独居与非独居老年人居家照护未满足需求的比较研究

doi:10.3761/j.issn.0254-1769.2021.09.002

摘要/Abstract

摘要：

目的对比北京市城市社区独居与非独居老年人居家照护需求未满足状况以及服务购买意愿方面的差异,为制订有针对性的居家养老服务对策提供参考。方法于2017年2月—8月采用便利抽样的方法对北京市的5 457名居家老年人进行问卷调查,采用倾向性评分匹配的方法将独居老年人与非独居老年人进行1：1匹配后,比较两者居家照护未满足需求及服务购买意愿的差异。结果经倾向性评分匹配后,共1 072名居家老年人（独居/非独居老年人各536名）纳入比较分析,结果显示,独居老年人的躯体性日常生活照护未满足需求比例（17.4%）、工具性日常生活照护未满足需求比例（21.9%）、疾病管理未满足需求比例（42.6%）及社会支持未满足需求比例（33.2%）高于非独居老年人,差异有统计学意义（P<0.05）;愿意购买照护服务的老年人中,独居老年人在健康指导（65.5%）、上门服务（58.3%）、紧急救援（61.9%）和家政服务（63.2%）4个项目上的购买意愿比非独居老年人更为强烈（P<0.05）。结论与非独居老年人相比,独居老年人居家照护未满足需求和服务购买意愿集中于日常生活照护、疾病与健康管理、安全照护及社会支持方面。要针对独居老年人的居家照护未满足需求制订有针对性的居家照护策略,从而有效降低独居老年人居家照护的未满足需求比例,提高其健康水平和生活质量。

关键词: 独居老年人, 居家养老服务, 未满足需求, 服务购买意愿, 倾向性评分匹配, 社区保健护理

Abstract:

Objective To compare the differences in the unmet needs of home care and the purchase intention of home care services between the elderly living alone and non-living alone in urban communities in Beijing,and to provide references for the development of targeted home care service countermeasures. Methods A convenience sampling method was used to conduct a questionnaire survey of 5 457 home-based elderly people in 6 urban areas of Beijing from February to August 2017. The propensity score matching method（PSM） was used to match the elderly living alone with the elderly non-living alone at 1:1,and the differences in the unmet needs of home care and the willingness to purchase services between the 2 groups were compared. Results After PSM matching,a total of 1072 elderly people living at home（536 each living alone/not living alone）were included in the comparative analysis. The results showed that the proportion of unmet care needs of physical daily care（17.4%）,instrumental care （21.9%）,disease management （42.6%） and social support （33.2%） of the elderly living alone were higher than those of the elderly non-living alone,and the differences were statistically significant（P<0.05）. Among the elderly who are willing to purchase care services,compared with the elderly who are not living alone,the elderly living alone have a stronger willingness to purchase several items of health guidance（65.5%）,door-to-door service（61.9%）,emergency assistance（63.2%） and housekeeping service（63.2%） than those who are not living alone（P<0.05）. Conclusion Compared with the elderly non-living alone,the unmet needs of home care for the elderly living alone and their willingness to purchase services mainly focus on the aspects of daily life care,disease and health management,safety care and social support. Aiming at the unmet needs of home care for the elderly living alone,we should formulate targeted home care strategies,so as to effectively reduce the proportion of insufficient needs of home care for the elderly living alone,and improve their health level and quality of life.

Key words: Elderly People Living Alone, Home Care Services, Unmet Needs, Willingness to Purchase, Propensity Score Matching Analysis, Community Health Nursing

张继文, 范环, 肖树芹, 杨芳宇, 吴瑛. 独居与非独居老年人居家照护未满足需求的比较研究[J]. 中华护理杂志, 2021, 56(9): 1293-1298.

ZHANG Jiwen, FAN Huan, XIAO Shuqin, YANG Fangyu, WU Ying. A comparative study on the unmet needs of home care and the willingness to purchase services of the elderly living alone and non-living alone[J]. Chinese Journal of Nursing, 2021, 56(9): 1293-1298.

图/表 4

表1 倾向性评分匹配前后独居与非独居老年人一般资料比较

Table 1 Comparison of general data of the elderly living alone and non-living alone before and after propensityscore matching

表2 倾向性评分匹配后独居与非独居老年人居家照护需求比较[名（百分比,%）]

Table 2 Comparison of the care needs of the elderly living alone and non-living alone after propensity score matching[case（percent,%）]

表3 倾向性评分匹配后独居与非独居老年人居家照护未满足需求比较[名（百分率,%）]

Table 3 Comparison of unmet needs of home care for elderly people living alone and non-living alone after propensity score matching[case（percent,%）]

表4 倾向性评分匹配后有购买居家照护服务意愿的独居与非独居老年人在具体项目选择上的比较[名（百分比,%）]

Table 4 Comparison of the choice of specific programs between the elderly living alone and non-living alone who were willing to purchase home care services after propensity score matching[case（percent,%）]

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