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。     

社区离休干部健康状况及卫生保健需求调查

目的调查本社区离休干部健康状况及卫生保健需求。方法2006年4至9月对本社区406名离休干部进行问卷调查，包括基本生活状况、健康状况和就医情况等。结果调查显示，本社区离休干部的年龄普遍较大；独居者比例较高（70．2％）；患各种慢性病比例高达97．78％，对社区医疗卫生保健的需求愿望迫切。结论培训高素质的社区医疗保健队伍，提高全科医师医疗水平，开展形式多样的医疗保健服务，以提高离休干部的生活质量。     

深圳市南山区社区老年人慢性病共病患病情况及其对身体功能影响

目的 了解广东省深圳市南山区社区老年人慢性病共病（MCC）患病情况及其对身体功能的影响，为提高老年人的生命质量提供参考依据。方法 于2018年1月—2019年12月采用随机整群抽样方法，抽取在深圳市南山区62个社区健康服务中心健康体检的4 475名≥65岁社区老年人进行问卷调查和身体功能测量，并应用多因素非条件logistic回归模型分析社区老年人MCC患病情况及对其身体功能的影响。结果 深圳市南山区最终纳入的4 297名社区老年人中，患MCC者2 728例，患病率为63.49%；在2 728例患MCC社区老年人中，患2种慢性病者1 043例（38.23%），患3种慢性病者793例（29.07%），患≥4种慢性病者892例（32.70%）;4 297名社区老年人中，身体功能下降者745人（17.34%），步速下降者1 293人（30.09%），起坐时间延长者1 475人（34.33%），握力下降者1 761人（40.98%）；在调整了性别、年龄、文化程度、婚姻状况、户籍地、吸烟情况和饮酒情况等混杂因素后，多因素非条件logistic回归分析结果显示，深圳市南山区患MCC社区老年人身体功...     

深圳市皇岗社区老年人慢性病流行病学调查

目的为开展社区老年人全科医学保健服务提供依据。方法根据社区老年人慢性病筛查、老年功能量表评估、家庭功能评估、周期体检和个人健康档案,进行回顾性流行病学调查。结果黄岗社区老年人慢性病患病率为49.7%。通过多因素Logistic回归分析,社区老年人慢性病的主要影响因素依次为经济状况、遗传、与家人同住、社区健康服务满意度、年龄、心理健康、健康行为、体育活动和社会医疗保险等。结论社区老年人是多种慢性病的高发人群,应采用生物—心理—社会的全科医学保健措施进行干预,以提高其健康水平,同时为社会和家庭节约医疗开支。     

疫情防控常态化下长春市社区慢性病老年人养老服务需求及影响因素分析

目的 了解疫情防控常态化下，长春市社区慢性病老年人养老服务需求的现状并分析其影响因素。方法 2021年4月30日—10月15日采用便利抽样法选取长春市内15个社区中的481名老年慢性病患者为调查对象，采用一般资料调查表和慢性病老人养老服务需求问卷对其进行调查，并对数据进行分析。结果 长春市社区慢性病老年人养老服务需求总分为（122.154±15.025）分，条目均分为（3.701±0.455）分，自理能力、患病数量、有无配偶、年龄及有无子女是社区慢性病老年人养老服务需求的影响因素，差异均有统计学意义（均P<0.05）。结论 疫情防控常态化下长春市社区慢性病老年人养老服务需求处于中上水平，应通过分析其影响因素并给出相应对策以满足社区慢性病老年人对养老服务的需求。     

北京市朝阳区300名老年人慢性病知识水平与服务需求调查分析

目的了解社区老年人慢性病知识的掌握情况与服务需求,探索适合老年人的慢性病服务模式,为有针对性的开展慢性病管理提供指导。方法选取北京市团结湖社区部分老年人作为研究对象,采取调查问卷的方式进行调查,调查内容包括个人基本情况,慢性病知识的了解情况,服务的需求情况。结果共收回有效调查问卷300份。调查对象以女性、技术及管理人员为主,调查对象慢性病患病比例达76.7%,慢性病排序依次是高血压、冠心病、糖尿病、脑卒中、其他消化系统及呼吸系统疾病。慢性病知识的获得途径以大众传媒及朋友、邻居为主,提示社区开展广泛的慢性病宣传大有空间。老年人对慢性病治疗、预防、保健、护理等知识的需求较大。围绕老年人服务需求开展有针对性地卫生服务势在必行。结论社区老年人慢性病患病率高,对慢性病知识的认识不足,社区医疗优势利用不够。提示老年人慢性病防治工作应充分发挥社区医疗、保健优势,以需求为导向加强社区医疗保健的延伸服务。     

