北京市农村地区老年人长期护理的需求现状及相关因素研究

目的 了解北京农村地区老年人长期护理现状和未来选择意愿及相关因素,为政府完善有关老年人长期关爱和照顾政策提供参考.方法 2012年12月至2013年1月,采用现况调查的方法,以北京农村地区1022名60岁以上老年人为调查对象,问卷调查其人口学信息、健康状况、长期护理现状和未来长期护理模式的选择意愿;采用Х^2检验和多元非条件Logistic回归,分析调查对象未来选择不同长期护理模式的相关因素.结果 调查显示有6.00％（59/1016）的老人目前需要长期护理,有82.86％（841/1013）的老人今后会选择家庭长期护理模式,有7.68％（78/1013）的老年人选择社区长期护理模式.单因素分析发现,影响老年人选择家庭长期护理的因素有文化程度、职业、月人均收入、居住情况、同住子女数量、医疗保险、养老保险、慢性病患病情况、听力、味觉和触觉自我评价（Х^2=33.03、136.17、99.32、88.83、58.07、147.71、108.11、9.85、33.78、30.45、22.22,P＜0.05）.多因素分析发现影响老年人选择家庭长期护理的相关因素是职业、月人均收入、与配偶居住情况、参加新农合以及对视力状况的自我评价,OR值（95％CI）分别为：2.48 （1.21～5.10）,0.82（0.71～0.95）,1.64（1.08～2.49）,4.78（2.93～7.82）,0.72（0.59～0.89）.结论 以家庭为基础的综合性长期护理和健康管理体系建设,是北京市农村老年人未来重要的选择和需求方向.

Long-term care needs and its influencing factors among elderly people living in rural areas of Beijing

Objective To understand current status and influencing factors of long-term care for elderly people who lived in rural areas of Beijing.Methods A total of 1022 elderly people （age〉60 years old） were enrolled in this cross-sectional study during December,2012 and January,2013.Demographic information,health status and needs of and intent to long-term care were learned through a questionaire survey.Chi-square test and muhiple non-conditional logistic regression analysis were used to identify the factors that were related to the respondents＇ selection.Results Nearly 6.6% （61/1016） participants showed needs for long-term care.82.3% （841/1013） respondents preferred household-based long-term care,while 7.53% （77/1013） preferred community-based long-term care.In single factor analysis,education level,occupation,household income,living conditions,number of children living together,medical insurance,pension insurance,chronic diseases and self-report hearing ability,taste and touch were related with longterm care needs （Х^2values were 33.03,136.17,99.32,88.83,58.07,147.71,108.11,9.85,33.78,30.45 and 22.22,respectively; all P〈0.05）.Multivariate analysis showed that occupation,income per capita,spouses living conditions,new corporative medical systems and self-report visual status were correlated with household-based long-term care （odds ratio （OR） were 2.48 （95% confidence interval （CI） 1.21-5.10）,0.82（0.71-0.95）,1.64 （1.08-2.49）,4.78 （2.93-7.82） and 0.72 （0.59-0.89）,respectively）.Conclusion Householdbased long-term care and health management system may be needed and chosen by the elderly living in rural areas of Beijing.