绍兴地区农村老年人健康状况调查

目的 了解绍兴农村地区老年人健康状况,为有针对性开展农村老年卫生保健服务提供依据.方法 采用二级抽样方法,抽取814位农村老年人进行入户问卷调查.结果 农村老年人一种以上慢性病的患病率为79.4%,两种以上的患病率为51.72%;排在前5位的慢性病是骨关节病、高血压、白内障、高血脂和慢性支气管炎.结论 绍兴农村地区老年人群健康状况不容乐观,应积极开展老年人健康教育,有重点地进行慢性病的防治,提高老年人生活质量.     

新疆65岁及以上居民两周患病及影响因素分析

目的　了解老年人口的健康状况及卫生需求 ,更好地为老年人群提供卫生服务。方法　采取分阶段整群随机抽样、入户调查的方法。结果　 65岁及以上老年人的两周患病率为 2 2 6.2‰ ,城市老人两周患病率高于农村 ,女性高于男性 ,族别、婚姻状况、文化程度、职业、慢性病对两周患病率的影响 ,具有显著性差异。结论　应针对影响老年人健康的因素及老年人对卫生服务的需求 ,开展一些老年人需要且能接受的卫生服务项目     

长春市城乡社区老年人健康状况与护理需求分析

目的调查长春市城乡社区老年人口的健康状况和护理需求,为疾病的预防及社区卫生服务提供决策性依据。方法分层整群随机抽取位于长春市不同地区（城区、城乡结合部、农村）60岁以上的老年人群560人。调查内容包括人口学资料、身体健康状况、经济状况、护理需求四部分。比较三地社区老年人的健康状况、经济状况与护理需求情况的差异。结果老年人慢性病患病率较高为77.14%,慢性病患病率前五位的依次为：心脏病、高血压、关节炎、脑血管病和呼吸系统疾病。其影响因素与老年人居住地理环境和日常的饮食行为习惯有关。结论随着人口老龄化,老年人慢性病患病率有所增加,社区护理服务需求量加大。大力开展社区卫生服务,倡导健康老龄化是社区护理工作者的主要任务。     

老年人卫生服务需求与利用的现况调查及影响因素

目的了解长治市老年人口卫生服务需求和利用情况及影响因素。方法分层整群抽取1 128名老年人。主要调查一般情况、健康状况、卫生服务的需求与利用、医疗保障情况。结果长治市老年人自我健康评价较高,62.6%老年人患有慢性病,2 w患病率为23.2%,年住院率为22.9%,平均住院天数为14 d。有老伴、文化程度高、收入水平越高、慢性病种类越多、自我健康评价越差、平时锻炼少、保健知识少、体检周期长患病后住院的越多。结论慢性病已成为老年人主要的健康问题,应加强社区卫生服务建设,针对老年人开展多种形式的服务。     

武汉市城区老年人对社区中医药卫生服务的需求及影响因素

目的了解武汉市城区老年人对社区中医药卫生服务的需求及影响因素。方法采用问卷调查和专题小组访谈相结合的形式对640名60岁以上的社区卫生服务中心就诊的老年人进行调查。结果 67.7%的调查对象确诊患有各种慢性病。老年人对社区卫生服务中心中医药医疗服务的满意度为44.5%,不满意度为35.4%,认为一般的占20.1%,社区卫生服务机构中医师技术力量薄弱最为突出。结论老年人群是社区卫生服务的重点人群。以中医药医疗服务为切入点,大力发展社区中医药服务是满足老年人群健康需求的必然途径。     

农村老年居民健康状况及保健需求情况调查

目的 了解江苏省高邮市农村地区老年居民的健康现状及保健需求,为加强乡村两级医疗机构服务,开展针对性的老年保健服务提供依据.方法 采取多阶段分层随机抽样方法抽取样本户,用自行设计调查问卷对户中60岁及以上老年人进行调查.结果 受访老年居民2w患病率为35.2％,慢性病患病率为30.5％,住院率为5.1％.有26.3％的老年人存在不同程度的听力障碍,22.7％的老年人视力存在中度或重度困难,7.7％的老年人说话有困难.累计10.9％的老年人存在中度及重度焦虑或沮丧.结论 基层医疗机构应切实了解老年人生活与健康需求的基本情况及特点,为他们提供多形式、全方位、更有针对性满足老年人生活与健康需求的服务.     

