农村老年人群养老需求模式及其影响因素分析

目的 了解农村老年人群的养老需求,分析其影响因素,为寻求适宜的农村养老服务模式提供参考.方法 随机抽取60岁以上的农村老年人1 200例进行问卷调查.结果 有89.8%的老年人选择家庭养老,1.7%的老年人选择社区养老,8.5%的老年人选择机构养老.养老方式的选择受年龄、文化程度、职业、医疗保障形式、家庭人均月收入、健康状况等多种因素的影响.结论 家庭养老仍是现阶段农村老年人养老的主要方式,但从家庭养老向社会化养老过渡将成为我国未来养老模式发展的必然趋势.     

农村老年人群对养方式的态度及养老模式探析

目的:了解农村老年人群对养老方式的态度,为寻求适宜的农村养老服务模式提供参考,方法:采取问卷法,随机抽取60岁以上的农村老年人600例进行调查.结果:有91.3%的老年人选择家庭养老,0.5%的老年人选择社区养老,8.2%的老年人选择机构养老.养老方式的选择受年龄、文化程度、职业、医疗保障形式、家庭人均月收入、健康状况多种因素的影响.结论:从家庭养老向社会化养老过渡将成为我国未来养老模式发展的必然趋势.应逐步建立以居家养老为基础、社区服务为依托、机构养老为补充的农村养老保障体系.     

老年人养老模式选择的影响因素研究

目的 了解老年人对家庭养老和机构(养老院等)养老两种养老模式的选择意愿及其影响因素，探索适合中国国情的养老模式，为政府对老年设施的投资提供参考依据。方法 采用目的抽样的方法，分别调查家庭、社区老人的个人特征、养老状况、养老的意愿及其可能的影响因素、健康状况、生命质量等，用t检验、χ2检验、方差分析和逐步回归方法进行统计分析。结果 自愿选择家庭养老的老人占54．9％，多于选择机构养老的老人(占44．9％)；无论单因素分析还是多因素分析，年龄，性别，婚姻状况，月基本生活费用，生命质量中的躯体活动功能、疼痛、社会功能、心理功能都是影响老人养老模式选择的主要因素。结论 发展以家庭养老为主的综合性社区养老服务体系，提高老人的经济收入，是实现“健康老龄化”的保证。     

浙江省农村老年人养老意愿调查

目的探讨浙江农村老年人养老意愿的差异。方法 2015年7—8月采用"农村养老情况调查与新型养老模式构建"问卷对浙江省部分农村老年人进行调查,采取单纯随机抽样与定额抽样相结合的方式,回收有效问卷199份。计数资料比较采用χ2检验,P0.05为差异有统计学意义。结果 86.9%的农村老年人选择居家养老,8.0%的则选择机构养老。倾向于在家中养老的原因,排名前三位的分别是想和子女在一起(40.7%)、方便(12.1%)、人多热闹(6.5%)。浙江农村老年人经济来源主要有退休、养老金(64.8%),务农打工(41.2%),子女供给(24.6%)。农村老年人多选的是居家养老,月补助金额多者(600元)选择居家养老占93.6%;月补助金额一般(90~600元)者选择居家养老占93.3%;月补助金额少者(90元)选择居家养老占65.2%。月补助金额不同的农村老年人在养老方式选择意愿上比较,差异有统计学意义(P0.05)。不论晚辈探望频率程度如何,绝大部分浙江农村老年人选择居家养老。从居住情况来看,独居者选择居家养老的占73.0%;和老伴居住者选择居家养老的占88.8%;和子孙居住者选择居家养老的占91.5%;不同居住情况的老年人养老意愿选择比较,差异有统计学意义(P0.05)。结论 "居家养老为主,机构养老为辅"仍是大部分浙江农村老年人的抉择,居家养老方式依旧占主导地位。     

老年人群养老需求及其影响因素调查分析

目的:了解老年人群的养老意愿与需求,分析其影响因素,探讨适宜的养老服务模式。方法:随机抽取60岁以上的老年人1200例,城乡各半,采取问卷法进行养老需求调查。结果:有79.0%的老人选择家庭养老,9.8%的老人选择居家养老,11.2%的老人选择机构养老。影响养老方式选择的因素主要有年龄、婚姻状况、文化程度、职业、医疗保障形式、家庭经济状况、是否拥有养老金、生活自理能力以及城乡等。结论:从家庭养老向社会化养老过渡是未来养老模式发展的必然趋势。应完善社会保障制度,逐步建立以居家养老为基础、社区服务为依托、机构养老为补充的养老服务体系。     

