失能老年人机构长期照护需求及影响因素

目的了解重庆市失能老年人机构长期照护需求及影响因素。方法基于日常生活能力(ADL)量表对机构照护的老年人进行失能判定,并设计机构长期照护需求调查表进行问卷调研。结果重庆市机构照护的失能老年人对日常生活必需且服务频次多的项目需求率较高,影响照护需求最为显著的因素是失能程度、失能时间及月收入。结论重庆市长期照护服务内容制定应首先解决需求率较高的照护项目。     

失能老年人长期照护需求及影响因素

目的了解新疆石河子市失能老年人长期照护的需求,分析其影响因素。方法采用日常生活能力(ADL)量表对石河子市老年人进行失能筛查,对符合失能标准的298名老年人采用以Maslow需求论为理论框架,自行设计的长期照护需求调查表进行问卷调查。结果石河子市失能老年人对长期照护的需求水平低,经多元线性回归分析,影响其长期照护需求的因素为失能原因和失能程度。结论以石河子市失能老年人的需求为向导,结合影响需求的因素,开展适合该人群的居家长期照护服务。     

重庆市城市养老机构失能、半失能老年群体长期照护现状

目的探究人口老龄化背景下重庆市失能、半失能老年群体长期照护现状。方法主要采用问卷调查法、访谈法,全方位分析当前重庆市养老机构长期照护现状。结果国家顶层设计滞后,政策法规不完善,长期照护标准尚未建立;机构照护形式较单一、照护质量较低;失能老年群体长期照护需求未得到有效满足。结论为了提升机构长期照护质量,满足不同程度失能老年群体多样化照护需求,相关部门应尽快制定政策法规,落实照护评估标准,提升照护人员的综合素质。     

基于测算非正式照护时间视角分析居家失能老年人对非正式照护的需求

目的基于居家非正式照护时间测量视角,初步筛选失能老年人非正式照护需求关键指标。方法对23名专家应用Delphi法进行两轮咨询,以确定非正式照护需求指标。结果居家失能老年人对非正式照护需求包含:一级指标4项,二级指标20项,三级指标46项。结论构建失能老年人居家非正式照护需求指标体系,为下一步测算居家非正式照护时间及时间成本奠定基础。     

城市失能老人照护需求、偏好及长期照护服务体系建设

目的了解城市失能老人的照护需求、照护者偏好与影响因素,探讨长期照护服务体系建设与实施策略。方法对244例浙江省H市的失能老人进行访谈式问卷调查。结果失能老人照护需求依次为上门诊视与医疗护理(92.53%)、个人卫生起居服务(89.21%)、陪同出门(86.05%)、辅助康复(85.77%)、陪伴聊天(83.33%)、协助参与聚会活动(70.29%)等服务领域。失能老人根据不同的照护内容对照护者的选择存在主观偏好。失能程度、个人经济水平、家庭代际支持能力是影响失能老人选择照护内容的主要因素。结论设计多元化服务供给体系,实现多元照护力量的协同互补,发挥家庭、社区、机构等多维度的利益相关者功能,提高失能老人照护质量。     

中国高龄失能老人长期照护策略

<正>失能老人中有92.54%出现在80岁以上的高龄阶段~([1]),高龄失能普遍存在,是养老照顾的点人群,需要更多的照护资源与照护成本~([2])。"失能"是失去最基本日常生活能力(ADL)的略称。ADL包括:进食、更衣、沐浴、如厕、控制大小便6项指标。按照失去自我照护能力的程度,又分为失能与部分失能。2010年中国城乡有照护需求的失能、半失能老人有3 300万~([3]),     

社区居家失能老人长期照护服务需求问卷的编制

目的编制社区居家失能老人长期照护服务需求调查问卷,并检验调查问卷的信效度。方法采用多阶段分层随机抽样,选取南昌市220名失能老人作为预试验的调查对象,运用SPSS19.0统计软件对问卷进行条目分析,检验问卷的内容效度、结构效度、内部一致性及重测信度等进行评价。结果社区居家失能老人长期照护服务需求问卷Cronbach总系数为0.957,2 w后问卷总的重测信度为0.857。利用探索性因子分析来判定问卷的结构效度,提取5个公因子,37个条目,条目负荷系数在0.527~0.938,5个因素可解释的总方差为71.268%。结论社区居家失能老人长期照护服务需求问卷具有较好的信效度,可用于测量社区居家失能老人长期照护服务需求现状。     

