养老机构老年人迁居应激综合征及影响因素的研究进展

综述养老机构老年人迁居应激综合征及影响因素的研究进展,指出目前尚未开发专门针对养老机构老年人迁居应激综合征的评估量表,今后还需在开展多机构合作研究、研制评估养老机构老年人迁居应激综合征的工具、探讨改善养老机构老年人迁居应激综合征的护理措施等方面进行深入研究。     

Sickness absence and disability pension following breast cancer – A population-based matched cohort study

PurposeTo compare sickness absence and disability pension in a population-based cohort of women with breast cancer (n = 463) from 1 year pre-diagnosis until 3 years post-diagnosis with a matched control group (n = 2310), and to investigate predictors of sickness absence during the 2nd and 3rd year post-diagnosis.ResultsFollowing breast cancer, the proportion of disease-free women with sickness absence decreased post-diagnosis (1st–3rd year; 78%-31%-19%), but did not reach the pre-diagnostic level (14%; P < 0.05). Post-diagnosis, patients were more likely than controls to be sickness absent (1st–3rd year; P < 0.001). No between-group differences were observed for disability pension post-diagnosis (P > 0.05). Among patients, chemotherapy, baseline fatigue and pre-diagnosis sick days predicted sickness absence during the 2nd, 3rd, and 2nd and 3rd year post-diagnosis, respectively (P < 0.05).ConclusionsBreast cancer is associated with increased sickness absence 3 years post-diagnosis. In a clinical setting, prevention and treatment of side effects are important in reducing long-term consequences.     

Sickness absence due to musculoskeletal diagnoses and risk of diagnosis-specific disability pension: A nationwide Swedish prospective cohort study

Musculoskeletal disorders constitute major public health problems. Few studies have, however, examined risk of disability pension among persons sickness absent due to musculoskeletal diagnoses. Thus, we constructed a prospective nationwide population–based cohort study based on Swedish registers, consisting of all 4,687,756 individuals living in Sweden December 31, 2004/2005, aged 20–64 years, who were not on disability or old-age pension. Those individuals who were sickness absent in 2005 due to musculoskeletal diagnoses were compared to those sickness absent due to non-musculoskeletal diagnoses and those with no sickness absence. Musculoskeletal diagnoses were categorized as follows: 1) artropathies/systemic connective tissue disorders, 2) dorsopathies, and 3) soft tissue disorders/osteopathies/chondropathies/other musculoskeletal disorders. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2009. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for socio-demographic factors and morbidity, sickness absence due to all categories of musculoskeletal diagnoses was associated with 12- to 18-fold increased risks of all-cause disability pension (adjusted model, category 2 diagnoses, IRR = 18.57, 95% CI = 18.18–18.97). Similar associations were observed among both women and men sickness absent due to all 3 musculoskeletal diagnostic categories. Moreover, increased risks of disability pension because of cancer, mental, circulatory and musculoskeletal diagnoses were observed among individuals sickness absent because of any musculoskeletal diagnostic category (disability pension due to musculoskeletal diagnoses, adjusted model, category 2 diagnoses, IRR = 50.66, 95% CI = 49.06–52.32). In conclusion, this nationwide cohort study reveals strongly increased risks of all-cause and diagnosis-specific disability pension among those sickness absent due to musculoskeletal diagnoses.     

Labor market position after a rejection of a disability pension application: a register-based cohort study

Abstract

Purpose: To study labor market positions of rejected disability pension applicants and to examine which characteristics predict ending up in these positions after the rejection.

Methods: Nationwide Finnish register data was used to describe employment, unemployment and disability pension trajectories of rejected applicants (n?=?5740) from four years before to four years after the rejection. Demographic, occupational and health-related determinants of labor market position after the rejection were examined among those employed and not employed at the time of the rejection.

Results: The proportion of the employed steeply decreased and that of unemployed increased before the rejection of a disability pension application. Four years after the rejection, 30% of the rejected applicants were employed, 24% were unemployed and 30% received disability pension. Employment at the time of the rejection, younger age, shorter unemployment history, public sector employment and milder work disability increased future employment. Manual work, public sector employment and previous long-term unemployment predicted future unemployment. Apart from higher age, associations with receiving disability pension were relatively weak.

