80例福利院老年人死因分析

目的探讨福利院老人死因分析,为延长老人寿命,降低老人死亡率提供依据。方法回顾分析2005年1月～2006年12月长沙市第一社会福利院80例死亡老人死亡原因、生前基础疾病、死亡季节、生活自理程度、家属对老人关注态度等因素、主要死因与各因素的相互关系。结果福利院老人死因顺位有自身特点：感染性疾病、心、脑血管疾病分别为死因的前三位,主要死因与死亡季节、自理程度、家属态度相关（P〈0.05）。结论通过干预相关因素,可能有利于提高老人生存质量,延长老人寿命,能降低老人死亡率。     

老年人日常生活能力状况与影响因素分析

目的 探讨社区老年人日常生活能力状况及其影响因素.方法 对市桥街北片社区1 000名60岁以上老年人日常生活能力(ADL)进行调查,分析ADL的影响因素.结果 生活不能自理者占3.1%;生活部分自理,但多病者占5.8%;基本健康者占91.1%;老年人ADL的下降程度不一致,日常生活能力的影响因素为高龄、丧偶、自费医疗,残疾、患有慢性病.结论 该社区大部分老年人日常生活能自理,高龄、丧偶、自费医疗、残痰、患有慢性病是影响老年人日常生活能力的主要因素.     

陈丽宁:我们重在发展孤残儿童的特殊教育

人物:陈丽宁,广西南宁市社会福利院副院长时间:2006年11月8日地点:广州市广州大道北507号二楼2006年11月初,广西南宁市社会福利院陈丽宁副院长、医务科陈继红科长和重庆市第九人民医院儿童保健中心邵智主任等一行十四人来广东考察儿童特殊教育。在国家医疗保健器具工程技术研究中心,陈丽宁副院长和陈继红科长向记者讲述了社会福利院这个神秘的世界。记者:听说南宁市社会福利院有一群孩子,这群孩子总共有多少人?陈丽宁:我们有一大批孩子,有三、四百人吧。记者:我想了解一下这一大批孩子在心智发育方面是怎样的一个状况呢?陈丽宁:福利院的孩子…     

我国老年残疾人得到妥善供养

调查显示,我国60岁以上残疾人口有4416万人,占残疾人口总数的53.24%。目前全国农村五保供养机构近35000家、社会福利院1490家、儿童福利机构269家、精神病人福利院153家。     

受教育程度对山东省老年人生活自理预期寿命的影响研究

目的探讨受教育程度对老年人生活自理预期寿命的影响,为山东省老年人健康政策制定提供参考。方法采用多阶段整群随机抽样的方法,抽取2018年山东省60岁及以上老年人进行日常生活活动能力(ADL)测量,共获得研究样本3349例。Sullivan法测算不同受教育程度老年人的生活自理预期寿命及其占比。结果不论男女和受教育程度高低,山东省老年人失能率均随着年龄增长而不断增加。小学及以下(10.04%)老年人失能率高于小学毕业及以上者(4.74%)。小学及以下老年人生活自理预期寿命为20.39岁,小学毕业及以上为21.24岁,生活自理预期寿命占比分别为87.61%和91.27%。小学毕业及以上老年人在各年龄组的生活自理预期寿命及其占比均高于小学及以下者。结论受教育程度较高的老年人生活自理预期寿命及其占比均高于受教育程度较低者。教育水平能有效提高老年人的生活自理预期寿命,尤其对女性更为明显。教育对老年人健康具有保护作用,应通过健康教育提高老年人预防保健意识,改善其生活方式。     

福州市鼓山镇老年人健康行为调查

目的 了解福州市鼓山镇老年人的健康行为状况,为探索城乡结合部老年人的健康管理模式提供科学依据.方法 采用整群抽样的方法,随机抽取福州市鼓山镇的14个村(居)委会,对所有登记在册的年龄≥60周岁的老年人进行问卷调查.结果 每天注意饮食状况的老人占10.9%;老年人的吸烟率为19.7%,饮酒率为22.5%;老年人主要的身体活动形式是户外步行(>4次倜占71.8);29.5%的老人自诉睡眠质量不好;46.4%的老年人主要的日常社会活动是看电视、电影或现场表演;27.8%的老年人选择社区医疗中心就诊;对社区卫生服务需求最大的是健康体检(37.5%).结论 老年人的生活行为方式尚存在较多的健康危险因素,应大力开展健康教育活动,加强老年人的健康管理,实现健康老龄化.     