牡丹江市慢性病老年人社区护理需求调查分析

目的:了解牡丹江市慢性病老年人社区护理服务需求情况,为开展牡丹江市社区老年护理服务提供理论依据。方法:于2017年6～8月采用便利抽样的方法对牡丹江市四所社区进行问卷调查。采用自编的牡丹江市慢性病老年人对社区护理需求的调查问卷,对牡丹江市163名慢性病老年人的一般资料、社区卫生服务现状及护理需求进行问卷调查。结果:牡丹江市老年人慢性病患病率较高,社区卫生服务实际利用率较低,但在健康监测、健康指导和疾病护理等方面的社区护理服务需求较大。结论:牡丹江市慢性病老年人健康指导需求较高,社区卫生机构应建立合理的组织体系,有针对性地开展慢性病老年社区护理服务。     

周家桥社区老年人慢性病及不良生活方式调查

目的了解周家桥社区老年人慢性病患病情况及主要不良生活行为，为制订相应的防治策略提供依据。方法以居委会为单位整群随机抽样，入户访谈获取老年人慢性病及相关资料。结果本组老年人慢性病总患病率为58．2％。疾病构成顺位依次为高血压、心脏病、脑血管疾病、高脂血症、慢性支气管炎等。老年人主要不良生活方式依次为低纤维饮食（67．52％）、缺乏锻炼（53．83％）、吸烟（21．13％）、高盐饮食（19．92％）、饮酒（12．73％）。结论老年人慢性病防治应列为神区卫生保健的重要内容，慢性病的防治应以健康教育和健康促进为基础，面向全人群，重在教育人们改变不良生活习惯。     

都匀市城市社区老年人健康状况及社区护理需求调查

目的 了解都匀市老年人健康状况及对社区护理的需求.方法 采用老年人社区护理需求调查表、老年抑郁量表（GDS）及社会支持评定量表对都匀市城区210名60岁以上老年人进行问卷调查.结果 210名老年人中67.1%患有慢性病,22.4%存在自理缺陷,50.5%有抑郁症状.对社区护理的客观需求方面有慢性病系统管理、康复指导、照顾者培训、心理护理及健康教育等.主观需求方面前10位依次为上门服务（30.5%）、慢性病管理（27.6%）、保健指导（26.7%）、健康档案（21.4%）、饮食指导（18.6%）、照顾者培训（13.8%）、专科护理（12.9%）、康复指导（11.4%）、技术性护理操作（11.0%）及家庭病床（11.0%）等.结论 老年人群是社区护理服务的重点人群,应加强对社区护理服务宣传,完善社区卫生服务体系,针对老年人需求调整社区护理工作重点.     

老西门社区独居老年人慢性病现患状况分析与对策探讨

目的了解本社区独居老年人慢性病患病状况，为开展有效健康干预提供依据。方法采用随机抽样方法对社区中418名≥60岁的独居老人作慢性病患病情况的问卷调查。结果独居老年人的慢性病患病率高，心血管病、骨质疏松症等疾病顺位靠前，92．82％的老人同时患有1至数种慢性疾病。结论要重视独居老年人慢性病的防治和管理，以降低患病率，提高独居老年人生活与生命质量。     

香花桥社区102例脑卒中患者发病特点分析

目的 探讨香花桥社区脑卒中患者的发病特点，为制订本社区有效的健康干预方案提供依据。方法选取香花桥社区102例脑卒中患者，按年龄分为＜60岁组（n=32）和≥60岁组（n=70），以问卷方式由经统一培训的医师入户调查，并进行结果分析。结果 ＜60岁组的脑卒中患者，其吸烟、饮酒、从事中、重体力劳动的比例以及高脂血症患病率均高于≥60岁组，差异有统计学意义（P＜0．01）；＜60岁组高血压病患者的规则用药比例明显低于≥60岁组，差异有统计学意义（P＜0．01）。结论应加强社区中、青年人群慢性疾病相关知识的健康教育，倡导健康生活方式，降低脑卒中的发生率。     

上海市奉贤区农村高龄老人综合健康状况调查

目的了解高龄老人身体健康、经济状况、家庭和社会保障、日常生活能力及医疗服务的需求,以便对社区高龄老人的综合健康质量作出正确评估.方法采用整群抽样方法对奉贤区按东、南、西、北、中5个区域中各抽查1个镇共1 634名80岁以上老人入户调查.结果高龄老人慢性病患病率为68.05%,以高血压、慢性阻塞性肺病、心脏病为主,有17.20%的高龄老人生活能力处于半自理和完全不能自理的状态,享有医保或初级合作医疗待遇的老人占69.98%,有77.41%的老人月经济收入低于100元,对生活和健康总体满意或较满意的占90.33%.结论奉贤区高龄老人经济收入偏低,总体生活满意度较高.有必要针对不同情况采取不同的社区干预措施,以提高老年人综合健康水平.     