温州城区空巢老人社区卫生服务需求及利用分析

目的 探讨空巢老人社区卫生服务需求及利用的现状.方法 采用整群随机抽样入户调查的方法,用自编问卷对760名60岁及以上老年人进行了调查.结果 空巢老人慢性病患病率为73.2%,空巢组对社区卫生服务需求,前三位的分别为上门诊疗服务、定期体检、健康教育;空巢组和非空巢组老人对社区卫生服务需求项目无差异(P>0.05).男女性空巢老人2 w就诊率分别达31.6%、22.7%,不同文化程度空巢老人2 w内发病就诊率和利用社区卫生服务有差异(P＜0.01,P＜0.05);不同医疗保障的空巢老人对就医机构选择差异有统计学意义(P<0.001).结论 社区卫生服务应根据老年人特性,以需求为导向,提供多形式、全方位的社区卫生服务,提高其利用率和服务质量,满足空巢老人的需求.     

老年人健康需求特点与健康管理对策

正我国已经进入人口老龄化快速发展阶段,2012年底60周岁以上人口已达1. 94亿,预计2025年将突破3亿[1]。老年人机体衰老、身体功能退化,各种慢性病患病率高[2],对健康的需求十分迫切。结合老年身心特点深入分析老年人群健康需求,进行比较研究,提出针对性较强的健康管理对策建议,有利于推动老年健康管理的持续发展。本文针对老年人群特点,区分不同年龄段[3]、养老方式[4],探讨总结老年人健康需求     

宁夏农村老年人群慢性病卫生服务需求

目的分析宁夏农村老年人群慢性病卫生服务需求状况。方法采用多阶段随机抽样的方法抽取宁夏5县3 507例60岁及以上农村老年居民,进行面对面问卷调查。结果宁夏农村老年人群慢性病患病率为41.32%,标化患病率为41.45%,女性患病率高于男性,患病率年龄分布上呈先增后降趋势;循环系统、骨骼肌肉结缔组织疾病、消化系统、呼吸系统、内分泌代谢疾病位于系统别患病率前5位;单病种顺位前5位分布是高血压、类风湿关节炎、胃肠炎、糖尿病及胆结石胆囊炎;老年慢性病患者与非慢性病老年人群相比,健康自评状况明显较差;近3个月因慢性病就诊人数占30.57%,就诊机构以县级以上医院所占比例最大。结论宁夏农村老年人群慢性病卫生服务需求处于较高水平,应切合实际,合理配置卫生资源,开展卫生服务。     

银川市城市社区老年人群健康状况调查

目的了解银川市城市社区老年人健康状况,为社区卫生服务中心制定良好的有针对性卫生保健服务计划提供依据.方法采用问卷访问和体格检查相结合的方法,对银川地区城市社区老年人进行了入户调查.结果 80.1%的老年人群有慢性病史,常见慢性病患病率前10位的是:高血压、骨关节病、冠心病、胃病、高脂血症、慢性支气管炎、糖尿病、肥胖、脑血管病、肿瘤.回族老人慢性病患病率高于汉族.结论银川市老年人群健康状况不容乐观,应积极开展社区医疗、健康教育、预防、卫生保健等公共服务,加强慢性病的防治和管理,改善健康状况,提高老年人活质量.     