老年人躯体机能受损现状及其影响因素分析

目的 了解老年人躯体性日常生活能力(PADL)以及工具性日常生活能力(IADL)的受损现况及其影响因素.方法 利用中国老年健康长寿跟踪调查数据,对其中2002年PADL和IADL完全自理的6761人和3556人进行跟踪分析.结果 2002年1ADL(或PADL)完全自理的老年人到2005年时保持IADL(或PADL)完全自理的男女比例分别为59.3%和51.8%(或87.1%和81.5%).65～74、75～84、85～94以及95～105岁组的老年人,从2002年IADL或PADL完全自理到2005年时分别只有70.0%、47.0%、24.0%和15.0%保持IADL完全自理,约有95.0%、87.0%、74.0%和55.0%保持PADL完全自理.在控制性别、社会经济等变量后,老年人年龄越大、过去2年内患重大疾病的次数越多以及认知能力越低其IADL或PADL受损的可能性越大.结论 老年人躯体机能受损程度随着年龄增大加重.IADL受损程度严重于PADL.老年女性受损程度均比男性严重;老年人的年龄、过去2年内息重大疾病的次数以及认知能力对其躯体机能受损具有预测性作用.     

平湖市敬老院老年人健康状况和就诊情况调查

目的了解平湖市敬老院老年人健康状况和就诊情况,为提高敬老院老年人保健服务提供依据。方法选取平湖市10家敬老院175名老年人进行问卷调查,收集慢性病患病、近半年就诊及近1年住院信息;采用《日常生活能力评分量表》评价调查对象自理能力;采用多因素Logistic回归分析敬老院老年人就诊和住院治疗的影响因素。结果共发放问卷175份,回收有效问卷162份,问卷有效率为92.57%,敬老院老年人轻度自理障碍18人,占11.11%,明显自理障碍23人,占14.20%,慢性病患病108人,占66.67%,近1年意外伤害事故发生率11.11%,近半年内就诊比例为55.55%,近1年住院比例为47.53%。多因素Logistic回归分析结果显示,初中文化程度的老年人(OR=0.280,95%CI:0.091~0.858)较文盲就诊率低;五保供养老年人(OR=2.418,95%CI:1.161~5.036)较寄养老年人就诊率高;患有1种慢性病的老年人(OR=2.656,95%CI:1.247~5.659)较未患慢性病的老年人就诊率高;女性老年人(OR=0.457,95%CI:0.228~0.913)住院率较低;明显自理障碍的老年人(OR=0.330,95%CI:0.170~0.931)虽较自理功能正常老年人就诊率低,但轻度自理障碍(OR=2.86,95%CI:1.092~7.502)和明显自理障碍(OR=8.278,95%CI:1.753~39.085)的老年人住院率则明显较高。结论文化程度低、五保供养、患有慢性病的老年人就诊需求相对较大;存在自理功能障碍的老年人住院需求大;建议进一步合理配置卫生资源,以提高养老机构老年人健康水平。     

我国城市老年人生活自理能力受损情况分析

对我国城市生活失自理老年人的残疾状况、婚姻状况、居住状况、疾病状况等进行分析。结果表明：女性生活自理能力受损率高于男性且生活质量不如男性;对生活失自理老人的照顾目前仍然是家庭照顾占主导地位     

老年人日常生活活动能力的影响因素分析

目的　探讨老年人日常生活活动能力 (ADL )的影响因素。方法　对北京市朝阳门社区和中关村社区 90 0名 6 0岁及以上老年人进行社区卫生服务问卷调查。结果　北京市 895名老年人日常生活活动能力有损害的比例为19.4 % ,其中生活完全不能自理的比例为 6 .2 % ;日常生活活动能力的影响因素为年龄、经济收入、是否有值得信赖的朋友、是否患慢性病、患慢性病种类数、是否患脑血管病和类风湿性关节炎。结论　老年人 ADL损害严重 ,年龄、经济收入、是否有值得信赖的朋友、是否患慢性病、患慢性病种类数、是否患脑血管病和类风湿性关节炎是老年人 ADL的重要影响因素     