Developing socio-spatial knowledge networks: a qualitative methodology for chronic disease prevention

Chronic disease is a significant and costly social problem. The burden is even more pronounced in communities with high rates of a particular chronic disease. Assessment of health belief systems and the local geographies of health beliefs can assist community health planners to create cost-effective strategic intervention programs where populations are at high risk for chronic diseases. In this paper, we elaborate the concept of socio-spatial knowledge networks (SSKNs) and demonstrate that SSKNs can be useful in informing the design of health care prevention strategies. In our project, we demonstrate how to identify key socio-spatial information for intervention strategies which will prevent or delay the onset of a particular chronic disease, Type 2 diabetes. Our qualitative framework allows us to determine which sites might be best characterized as socio-spatial knowledge network nodes for sharing diabetes information and which sites might be less suited to such exchange. Our strategy explores cross-cultural similarities, differences, and overlap in a multi-ethnic rural North Carolina context through simple techniques such as mapping social networks and sites in which people share their knowledge and beliefs about diabetes. This geographical analysis allows us to examine exactly where health knowledge coincides with other social support, and where such resources may be improved in a particular community. Knowing precisely what people in a community understand about a chronic disease and its treatment or prevention and knowing where people go to share that information helps to (1) identify strategic locations within a community for future interventions and, (2) evaluate the effectiveness of existing interventions. The geographical approach presented here is one that can serve other communities and health practitioners who hope to improve chronic disease management in diverse local environments.     

乍浦社区主要疾病诊断

目的 分析社区相关资料，确定优先解决的健康问题，为改进社区卫生服务提供依据。方法 对社区内医学人口学资料、慢性非传染性疾病和传染病危害情况进行分析。结果 本社区60岁及以上老年人占22.11％；2004年居民前4位死因顺位依次为循环系统疾病、恶性肿瘤、脑血管病和呼吸系统疾病，死亡率（1／10万）分别为350．65、281．63、198．07和114．44；肺结核和急性肝炎年发病率略高于虹口区水平，痢疾的发病率略低于虹口区。未见性传播疾病报告。结论 本社区老龄化程度较高；应进一步加慢慢性心血管疾病的三级预防，同时应积极寻找原因．做好肺结核等传染病的防治工作。     

北京市老年人慢性病社会决定因素研究

目的：研究北京市老年人慢性病在不同社会阶层人群中的患病差异。方法：利用北京大学公共卫生学院2013年对北京市老年人进行的入户调查数据库,获取1717名具有北京代表性的60岁及以上人口的入户调查信息。以收入、受教育程度、职业和户口等社会经济地位指标对社会阶层进行度量,采用Logistic回归模型,分析北京市老年人慢性病患病在不同社会阶层人群间的分布。结果：非农业户口人群、收入位于中间和最高人群、小学组和大专及以上组慢性病患病风险较低。退休前从事农林牧渔业水利业生产人员慢性病患病风险较高。收入次低20％组同时患3种以上慢性病风险较高。结论：慢性病防控策略的制定应充分考虑社会分层等健康社会决定因素,而不仅仅是针对慢性病的直接病因。北京市老年人的慢性病防控工作应当重点关注农业户口、低收入和受教育程度较低人群。     

构建和谐医患关系与医务社会工作的专业使命

医务社会工作是现代健康照顾体系的重要组成部分，服务范围广泛多样，覆盖疾病预防、临床医疗、康复服务、社区卫生服务、公共卫生和区域卫生规划等所有服务领域。在恢复医务社会工作过程中，医务社会工作发展的优先领域、战略重点与介入策略至关重要。在医患关系日趋紧张，医疗事故频繁发生和医疗纠纷不断增多的处境下、医愚关系和医患沟通是医务社会工作介入的优先领域，改善医患关系是医务社会工作战略重点和最佳介入策略。     

‘Getting the vaccine makes me a champion of it’: Exploring perceptions towards peer-to-peer communication about the COVID-19 vaccines amongst Australian adults

Objectives

Peer-to-peer communication approaches have been previously described as the ‘power of personal referral’. Rather than relying on official channels of information, peer-to-peer communication may have a role in supporting changes in understanding and possibly behaviours. However, in emergency or pandemic situations, there is currently limited understanding of whether community members feel comfortable speaking about their vaccine experiences or advocating to others. This study explored the perceptions of COVID-19 vaccinated and unvaccinated Australian adults regarding their preferences and opinions about peer-peer communication and other vaccine communication strategies.