Conclusions: For many rejected disability pension applicants return to work is challenging. Special efforts should be targeted to support the remaining work ability and to promote employment opportunities of the rejected applicants.

• Implications for Rehabilitation

• Employment, unemployment and receiving disability pension were equally common labor market positions four years after the rejection.

• Rejected DP applicants with unemployment history need special efforts to increase their employability.

• As a disability pension application, even if rejected, clearly indicates some degree of work ability problems, rehabilitation should be targeted at this time point to support employment.

     

1520例老年人综合健康状况调查及护理干预

目的：了解城区老年人综合健康状况,对养老方式进行护理干预.方法：采取随机抽样调查的形式,利用一般情况问卷、症状自评量表（SCL-90）、生活质量简明量表（WHOQOL-BRIEF）,对城区1600名老人（≥60岁）进行问卷调查.结果：1600调查问卷中,回收有效调查问卷1520份,影响老年人心理健康的因素依次有生活质量、躯体健康、经济状况、婚姻状况等.结论：城区老年人综合健康状况不容乐观,不仅要重视老年人躯体疾病的防治,更要重视老年人的心理健康,尤其要指导老年人了解季节性养生保健知识.     

社区老年慢性病人群“互联网+医养结合”健康管理服务的困境及对策

随着我国人口老龄化进程的加剧,老年人对医疗服务、养老服务及健康的需求也逐渐加大。随着我国互联网以及智能化产品的普及,如何将医养结合社区养老模式与互联网有机融合,推进养老和医疗服务的快速发展也成为目前亟须探讨并解决的一大问题。本文探讨了我国“互联网+医养结合”在社区老年慢性病人群健康管理中的发展现状,分析面临的机遇和挑战,并提出相应的对策。针对我国“互联网+医养结合”养老模式的现状和存在的困难,提出了应对策略,包括：继续加大政府支持力度;提高线下服务能力,实现医养结合服务的闭环;培养优秀人才;强化信息技术支持作用,建设老年友好社会;整合资源,吸引更多企业和资本进入养老行业,共同探讨和创造适合我国国情的养老服务模式。在此基础上,本文尝试构建了包含基础数据库系统、终端用户系统、服务系统、监督与评价系统等在内的全面的“互联网+医养结合”健康管理服务体系。     

我国城镇职工基本养老保险的社会可持续性研究

近年来,随着我国人口老龄化问题的日益严峻,老年抚养比逐年升高,对于养老保险制度的可持续性研究成为学术界研究的中心问题之一,但多数研究主要集中在养老保险制度的财务可持续性问题上,而缺乏对其社会可持续性问题的关注.笔者运用定性分析与定量分析相结合的研究方法建立了养老保险制度社会可持续性的评估体系,并以2013年的中国家庭收...     

国外“医养结合”养老模式的特点及其经验启示

随着我国老龄化问题的加重,传统的家庭养老模式不足以满足社会发展需要,而国外发达国家社会养老模式的经验可以为我国借鉴。文章主要通过对美国、日本、澳大利亚和德国有关"医养结合"养老模式各方面建设的介绍,指出、分析和总结了国外的特点和经验。为我国养老模式的建设提供经验启示,包括建立居家养老为主的家庭养老模式、形成政府主导和多方参与的筹资模式、建立完整的法律体系、建立相关护理保险机制以及培养专门的医护人员,从而发展形成具有中国特色的"医养结合"养老模式。     

养老机构老年人归属感、家庭关怀度与述情障碍的相关性研究

目的探讨养老机构老年人归属感、家庭关怀与述情障碍的相关性。方法采用抽样的方法,在唐山市整群抽取7所养老机构,使用一般情况调查表、养老机构老年人归属感量表、家庭关怀度量表(APGAR)和多伦多述情障碍量表(TAS-20)对符合入组标准的517位老年人进行问卷调查。结果老年人述情障碍的总分为(58.74±7.23),养老机构老年人归属感和家庭关怀度与述情障碍呈显著负相关。多元逐步回归分析显示,民族、文化程度、收入状况、睡眠质量、身体状态及老年人归属感和家庭关怀度是机构老年人述情障碍发生的影响因素。结论养老机构医护人员应当重点关注老年人归属感和家庭关怀情况,并采取有效措施提高老年人的归属感和家庭关怀,从而降低述情障碍的发生。