中国城市独生子女父母养老模型的建构思考(二)

二、独生子女家庭对养老模式的理性选择 探索独生子女家庭各种境况下的合理养老方式选择和建构养老模型，必须考虑3个重要变量：其一是家庭经济状况，其二是住房条件的差异，其三是老年人养老观念和生活方式的差异。     

海口市老年人养老方式选择及其影响因素分析

目的：调查海口市老年人养老方式的选择意愿及养老服务需求等,探讨影响海口市老年人养老方式选择意愿的相关因素。方法：采用多阶段分层整群抽样选取海口市4个区（秀英区、美兰区、龙华区、琼山区）,每个区随机抽取1~2个社区,采用自制的调查问卷,对社区60岁及以上的老年人进行入户问卷调查。结果：调查的365名60岁以上居民中,选择家庭养老的老人占86.85%,社区居家养老占6.30%,机构养老占6.85%;单因素x2检验分析结果显示,年龄、户籍、现居住情况、文化程度、个人年收入、医疗保险类型及患慢病情况等对养老方式的选择有影响（P < 0.05）;Logistic回归分析显示,户籍、现居住情况、个人年收入及医疗保险类型是老年人养老方式选择的影响因素。结论：家庭养老仍然是海口市老年人首选的养老模式,且养老方式受到诸多因素的影响,但随着老年人口的不断增加,老龄化程度逐年加剧,养老需求的进一步激增与家庭养老功能趋向弱化的大环境下,创新适宜的养老模式对满足老年人养老需求,合理利用养老资源具有重要的现实意义。     

慢性病老年人养老方式选择的影响因素研究

目的 了解慢性病老年人养老方式选择的影响因素,为其提供合适的养老方式。方法 通过多阶段分层抽样调查厦门市60岁及以上常住老年人的人口学资料、养老方式选择及慢性病患病情况等,采用χ2检验和多分类Logistic回归分析慢性病老年人养老方式选择的影响因素。结果 1 276名老年人中慢性病患病率为61.4%,慢性病老年人（相比未患慢性病老年人）选择社区居家养老和机构养老的比例均较高。以家庭养老为参照,慢性病老年人选择社区居家养老与机构养老的影响因素分别是与子女关系、居住地、文化程度、婚姻、孤独感,独居、与子女关系、文化程度、年龄、居住地。结论 慢性病老年人养老方式选择仍以家庭养老为主,但较未患慢性病老年人低。独居、年龄、婚姻、居住地、孤独感是慢性病老年人养老方式选择特有的影响因素。     

山东省城乡老年人养老现状及影响因素分析

目的了解山东省城乡老年人的养老现状及其影响因素,为山东省养老服务的完善提供有效依据。方法采用多阶段整群随机抽样方法对在山东省济南、泰安、临沂、菏泽、聊城、德州、枣庄7个地市抽取的2 932名≥60岁城乡老年人进行问卷调查。结果山东省2 932名城乡老年人中,家庭养老者占98.0%,机构养老者占2.0%;多因素非条件logistic回归分析结果显示,与未患慢性病的老年人相比,患1~3种慢性病的老年人更愿意采用家庭养老模式进行养老,与无子女的老年人相比,有1个子女的老年人更愿意采用机构养老模式进行养老,与无住房老年人相比,有住房的老年人更愿意采用机构养老模式进行养老。结论家庭养老是山东省城乡老年人的主要养老模式,住房情况、子女数和现患慢性病种数是山东省城乡老年人养老模式的主要影响因素。     

郑州市不同养老模式老年人生存质量及影响因素

目的 了解河南省郑州市不同养老模式老年人生存质量及其影响因素,为老年人选择适宜的养老模式、提高其健康水平和生存质量提供参考依据.方法 采用分层随机抽样方法在河南省郑州市抽取5个区共1 630名≥60周岁老年人进行问卷调查.结果 郑州市家庭养老、机构养老和社区养老3种不同养老模式老年人生存质量得分比较,不同养老模式老年人生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、社会功能(SF)、情感职能(RE)和综合评分间差异均有统计学意义(P=0.000);相关分析结果表明,住房面积和退休工资与家庭养老模式老年人生存质量综合评分呈正相关(P＜0.05),年龄、文化程度、职业和患病种数均与家庭养老模式老年人生存质量综合评分均呈负相关(P＜0.05);文化程度、退休工资和患病种数均与机构养老模式老年人生存质量综合评分呈正相关(P＜0.05),性别、年龄和住房面积均与机构养老模式老年人生存质量综合评分呈负相关(P＜0.01);文化程度和职业均与社区养老模式老年人生存质量综合评分呈正相关(P＜0.05),性别和年龄均与社区养模式老年人生存质量综合评分呈负相关(P＜0.05).结论 郑州市不同养老模式老年人生存质量不同,性别、年龄、文化程度、职业、住房面积、退休工资、患病种数和养老费用是郑州市老年人的影响因素.     