Study Design

Qualitative interview research.

Methods

In-depth interviews were conducted in September 2021 with 41 members of the Australian community. Thirty-three participants self-identified as being vaccinated against COVID-19, while the remainder were not vaccinated at the time or did not intend on receiving a COVID vaccine.

Results

Amongst those who were vaccinated, participants spoke about being willing to promote the vaccine and correct misinformation and felt empowered following their vaccination. They highlighted the importance of peer-to-peer communication and community messaging, expressing the need for both strategies in an immunisation promotional campaign, with a slight emphasis on the persuasive power of communication between family and friends. However, those who were unvaccinated tended to dismiss the role of community messaging, commenting on a desire not to be like one of the many who listened to the advice of others.

Conclusion

During emergency situations, governments and other relevant community organisations should consider harnessing peer-to-peer communication amongst motivated individuals as a health communication intervention. However further work is needed to understand the support that this constituent-involving strategy requires.

Patient or Public Contribution

Participants were invited to participate through a series of online promotional pathways including emails and social media posts. Those who completed the expression of interest and met the study criteria were contacted and sent the full study participant information documentation. A time for a 30 min semi-structured interview was set and provided with a $50 gift voucher at the conclusion.     

Pandemic influenza communication: views from a deliberative forum

Objective  To use a deliberative forum to elicit community perspectives on communication about pandemic influenza planning, and to compare these findings with the current Australian national communication strategy. Design  Deliberative forum of 12 persons randomly selected from urban South Australia. Forum members were briefed by experts in infection control, virology, ethics and public policy before deliberating on four key questions: what, how and when should the community be told about pandemic influenza and by whom? Results  The forum recommended provision of detailed and comprehensive information by credible experts, rather than politicians, using a variety of media including television and internet. Recommendations included cumulative communication to build expertise in the community, and specific strategies to include groups such as young people, people with physical or mental disabilities, and rural and remote communities. Information provided should be practical, accurate, and timely, with no ‘holding back’ about the seriousness of a pandemic. The forum expressed confidence in the expert witnesses, despite the acknowledged uncertainty of many of the predictions. Discussion and Conclusion  The deliberative forum’s recommendations were largely consistent with the Australian national pandemic influenza communication strategy and the relevant literature. However, the forum recommended: release of more detailed information than currently proposed in the national strategy; use of non‐political spokespersons; and use of novel communication methods. Their acceptance of uncertainty suggests that policy makers should be open about the limits of knowledge in potentially threatening situations. Our findings show that deliberative forums can provide community perspectives on topics such as communication about pandemic influenza.     

Measurement of handicap in the community: a micro survey in a French village

Handicap is the result of a process initiated by an underlying disease, an accident or an abnormality, which leads to a functional deficit in various situations of everyday life. This definition, derived from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), reflects the desire of the elderly and the handicapped for social integration. It may also form the conceptual basis for analysis of the capacities of individuals and populations. To this end, a micro-survey was conducted in a homogeneous village community of 532 people aged 1-92 years. This study was of the ergonomic type, accompanied by a questionnaire on perceived restrictions and handicaps, and carried out transversely over a period of one month (94.7% participation). The specific objectives of the study were to obtain a reliable functional representation of the population of the village, comparing self-assessment of functional capacity with observed performance, and analysing the effects of age on capacity. The copious data collected in the areas of locomotion, prehension and communication have provided a detailed functional profile of the population studied. These data may be transposed to particular environments, such as transport, housing, school or work, and may serve as a basis for comparisons. The difficulties encountered by subjects in the tests were closely correlated with the situations simulated by the tests. Subjective estimation of handicap proved to be reliable in comparison with actual performance, especially for tests of mobility and highly demanding situations. Estimation of the presence of a handicap increased with age. The deterioration in performance observed was proportional to age, but can be perceived to begin early, at about 30-40 years. Disability-free life expectancy (DFLE) could be an interesting indicator in so far as it appears to be sensitive to the confrontation of individual functional capacities with the environment. However, it is important that any disability used as a basis for calculation should be measured with maximum precision. A community survey of this kind is thus particularly useful for ergonomic purposes, but is also valuable for the planning of medical and social assistance at the local level in the areas of disability and handicap. The combination of observation and listening to people, with an interview, appears to be fruitful and reliable. Single studies of well-targeted samples of the population, or, alternatively, of larger and more significant populations, would be desirable in public health, since the epidemiological approach to handicap has hitherto been essentially focused on diagnosis and medical evaluation.