A five-year follow-up study of recipient rates for welfare allowance for the disabled elderly in a metropolitan area

Improvement of the domiciliary care system for the disabled elderly is one of the most urgent issues of welfare for the elderly. In order to understand more clearly the utilization of domiciliary care service in a metropolitan area, we studied recipient rates for welfare allowance for disabled elderly which was the most frequently used welfare service. Between October 1984 and March 1985 a baseline survey was performed on a random sample of elderly living at home, aged from 65 to 89, in Shinagawa-ku, Tokyo. A follow-up survey of this sample of 873 persons was performed in November 1989 where survival and their recipience of welfare allowance were reviewed. The main results were as follows: 1. Recipient proportion of welfare allowance increased rapidly with disability of ADL. Of the severely disabled elderly at the baseline the recipient proportion was 46%. During the following five years 27% of the severely disabled were accepted as new recipients. 2. Recipient proportion of elderly who died at age 75 or greater for the following five years was more than 30%. 3. The recipient incidence rate of those who were non-recipient at baseline increased significantly with age after controlling for ADL. This indicates that the risk of ADL disability increases with age. 4. Mean recipient duration varied according to age. Mean durations for those aged over 80 and those under 80 were 2.1 years and 3.9 years respectively.     

A comprehensive fact finding study of home care elderly for planning of the community based rehabilitation system in Koga City, Ibaraki Prefecture]

An interview survey was held with the purpose of grasping the problems faced by the home care elderly living in Koga city in Ibaraki prefecture. The subjects of the study were 100 cases who had been registered as elderly requiring home care in the municipality. The main results were as follows: (1) The most frequent underlying disorders that were considered as causes of disabilities in the home care elderly were cerebrovascular diseases, senile dementia and external injuries. In 67 percent of the subjects, one of these three disorders had caused the disabilities. (2) Disabilities in self care activities and in mobility were closely related to each other and the order of the difficulty in performing these activities was similar in many cases. A large number of the subjects sustaining severe disabilities expressed discontent with their daily life. (3) Forty two percent of the subjects were so-called bedridden elderly who got out of bed for less than 3 hours a day. The Barthel index score was 60 or less in all of the bedridden subjects. (4) For most of the bedridden elderly, bed rest was not required and probably exacerbated the disuse syndrome. In order to ameliorate their condition, adequate rehabilitation programs and assistance in their daily activities need to be offered. (5) Seventy eight percent of the care givers complained about the burden of care. Those who had no assistant care giver complained more frequently. Many of the care givers complaining about their burden had their own health problems. (6) The utilization of social welfare services were not always without any problems. The number of the experts who can deal with the psychosocial aspects in the elderly should be increased in order to improve the situation.     

#74 Ethnic differences in the prevalence of chronic diseases in the elderly

PURPOSE: In The Netherlands, as elsewhere, labor migrants who entered the country in the 1960's and ‘70’s are now becoming older. In contrast to their original expectation, most of the first generation of migrants will not return to their country of origin. To target health care effectively, information is required about the prevalence of chronic diseases among first generation migrants.METHODS: Data are derived from a population based health survey among inhabitants of Dutch, Moroccan and Turkish decent aged 55–74 years living in Amsterdam, The Netherlands. The survey was conducted in October 1999-June 2000. Among the respondents, 236 were from Dutch, 347 from Turkish and 257 from Moroccan descent. Data on the prevalence of chronic diseases were obtained using an oral questionnaire.RESULTS: For respondents 55–64 years of age the prevalence of at least one chronic disorder was 42% for Dutch males, 70% for Turkish and 64% for Moroccan males. For females these figures were 66%, 85% and 78% respectively. For those 65–74 years of age, the prevalences were 54%, 78% and 71% for males, and 71%, 89% and 78% for females. All differences were statistically significant. Differences among the ethnic groups remained after controlling for socio-economic status. Among Moroccan elderly, diabetes is most prevalent (27%). For both Turkish and Dutch elderly high blood pressure was most prevalent (42% and 25% respectively).CONCLUSION: The elderly of Turkish and Moroccan descent suffer more chronic diseases at a younger age than the elderly of Dutch origin.     