The self-rated health status and key influencing factors in middle-aged and elderly: Evidence from the CHARLS

To evaluate the self-rate health (SRH) status and explore influence factors of middle-aged and elderly in China.China Health and Retirement Longitudinal Survey was conducted in 2011, 2013, 2015 and 2018. Data of the China Health and Retirement Longitudinal Survey in 2018 was used in our study and a total of 17898 participants were included. SRH status was graded as “very good, good, average, bad, very bad.” Participants who answered “very good” and “good” were regarded as self-rated good health and who answered “average,” “bad” and “very bad” were regarded as self-rated poor health. Odds ratio and 95% confidence interval of Logistics regression were calculated to evaluate the correlation between SRH and chronic diseases, demographic characteristics and lifestyle of middle-aged and elderly participants.A total of 4476 (25.01%) participants reported they had good health, and 13422 (74.99%) reported they had poor health. 9975 participants self-rated they had no chronic disease (55.73%), and 7923 (44.27%) participants self-rated they suffered from one and above chronic diseases. The prevalence of chronic diseases showed significant odds ratio and trend with SRH poor rate of participants. The more kinds of chronic diseases they suffered from, the poorer SRH was reported in middle-aged and elderly participants. Except for the chronic diseases, participants with higher age, living in rural, with high Center for Epidemiological Survey-Depression Scale score of depression and fewer time of physical activities also correlated with higher SRH (poor) rate.The SRH (good) rate was very low in middle-aged and elderly, participants who accompanied with more kinds of chronic diseases, fewer physical activities, higher age and living in the rural had a worse health status. A more comprehensive and integrated health framework should be strengthened to improve the health of middle-aged and elderly in China.     

福州市城区老年人健康状况及社区卫生服务需求调查

目的 了解我市城区老年人健康状况及卫生服务需求,为福州市社区老年人卫生服务的开展和完善提供科学依据.方法 采用分层随机抽样方法,选取福州市城区3285例60岁及以上老年人进行问卷调查.结果 城区老年人的平均生活质量中等偏上,但社区老人受教育程度偏低,老年人慢性病患病率较高,患1种及以上慢性病者2134例(65.0%),且年龄越大,同时患多种慢性病的老年人所占的比例越高(P＜0.01),慢性病患病率前5位依次为:高血压、糖尿病、冠心病、骨关节病、脑卒中;老年人抑郁症状发生率高达60.3%;该区老年人对社区卫生服务总需求率为75.2%,年龄越大,所需求项目越多(P＜0.05),老年人对卫生服务需求排在前5位的是定期体检、健康教育、定期家访、保健指导、饮食指导.结论 福州市城区老年人存在不同程度的健康问题和多种卫生服务需求,应整合资源,为老年人提供多形式、多途径的社区卫生保健服务,以提高老年人的生活质量.

Abstract：

Objective To find out the health status and community health care requirement of the elderly in urban Fuzhou and to provide suggestions on how to develop and consummate the community health care for elderly. Methods With the method of stratified random sampling, 3285 elderly people aged 60 years and over were surveyed by a questionnaire. Results The average quality of life of elderly people in urban Fuzhou was above the moderate level. But education level of the elderly was low. And the prevalence rate of chronic diseases was high. There were 2134 elderly people (65.0%) who had more than one chronic disease. The older the people, the higher proportion the coincidence of multiple diseases (P＜0.01). The first five chronic diseases in the elderly were hypertension, diabetes, coronary heart disease, arthropathy and stroke. The incidence rate of depression was high up to 60%. The requirement rate of community health care was 75.2%, and the older the people, the more items they needed(P＜0.05). The requirement of community health care at the first 5 rank position were regular physical examination, health education, regular home visiting, health direction and diet direction. Conclusions Elderly people have many health problems and requirements of community health care.We should provide more and more community health care, in order to improve the quality of life of elderly people.     