新疆维吾尔族、哈萨克族失能老年人生活质量现状及影响因素

目的探讨维、哈失能老年人生活质量现状及影响因素。方法应用SF-36生活质量问卷对621例维、哈失能老年人进行研究。结果维、哈失能老年人生活质量得分为(91.25±11.96)分;Logistic回归分析显示:照护者照护负担、失能程度、失能老年人性别、失能老年人年龄、失能年限及认知情况、家庭人口数是影响被照护者生活质量的重要因素,其中照护者照护负担为主要影响因素。结论提高维、哈失能老年人生活质量应从减轻照护者负担着手,同时考虑失能程度的影响。     

新疆维哈失能老年人生活满意度与照护者照护负担、社会支持交互作用

目的探讨新疆维哈失能老年人生活满意度与其照护者照护负担、社会支持交互作用。方法应用生活满意度指数B量(LSIB)表、主要照护者负担量表(ZBI)和社会支持量表(SSRS)等对621对维哈失能老年人/照护者进行研究。结果 (1)维哈少数民族失能老年人生活满意度得分为(13.15±3.744)分,低于新疆汉族失能老年人,也低于国内常模;(2)交互作用表明:照护者有照护负担及低社会支持、高龄失能老年女性、重度失能、失能老年人文化程度低、患2种以上疾病、子女经济差是影响维哈失能老年人生活满意度的危险因素。结论照护者有照护负担且社会支持低是影响新疆维哈失能老年人生活满意度的主要危险因素,因素间交互作用大大降低了失能老年人生活满意度。     

失能老人跌倒的影响因素及长期照护服务需求

目的调查并分析石河子地区失能老人跌倒的相关危险因素及长期照护服务需求。方法于2016年3～8月随机抽取石河子地区失能老人400例为研究对象,采用自拟调查问卷收集所有研究对象一般资料,以老年人接受调查为起点,记录6个月跌倒情况。根据是否跌倒分为对照组(未跌倒)和研究组(跌倒),比较两组一般资料,分析跌倒的相关危险因素。同时采用自拟照护服务需求调查问卷对失能老人的长期照护服务需求进行调查。结果 400例失能老人中,有172例在6个月内跌倒,跌倒率高达43.00%;多因素Logistic回归分析结果显示,年龄、独居、步态不衡、尿失禁、频繁如厕、听力下降、视力下降、使用辅助器械、高血压、糖尿病、担心跌倒是失能老人跌倒的危险因素(OR值1);影响失能老人理想护理方式选择因素依次为离家远近(72.00%)、情感关系(59.50%)及护理费用(59.50%);失能老人希望得到照护服务内容依次为日常生活照顾(75.50%)、医疗护理(70.50%)、聊天(67.50%);在"是否需要建立护理服务保障制度"这一问题中,67.00%的失能老人认为需要。结论石河子地区失能老人跌倒的危险因素众多,包括年龄、独居、步态不衡、尿失禁、频繁如厕、听力下降、视力下降、使用辅助器械、高血压、糖尿病、担心跌倒;失能老人长期照护服务需求没有保障,相关单位应完善护理服务保障制度,以减少失能老人跌倒发生率,提高生存质量。     

Factors affecting subjective satisfaction with verbal communication among the disabled elderly and their family caregivers