Characteristics of paediatric home care provision: the two dominant models in England

AIM: To describe characteristics of paediatric home care teams BACKGROUND: Home care provision is increasing and recent government initiatives such as support for Princess Diana Memorial Fund nursing teams will provide additional impetus to universal provision. However, little is known about the characteristics of paediatric home care teams. METHOD: A postal survey of all services in England (n = 137) listed in the 13th edition of RCN 1996 Directory of Community Children's Nursing Services was undertaken. A response rate of 85.5% was achieved. FINDINGS: More than half (54.6%) of the teams had been founded after 1990. Most (72.2%) were managed through paediatric or child health directorates and most (77.8%) were based in hospitals. The size of teams varied enormously (range 1-22; median 3). Only a small (5.6%) minority of teams provided care at night although over a third (37%) reported making special arrangements for terminally ill children. CONCLUSION: The survey revealed two dominant models of paediatric home care: the community model with strong links to primary health care and other local provisions and the hospital outreach model with strong links to the hospital service. A number of weaknesses in current provision are identified: variability in geographical coverage; undesirably low core staffing numbers; poor 24-h coverage; and potentially compromised staff skills and knowledge. The need for research to clarify the strengths of the different models and their effectiveness is highlighted.     

Evaluation of an emergency contraception advance provision service

Timely access to emergency contraception (EC) could increase use when needed, and potentially lead to improved efficacy. We evaluated an advance provision service in the UK. Women were supportive of the service. They indicated that having EC on hand would not change their regular contraceptive use, and supported wider dissemination of information on the service, particularly to younger women. Although some women were supportive of further deregulation of EC, many cited fear of "abuse" or health risks of EC as reasons for strict control. We conclude that advance provision services increase access to EC and are particularly important where EC is not yet available from pharmacists. Providers and women need accurate information on the safety of EC. Uptake of advance provision services could be improved by providing subsidized or free EC to those who cannot pay, and by targeting information to younger women.     

云南省人口计生部门出生缺陷一级干预服务的提供和利用研究

目的:通过对出生缺陷一级干预服务的提供和利用状况进行分析,从服务提供的角度,提出改进服务细节的建议。方法:采用定量、定性研究方法,对云南省红河州7个试点县为期3年的降低新生儿出生缺陷率的综合防治技术研究的项目实践,了解目前县、乡两级计划生育服务机构的服务能力和服务水平,育龄夫妇对这些服务的了解程度、利用情况及主要影响因素,收集现场的有关数据。结果:7个县计划生育服务机构具备了开展出生缺陷一级干预的相关工作基础和条件,3年中有超过40%的目标人群接受了所提供的各类服务,其中健康教育率为73.14%,叶酸增补率为41.63%。以全面实施三级干预的1个县为例,2005年6月～2006年12月共计出生婴儿5151人,参加队列研究的4058人,占出生人数的78.78%,项目筛查出了部分有生育出生缺陷儿风险的目标人群,通过积极干预避免不良妊娠结局的发生。结论:通过服务提供者的能力建设,健全技术服务标准和规范,加强咨询,提供优质规范的服务,促进育龄群众对服务的利用。     

Barriers to dying at home: the impact of poor co‐ordination of community service provision for patients with cancer

For patients dying of cancer, there is an emphasis on giving choice regarding preferred location for care, with the option of dying at home, which is integral to UK government health initiatives such as the End of Life Care Programme. However, patients continue to be admitted to hospital in the terminal phase of their illness when they have expressed a desire to die at home. A qualitative study, using two audio tape‐recorded focus group interviews, with a purposive sample of district nurses and community specialist palliative care nurses (19) was undertaken across two primary care trusts in the north west of England. Data were analysed using a thematic analysis approach. From a service provision perspective, the results reveal that poor discharge planning and co‐ordination, difficulty in establishing additional equipment and services together with inadequate out of hours medical provision were all factors contributing to hospital admissions for patients with cancer in the last hours and days of life, and thus were barriers to dying at home.     