社区儿童保健体检272例心脏杂音结果分析

目的初步探讨社区卫生中心针对0～6岁散居婴幼儿及儿童保健体检对疾病尤其心脏疾病筛查的重要性,以及心脏杂音体征在0～6岁散居婴幼儿和儿童心脏疾病诊断中的重要性。方法：对2009年7月-2013年6月本社区卫生服务中心所属辖区进行0-6岁散居儿童保健大体检中听诊到心脏杂音的272名婴幼儿及儿童进行专案管理登记并尽快转至上级专科医院进行心脏彩超、心肌酶等检查以明确产生心脏杂音的原因及疾病。结果：转诊的272名查体有心脏杂音的0-6岁儿童上级心血管专科医院的诊断结果为病理性杂音124例,占45．6％,生理性杂音148例,占54．4％,其中病理性杂音包括先天性心脏病85例（占31．3％）,即室间隔缺损（VSD）62例（占22．8％）、房间隔缺损（ASD）13例（占4．8％）、房室间隔缺损（AVSD）2例（0．7％）,动脉导管未闭（PDA）10例（3．7％）;继发性心脏病37例（占13．6％）,包括感染性心肌损害27例（9．9％）、心肌炎2例（0．7％）、感染性心内膜炎I例（0．4％）,贫血性心脏病7例（25．7％）;生理眭杂音148例,包括左室假腱索42例（15．4％）、瓣膜反流及瓣膜脱垂42例（15．4％）,心脏无异常64例（23．5％）。先天性心脏血管病〈1岁年龄组所占比例显著高于1-岁组,更高于2-岁以上组（均P〈0-01）。而继发性心脏病和生理性杂音〈1岁组所占比例显著低于1．岁组和2．岁组（均P〈0-01）。在〈1岁组中先天性心脏血管病所占比例显著高于继发性心脏病和生理性杂音。结论：本社区儿童保健体检查体中对发现的异常体征如心脏杂音的婴幼儿及儿童进行及时专科转诊后发现先天性心脏病和继发性心脏病的比例较高,是引起心脏杂音的主要原因。社区卫生中心针对散居婴幼儿及儿童每年定期免费保健大体检可对散居儿童的生长发育和疾病筛查有重要意义和积极作用,认真做好基层医疗儿童保健工作可使散居儿童得到疾病的早发现、早治疗。     

西安地区老年慢性病患者抑郁及其影响因素

目的探讨老年人群慢性病伴发的抑郁及其相关的影响因素。方法选取2011年1月至2012年5月西安地区部分年龄大于60岁的慢性病住院患者和病情稳定的社区老年人群,应用老年抑郁量表（GDS）和已确诊的各种慢性病及相关因素进行评估与分析。结果757例老年慢性病患者中,有抑郁症状者为40例,抑郁症状的发生率为5．28％。女性、文盲、重体力劳动者抑郁症状发生率显著高于男性、小学文化程度及以上者、脑力劳动者（P〈0．05）,而不同年龄组之间抑郁症状的发生率差异无统计学意义（P〉0．05）。老年人抑郁症状发生率与慢性疾病具有一定的相关性。有慢性胃肠疾病者抑郁症状的发生率显著高于无胃肠疾病者（P〈0．05）,其余各类疾病抑郁症状的发生率差异未见统计学意义。结论西安地区老年人慢性病患者抑郁症状的发生主要与慢性胃肠疾病相关,提示应该加强该类患者的心理疏导与关怀,以预防老年抑郁症状的发生。     