无锡市社会福利中心老年人群高血压现状调查

目的调查无锡市社会福利中心老年人群高血压患病率、知晓率、治疗率和控制率,为在该人群中开展有效的防控措施提供依据。方法采用问卷调查法对年龄≥60岁的153名常住老年人进行调查,由经过培训的医师对调查对象进行血压测量、资料收集,并按不同年龄段分为两组进行对比分析。结果福利中心老年人高血压患病率达78.43%,高血压患者的知晓率、治疗率和控制率分别为79.17%、71.67%和37.21%。≥80岁年龄组高血压的控制率显著低于60～79岁年龄组（P〈0.05）。应用最为广泛的口服降压药物为钙通道阻滞剂和国产复方制剂。结论福利中心老年人群高血压患病率较高,高血压控制率仍处于较低水平。高血压患者的规范化管理、经常性的健康教育、积极的社会援助和不良生活方式的纠正是福利中心老年人群高血压防治的有效措施和手段。     

北京市城区老年人传染病相关知识、行为和技能调查

目的 了解北京市城区老年人传染病相关知识、行为和技能方面的现况,为政府制定传染病防控策略提供科学依据.方法 采用多阶段抽样法从东城、西城和海淀3个区抽取1 350名60岁及以上的常住居民作为调查对象,使用自行设计的北京市居民传染病健康素养调查问卷进行调查.结果 “发热判断标准”(34.4％)、“乙肝的传播途径”(23.3％)、“艾滋病的传播途径”(35.6％)等知识的知晓率均较低,“注射流感疫苗”(40.5％)、“到发热门诊带口罩”(20.9％)等行为的报告率均较低,“能获取想要的传染病知识”(42.8％)、“能看懂简单的化验单”(51.8％)、“能看懂药品说明书”(58.0％)等技能的掌握率均较低.不同文化程度老年人的传染病知识知晓率、部分传染病相关行为报告率和技能掌握率的差异有统计学意义(P＜0.05).结论 北京市城区老年人传染病相关知识知晓率、行为报告率和技能掌握率均较低,应加强老年人传染病相关知识的宣传教育,促使其形成良好的卫生习惯,并提高其传染病防控技能.     

Awareness of and attitude of elderly subjects regarding health care and welfare in rapidly ageing population in Japan

OBJECTIVES: We aimed to obtain information on the degree of knowledge and understanding about the current systems of health care and welfare held by the elderly, in order to achieve comprehensiveness in family practice. METHOD: We conducted a study on the awareness of healthy elderly persons by direct interview. The study was carried out in Kuni Village in a remote mountainous region in Japan, where the elderly population accounts for 24.8% of the total population. The subjects were self-dependent in their daily living activities and were aged 65 years and older. RESULTS: The subjects' knowledge of health care and welfare systems was generally good, and the degree of their utilization of these systems was also good. But 83.3% of those who did not want to utilize the welfare system indicated their preference to depend on their family for support. CONCLUSION: Family physicians must endeavour to offer comprehensive care to their patients by including these systems for rapidly ageing communities.     

Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden

We explored the role of age, gender, and socioeconomic status in the occurrence of chronic diseases and multimorbidity in 1099 elderly participants in the Kungsholmen Project. Cardiovascular and mental diseases were the most common chronic disorders. Of the participants, 55% had multimorbidity. Advanced age, female gender, and lower education were independently associated with a more than 50% increased risk for multimorbidity. Multimorbidity is the most common clinical picture of the elderly and may be increased by unhealthy behaviors linked to education.     

