业作为一种新兴业态,是秉承新发展理念,在乡村舒适性资源利用、后生产主义乡村价值兴起、农村产业融合驱动、城乡地域共同体功能再造、康养政策引领与市场开发的共同作用下发展起来的。在实践中,通过对自然资源、文化资源、中医药资源和森林资源的开发,与乡村旅游、文化体验、休闲度假、景观游赏等相融合,发展出田园康养、文化康养、医疗康养和森林康养等新型形态,在一定程度上满足了老年群体多样化的养老需求,建立了互益性城乡交流渠道,推动了乡村产业振兴和社区建设。但目前其发展的体制机制尚不成熟,存在统筹规划力度不足、业态短板比较突出、专业康养人才匮乏、数字化技术融入较低等问题。文章建议从主体、资本、人才、技术的角度构建政策协同的路径,加强顶层设计、突出康养特色、创新职业培训、推进科技创新,实现农村康养产业的可持续和高质量发展。同时,围绕农村康养产业发展,还应加强对城乡互益性养老服务机制的研究,探讨建立衔接有序、功能互补的城乡养老服务网络的可能路径。

失能老人和配偶照顾者健康素养与自我效能对生活质量的交互作用

目的探讨失能老人和配偶照顾者的健康素养、自我效能与生活质量的关系。方法采用便利抽样法,于2020年12月—2022年6月对我国7个省(自治区)的1086对失能老人与配偶照顾者进行问卷调查,调查工具包括日常生活功能指数量表、慢性病病人健康素养量表、一般自我效能感量表、中文版生活质量量表,通过主客体互倚模型分析失能老人和配偶照顾者的健康素养、自我效能与生活质量的路径关系。结果失能老人和配偶照顾者的健康素养、自我效能与生活质量的中位数分别为79.00、20.00、378.33,85.00、20.00、548.11。模型结果显示,双方的健康素养与自我效能均能够正向预测自身的生活质量,即主体效应显著(β=0.389,β=0.267,β=0.340,β=0.222;均P<0.05);客体效应,失能老人的健康素养正向预测配偶照顾者的生活质量(β=0.138,P<0.001),配偶照顾者的健康素养对失能老人的生活质量预测作用不显著(β=0.050,P=0.078);双方的自我效能对对方生活质量的预测作用不显著(β=0.034,P=0.259;β=0.032,P=0.276)。结论失能老人和配偶照顾者的生活质量受自身健康素养和自我效能的影响,失能老人的健康素养与配偶照顾者的生活质量存在一定的交互作用。提示我们应将失能老人和配偶照顾者视为一个整体,进行“捆绑式”健康赋能以提升他们的健康素养和自我效能水平,提高他们的生活质量。

中国“失智症防治行动”任务清单的建议:基于WHO全球行动视角

失智症作为重大公共卫生问题引起了全球的广泛关注,早期识别认知功能障碍的高危人群和针对风险因素进行干预,有助于预防失智症和延缓疾病进展。中国老年失智症患者数量的快速增长给防治体系、健康促进、社会支持及研究创新等工作带来挑战,制定“失智症防治行动”任务清单具有必要性,但目前仍处于探索阶段。本文结合WHO发起的“2017—2025年失智症公共卫生应对全球行动计划”,从WHO全球行动视角,结合中国政策及实践现状,从失智症防治风险因素干预、“以人为本”的照护、社会支持、信息系统建设、创新研究与科技转化等方面提出中国“失智症防治行动”任务清单,将中国当前的失智症防治重点及现实资源结合起来,以供相关失智症防治决策及实践参考。

移动互联网背景下养老院健康管理服务设计研究

通过调研对养老院所存在的健康管理服务存在的问题进行分析,探讨如何能够提供更好的健康管理服务。采用服务设计的方法,分析养老院健康管理的痛点和设计切入点。结合老人对健康管理服务改善的预期,提出了基于移动互联网背景下养老院健康管理服务系统的优化整合设计,旨在进一步提高以用户为中心的健康管理服务的满意度,从而解决了我国老龄化和养老院健康管理问题。

老年抑郁症的影响因素分析

文章梳理了近五年老年抑郁症的相关研究,旨在对影响其发展水平的诸多因素进行分类总结,以期提出预防、减轻老年抑郁症的针对性举措。梳理结果发现性别、婚姻状况、健康水平、文化程度等人口社会学因素,以及家庭支持、社会支持等外界环境因素均与老年抑郁症的发生及发展水平相关。因此,应从老年人身心健康、设施供给、家庭支持等方面提高老年人的心理健康水平。