西部欠发达地区与发达地区养老现状对比研究

目的:通过欠发达地区-以贵州省为例,与发达地区养老现状综合比较,为政府及现有养老机构探索可行养老模式提供理论与实践依据。方法:采用定性与定量研究相结合的方法,结合文献回顾,实施深度访谈与问卷调查。结果:贵州省经济发展水平与老年比重、老龄化趋势不成正比;养老床位仅为我国发达地区的1/10、国际标准的1/20;以家庭养老和机构养老为主;各种养老政策和保障体系不健全、不到位。结论:欠发达地区养老模式单一,应结合自身现状,借鉴发达地区各种先进管理及运营经验,构建西部欠发达地区特色养老模式。     

Matching parenting support needs to service provision in a universal 13-month child health surveillance visit

Background The Glasgow Parenting Support Framework is an intervention to support families with preschool children. It provides structured support through universal and targeted interventions. Two routine family visits by health visitors have been piloted, one involving a home assessment when the child is 13 months old. Aims To establish the need for parenting support in the population at 13 months and whether or not the home assessment improved the match of service provision to need. Methods Health visitors were asked to collect data on existing problems and service provision to families, the mental state of the child's principal carer, an observation of the parent–child relationship and details of management plans. Data from the Child Health Surveillance System were also used. Results Data were obtained for 549 families. Nine families were noted to have problems in the parent–child relationship. Carers in these families had poorer mental health. In all, 20% of families had a revisit scheduled: they were also more likely to have poor mental health. All families with possible problems in the relationship had a revisit scheduled. Depression scores measured during the pilot were a significant predictor of revisiting and referral, with an odds ratio of 1.37 for every one point increase in score on the Adult Wellbeing Scale depression subscale. Conclusions Current service provision matches need to some extent but routine visits focused on parenting difficulties at 13 months, particularly parental depression, may help to identify families needing support who would not otherwise have received it.     

Patient satisfaction and energy intakes are enhanced by point of service meal provision

Aim: This systemic review aimed to investigate the effects of various methods of point of service meal provision on patient satisfaction and energy intakes of hospital patients. Methods: ‘Medline’ and ‘Wiley Interscience’ online databases (1999–2008) were consulted using search terms such as ‘food service’ and ‘food delivery in hospital’. Cross‐referencing was also used to select studies that compared the provision of full diets to hospital patients using two different methods of food service delivery. Results: Searching yielded 268 studies, of which 18 met the inclusion criteria (hospitals, all ages, oral intake only). Patient satisfaction was measured in 12 studies, while 9 studies measured energy intake, 9 measured food wastage and 4 studies measured costs. Conclusion: There is evidence to suggest that a more personalised meal service system in hospitals has the ability to improve energy intakes and patient satisfaction. Further research is necessary to evaluate the long‐term implications on cost‐effectiveness.     

Parents' evaluations of pre-school services for children with Down syndrome in two Scottish regions

Summary Parental evaluations of current pre-school provision for children with Down's syndrome were surveyed in two Scottish regions. Two methods were used: postal questionnaires and telephone interviews. Services covered were those provided by general practitioners, hospital specialists, health visitors, speech therapists, occupational therapists, physiotherapists, educational psychologists, home teachers, social workers and voluntary organizations. Regional differences were found in provision and in parental satisfaction with currently available services, with some of these differences being dependent on child age. Overall, parents felt they were being given insufficient professional support, with contradictory advice not uncommon. Findings indicate that if limited resources are to be used to the maximum benefit of family and child, both subjective and objective measures of the relative values of different kinds of support at different ages are urgently needed.     

Service Provision for Preschool Children who are Deaf: Parents' Perspectives

The data reported have been derived from the first national review of preschool service provision for deaf children and their families. This paper, examines the kinds of service provision seen as desirable by families with deaf children between 0-5 years of age in relation to current U.K. Government interest in: Universal Neonatal Hearing Screening; family support initiatives including a focus on parent-professional partnerships; Inclusive Education. Data presented includes families responses to early identification; to the information available following identification; perceptions of their own partnerships with professionals; the value of family centred services for themselves, their children and for family life. From these data aspects of good practice are identified and illustrated for consideration in future service development.