上海地区20例百岁老人健康与生活状况的调查

目的调查上海地区百岁老人的健康与生活状况,为社区老年人的医疗保健工作和健康长寿研究提供依据。方法在上海市范围内的各区县随机抽取20名百岁老人,由专职医师人户对百岁老人进行体格检查和面对面问卷调查。调查内容含健康状况和生活状况两个方面,健康状况的调查包括询问所患慢性病史、性格特点和体格检查;生活状况的调查包括月收入、居住方式、烟酒、运动能力、睡眠、日常生活自理能力及饮食。结果健康状况：（1）患病情况以心血管系统疾病最多,有8人,也有6人没有明确器质性病变;（2）性格特点：以外向型（开朗、语言丰富）居多;（3）体格检查：多数人日常血压控制稳定,神志清楚,保持准确的计算能力,视力尚佳,心、肺、腹部、肢体活动如常;但听力大部分人减退。生活状况：（1）大部分百岁老人有固定收入;与子女或老伴直系亲属共同居住为多,选择养老院模式少;每天能坚持（或在他人帮助下）慢步行走至少10min;16例有午睡习惯且时间≥1h;晚上睡眠时间充足,15例≥7h。另外有3人吸烟,7人喜饮酒;（2）生活自理能力方面,大部分百岁老人能自理完成穿衣、进食、行走、大小便,少部分需在他人帮助下完成行走、大小便;大部分百岁老人在打电话（手机）方面不能自理或需他人帮助完成;（3）饮食调查,百岁老人膳食营养显示主要是低热量、高纤维素、丰富的矿物质饮食。结论本组百岁老人得以健康长寿的主要因素是居家养老,无病则防,有病早治,坚持活动,充足睡眠,合理膳食,适量运动及不吸烟、少饮酒。     

Relationship between subjective social status and measures of health in older Taiwanese persons

OBJECTIVES: To compare the association between subjective ladder ranking and health measures with the association between objective indices and health measures in older Taiwanese men and women. DESIGN: Cross-sectional study. SETTING: A population-representative sample of elderly and nearly elderly men and women in Taiwan. PARTICIPANTS: The study included 991 participants from the Social Environment and Biomarkers of Aging Study in Taiwan. MEASUREMENTS: The information collected included demographic characteristics; subjective ladder score of SES; objective measures of SES, including education, income, and occupation; health behaviors; health-related variables such as self-rated health, basic activity of daily living difficulties, instrumental activity of daily living (IADL) difficulties, and physical activity difficulties; and depression score. RESULTS: Low ladder score was associated with poorer self-rated health and more reported IADL and physical activity difficulties, even after adjustment for objective measures of SES and other covariates. The multiply adjusted odds ratio for a one-quartile difference in ladder score and worse self-rated health was 1.19 (95% confidence interval=1.06-1.33). The associations between subjective ladder ranking and health status were generally stronger in those who had 6 years or less of education than in those who received more education. CONCLUSION: A simple subjective assessment of one's ranking on the social hierarchy was associated with self-rated health and physical functional status in an older ethnic Chinese population. The associations were independent of the effects of traditional objective measures of SES, such as education, income, and occupation.     

Association of physical performance and self-rated health with multimorbidity among older adults: Results from a nationwide survey in Japan

ObjectivesTo examine the association of physical performance measures and self-rated health with multimorbidity among older Japanese adults aged ≥60 years using cross-sectional data from a nationwide longitudinal survey.MethodsUsing respondents’ self-reported data from the 2012 National Survey of the Japanese Elderly, we analyzed multimorbidity involving nine major chronic diseases (heart disease, arthralgia, hypertension, diabetes, stroke, cataract, cancer, respiratory disease, and low back pain). Respondents who reported having two or more of these diseases were identified as having multimorbidity. Multivariate logistic regression analysis was used to examine if physical performance (grip strength and walking speed) and self-rated health were independently associated with multimorbidity after adjusting for potential confounders (e.g., demographic, physiological, and lifestyle-related variables).ResultsThe responses of 2525 participants who responded to the survey by themselves (i.e., without proxies) were analyzed (response rate: 57.9%). Among the chronic diseases examined, hypertension had the highest prevalence (44.1%), followed by low back pain (25.7%) and cataract (24.7%). Approximately 44.4% of the respondents had multimorbidity. The regression analysis revealed that multimorbidity was significantly associated with both poor grip strength (P = 0.006) and self-rated health (P < 0.001), but not with walking speed (P = 0.479).ConclusionsMultimorbidity is prevalent in older Japanese adults, and poor grip strength and self-rated health were independently and significantly associated with multimorbidity. Health assessments that include these indicators may provide insight into the health status patterns of older adults with multimorbidity and inform the development of health management strategies.     