The aims of the present study were to investigate satisfaction with verbal communication among the disabled elderly and their family caregivers; and to find the significantly influential factors of satisfaction with verbal communication. The subjects were 85 disabled elderly and 85 family caregivers. For the disabled elderly, satisfaction with verbal communication, demographic, and physical factors were examined using an interview survey. For the caregivers, satisfaction with verbal communication, demographic factors, and some factors related caregiving were examined using a self-administered questionnaire. In the disabled elderly, 82.4% were satisfied with their verbal communication while 55.3% of family caregivers were satisfied. Satisfaction with verbal communication between the disabled elderly and their caregivers showed low agreement (kappa = 0.17). Bivariate analysis revealed that satisfaction with verbal communication of the disabled elderly was significantly related to ADL (p < 0.01), dysphagia risk (p < 0.05), and ability of comprehension (p < 0.05) while satisfaction with verbal communication of caregivers was significantly related to the gender of the disabled elderly and caregivers' burden. Furthermore, multiple regression analysis showed that the factor most related to satisfaction with verbal communication for the disabled elderly was ability of comprehension (p value = 0.032, odds ratio = 2.960), and the most related factor for their caregivers was the burden evaluated by J-ZBI_8 (p value = 0.004, odds ratio = 0.842). These results suggest that satisfaction with verbal communication of the disabled elderly disagrees with that of the family caregivers, and that some related factors for the disabled elderly are different from those in their family caregivers.     

农村居家失能老年人社会支持满意度影响因素分析

目的:了解农村居家失能老年人对社会支持满意度影响因素,为进一步提高社会支持水平和失能老年人的养老质量提供决策依据。方法:于2020年6月—10月采用随机抽样法在陕西陕南、陕北、关中三个地区共6个乡镇对211名失能老年人开展问卷调查并进行访谈,并用有序Logistic回归模型分析失能老年人社会支持满意度的影响因素。结果:...     

Interactions of household composition and required care level with functional and cognitive status among disabled Japanese elderly living in a suburban apartment complex

Aim: In the forthcoming super‐aging society, the appropriate assessment of functional and cognitive conditions of disabled elderly people will become increasingly significant in providing care services. Care level and household composition would be key factors to assess function. There might also be an interaction between the two factors with the function. The present study examined the associations of household composition and care level with functional and cognitive status among the disabled elderly living in a suburban apartment complex with a high rate of aged residents (39% in 2009). Methods: Participants were 190 disabled elderly persons aged 65 years and over who lived in the apartment complex. Cross‐sectional data were collected between May 2009 and August 2010, including care level, household composition, basic activities of daily living (BADL), instrumental activities of daily living (IADL) and the independence level in relation to cognitive status. Lower scores meant less independence in BADL and IADL, and as determined by the cognitive/independence scale. Results: Approximately half of the participants lived alone. Generalized linear model procedure showed significant interactions with the BADL score and cognitive/independence scale between household composition and care level. Scores for BADL and the cognitive/independence scale in groups receiving a higher care level were lower; however, the slope of the trend for the elderly living alone was more gradual than for the elderly living with others. Conclusion: It is important for health‐care providers to assess in detail the status of the disabled elderly considering both their household composition and care level in planning and providing assistance for them. Geriatr Gerontol Int 2012; 12: 538–546.     

Social Integration and Healthy Aging in Japan: How Gender and Rurality Matter

The current study analyzed the 1999 and 2001 waves of the Nihon University Japanese Longitudinal Study of Aging. Two measures of social integration were associated with lower risks of being physically disabled or depressed at Wave 1 and with a lower risk of progressing into deeper levels of physical disability and depression by Wave 2. Ceteris paribus, compared to elderly urbanites, elderly ruralites had a much higher risk of being physically disabled but much lower odds of being depressed. And compared to elderly men, elderly women had similar risks of being physically disabled but much higher odds of being depressed. Suggestions are made on how future research on longevity in Japan, the world’s most longevous nation, can explore the links among social integration, place, gender, and the postponement of mortality.     

The housing of the disabled and non-disabled elderly in Wales

The Welsh Housing and Dwelling Survey examined housing conditions of a sample of 45,000 households in the principality. In this paper the quality of dwellings inhabited by the disabled and non-disabled elderly throughout Wales is described. It is demonstrated that disabled elderly have a lower standard of housing than their non-disabled counterparts.     