厦门市2002-2009年老年人口死因分析

目的了解厦门市老年人口死亡特征,评价老年人口主要死因的影响程度及变化趋势。方法应用死亡率、标化死亡率、死因构成及死因顺位、老年保健效益指数（GEI）等统计指标,对2002-2009年厦门市60岁以上老年人口死因资料进行分析。结果 2002-2009年间老年人口死亡总数为42 435人,占全部死亡人数的72.43%,平均死亡率为31.11‰。死亡率男性高于女性,城乡差异无统计学意义。主要死因为恶性肿瘤、脑血管病、心脏病、呼吸系统疾病、损伤与中毒等,前五位死因占总死亡的84.68%,全死因中慢性非传染性疾病的死亡占总死亡的90.59%。主要疾病的GEI顺位为恶性肿瘤、意外伤害、传染病、呼吸系统疾病和心脑血管疾病,大多数死因的GEI高于0.5,女性普遍高于男性。与1987-1997年统计结果比较,死亡率呈下降趋势,各主要疾病的GEI也有所下降。结论厦门市老年人口主要死因是恶性肿瘤、心脑血管疾病和呼吸系统疾病等慢性疾病,是影响老年人寿命的最主要原因,应当作为老年医疗卫生工作的重点,并引起全社会的关注。     

Do elderly clubs in Alexandria meet the needs of their consumers?

The rapid rise in the number of the independent elderly persons in the community has become a world-wide phenomenon. Recently, more attention has been devoted to community based programs for the elderly. One type of these programs offering multiple services is the elderly clubs. These clubs may provide health and physical care beside social interaction and peer group support for the independent elderly in the community. In Alexandria, elderly health and social care provided are not coping with the increasing numbers of the aged population and consequently with their needs and problems. So the aim of this study was to describe the health profile of the consumers of the elderly clubs in Alexandria and to determine the preferred activities needed by the consumers of the elderly clubs in Alexandria. To fulfil this aim, a sample of 163 elderly representing the consumers from all (five) elderly clubs in Alexandria were interviewed. The results revealed that almost one third (30.67%) of the elderly consumers had no health complaints, 35.58% had only one health complaint and 33.74% had more than one complaint. The most health complaints stated by the consumers were cardiovascular diseases/hypertension followed by diabetes mellitus then rheumatic diseases/arthritis. The results also revealed that all the elderly consumers had one or more minor signs and symptoms during the last six months of the interview. These signs and symptoms varied from amnesia, low concentration, constipation, dizziness and dyspepsia. The majority of the elderly consumers preferred the recreational trips and attending religious seminars/reading Quraan. Walking and checking on blood pressure were the most preferred activities mentioned by nearly half the consumers. The results of this study can be considered as a base line data to help policy makers in taking decisions during planning and providing the needed services to the elderly.     

Changes in community health and welfare services with introduction of the long-term care insurance system in Japan

OBJECTIVE: In Japan, a long-term care insurance system for elderly people was introduced in April, 2000. We have conducted a survey using a questionnaire in order to explore consequent changes in community health and welfare services. METHODS: We sent questionnaires to all municipal governments (671 cities, 1,991 towns, 567 villages and 23 wards) in Japan in November, 2001, and obtained replies from 441 cities (response rate: 65.7%), 800 towns (40.2%), 197 villages (34.9%), and 16 wards (69.6%). The questionnaire included questions concerning the budget and manpower for community health and welfare services, the state of the long term care insurance system, and the activities of public health nurses. RESULTS: A total of 57% of all municipal governments was found to be carrying out the long term care insurance program in collaboration with other governments. In order to clarify the changes in welfare services for elderly people from the budgetary viewpoint, we calculated the ratios of the 2000 and 2001 fiscal budgets applied for welfare services for elderly people, in comparison with the 1999 fiscal year. The budgets for elderly people declined to about 40% in 2000 and 2001 compared with 1999, since the budget for care services was transferred to the account of the long term care insurance system. The activities of public health nurses employed by municipal governments were not affected by the introduction of long term care insurance system. About 80% of all municipal governments suggested that both the amounts of care services received by each elderly people and the number of elderly people who received care services were increasing, and about 70% indicated that the quality of care services was improved with introduction of the long term care insurance system. DISCUSSION: Most municipal governments consider that introduction of the long term care insurance system has had a good influence on community health and welfare services. Moreover, our results suggest that the long term care insurance has a beneficial impact on care services themselves.