河北省燕郊社区717名老年人慢性病现况调查

目的 了解影响三河市开发区老年人健康状况的几种常见慢性病的现况，为开展社区老年卫生服务提供依据。方法 采用整群抽样方法对河北省燕郊年龄≥60岁717名老年人进行问卷调查。结果 老年人慢性病总患病率为92．1％，其中男性患病率91．2％，女性93．0％，两者差异无显著性。70．0％的老年人同时患有2种及以上慢性病。患病率位于前5位的病种依次是高血压(46．2％)、心脏病(26．9％)、骨关节炎或风湿性关节炎(21．9％)、口腔与牙病(16．2％)、颈椎病(16．0％)。文化程度、离退休前职业、医疗保障、居住状况、是否经常主动获得医疗保健知识、支付医疗保健费用有无困难是影响老年人患多种慢性病的因素。结论 慢性病是危害老年人健康的主要卫生问题，应充分考虑老年人疾病谱的特点，开展有针对性的社区卫生服务，提高老年人健康水平。     

A mortality comparison of participants and non-participants in a comprehensive health examination among elderly people living in an urban Japanese community

BACKGROUND AND AIMS: Recent studies have revealed that there are critical differences between participants and non-participants in health examinations. The aim of this study was to examine mortality differences between participants and non-participants in a comprehensive health examination for prevention of geriatric syndromes among community-dwelling elderly people, using a three-year prospective cohort study. METHODS: The study population included 854 adults aged 70 to 84 at baseline. The following items were all studied: the status of participation in the comprehensive health examination as an independent variable, age, gender, number of years of education, living alone, presence of chronic diseases, experience of falls over one year, history of hospitalization over one year, self-rated health, body mass index, instrumental activities of daily living, and subjective well-being as covariates; and all-cause mortality during a three-year follow-up as a dependent variable. RESULTS: In an adjusted Cox's proportional hazard regression model, the mortality risk for participants in the comprehensive health examination was significantly lower than that of non-participants (Risk Ratio (for participants)= 0.44, 95% confidence interval=0.24 to 0.78). CONCLUSIONS: The present study shows that there is a large mortality difference between participants and non-participants. Our findings suggest two possible interpretations: 1) There is a bias due to self-selection for participation in the trial, which was not eliminated by adjustment for the covariates in the statistical model; 2) There is an intervention effect associated with participation in the comprehensive health examination which reduces the mortality risk.     

The effect of multimorbidity on the gap between global and age-comparative self-rated health scores among the Korean elderly

Most of the behavior change models regard perceived health status as a motivation for healthy behaviors or chronic disease self-management. The aim of this study was to examine the association between the number of chronic diseases and the difference between global and age-comparative self-rated health scores (GSRH and ASRH). We used national representative survey data pertaining to the elderly in 2011 from the Korea Institute for Health and Social Affairs. In total, 10,003 participants (≥60 years old) were selected from those who had completed the survey in 2008. Multinomial logistic regression was used to estimate relative risk ratios (RRR) with 95% confidence intervals. Demographic factors, socioeconomic status, social connection, and healthy life style were adjusted. Individuals with many chronic diseases were more likely to have a positive gap, resulting in a better ASRH score relative to GSRH (p for trend <0.001): 1–2 diseases (RRR = 1.30, 95% CI = 1.07–1.57), 3–4 diseases (RRR = 1.90, 95% CI = 1.55–2.32), and ≥5 diseases (RRR = 1.75, 95% CI = 1.39–2.20). In addition, the association between the number of chronic diseases and a positive gap varied by sex and living area. Our results suggest that a positive gap between GSRH and ASRH that indicates an overestimated age-comparative health, was associated with the number of chronic diseases. Female or urban-living people had stronger associations. Further research is needed to understand how the gap between GSRH and ASRH could be an alternative measure of SRH and a predictor of major health outcomes.