An epidemiological study of the relationship between the number of remaining teeth and the disabled elderly receiving long-term care

This study attempts to clarify the relationship between the long-term care of the elderly and the number of remaining teeth by comparing the remaining teeth of the healthy with that of the disabled elderly. A survey was conducted in a town, Fukuoka Prefecture. The disabled group consisted of 62 persons with level of disability of 4-5 according to the Long-term Care Insurance categorization. Controls were selected randomly from healthy elderly residents, one for each in the disabled group, matching gender and age (less than +/- 1 year old). Public health nurses conducted interviews using a questionnaire to determine the cause of disease, medical history, lifestyle and period of long-term care, and counted the remaining teeth. The mean number of remaining teeth presented a significant difference with 3.7 for the disabled group and 9.1 for the control group (p < 0.01). A logistic regression analysis revealed that the odds ratio for long-term care to that of the reference with 20 or more teeth was 7.03 (95% CI: 1.15-42.85) for 10 to 19 teeth, 15.61 (2.89-84.26) for 1 to 9 teeth, and 15.11 (2.84-80.48) for no teeth. The age group of 65-69 years and 70-79 years in the disabled group had significantly smaller mean numbers of remaining teeth than their control group counterparts by approximately 14 and 12 respectively, but in the age group of 80 years or more, no significant difference was observed between the two groups. In conclusion, our results suggested that elderly people with fewer remaining teeth have a high risk for long-term care. Especially, the risk was thought to be strongly associated with the loss of some teeth in middle age.     

The influence of intergenerational exchange on nursing home admission in Taiwan

This study examines the effect of intergenerational exchange on nursinghome admissions among functionally disabled older adults in Taiwan. A groupof 317 nursing home residents were randomly selected from all nursing homesin Taipei, the capital of Taiwan. In addition, two community groups wererandomly selected as multiple controls in the study. The results showed thatintergenerational exchange has a statistically significant effect onnursing home admission after controlling for sociodemographic characteristics and health status. The odds of being admitted into a nursing home was lower for those elderly who provided instrumentalassistance to their families before they were disabled. The adjustedrelative risk estimate was 0.2 (95% CI = 0.1 - 0.6). It showsthat the instrumental assistance the elderly provided to the family beforethey became disabled was reciprocated when they needed ADL assistance. Thisfinding provides strong support for the social exchange theory.     

ICT-based health information services for elderly people: past experiences, current trends, and future strategies

Although health information is readily available on the Internet and has changed the way people deal with their health in many ways, the retrieval of relevant information remains problematic, especially for elderly people. With a focus on elderly people, this paper summarizes current trends in consumer health informatics, discusses past and present initiatives providing health-information services, and proposes a future strategy for the design of sustainable services. A systematic literature review and a review of past German and EU projects concerned with health information services for elderly people are given. Many publications focus on health information services for specific diseases and on their quality and semantic accessibility, yet few deal with presenting and customizing health information for elderly and disabled people. Past experiences from Germany suggest that very often the specific needs of this target group are not met, and therefore accessibility remains largely hypothetical. We propose a strategy with five key points for the design of sustainable health-information services for elderly people. More research is needed to customize web-based health information services to the needs of the user group that needs them most urgently - elderly and disabled people.     

A nursing home in Arab-Israeli society: targeting utilization in a changing social and economic environment

This article is a case study of the first 10 years of operation (1992-2002) of the Dabouriya Home for the Aged, the first publicly funded culturally adapted nursing home for Israeli citizens of Arab descent. Although 44% of Arab Israelis and 26% of Jewish Israelis aged 65 and older are disabled, in 1999, 4.3% of the Jewish population but only 0.7% of the Arab-Israeli population aged 65 or older lived in long-term care institutions; disabled Arab-Israeli elderly were mainly cared for by families. As Arab-Israeli society modernizes and traditional caregiving is reduced, alternatives must be found for this growing, disabled population. Medical and administrative records of 404 people admitted consecutively to a 136-bed facility over 10 years were analyzed. Two distinct segments of the needy population were served: people with independent activity of daily living (ADL) function but little or no family to provide help with intermediate ADLs and those dependent in ADLs and with health problems, especially dementia. Economic, demographic, and social changes in Arab-Israeli society may mean that traditional caregivers will not be able to adequately care for this highly disabled population. Administrators of the public health system in Israel should be aware of the underutilization of publicly funded long-term care by disabled Arab Israelis and the lack of care alternatives for the population that does use nursing homes, because there may be severe consequences in terms of caregiver burden and social stress when disabled elderly people remain in unsuitable environments.