Abstract:

Objective To compare the differences in unmet Activities of Daily Living（ADL） needs between disabled elderly people living in nursing homes and in families.Methods A total of 258 disabled elderly people from 11 nursing homes and 303 disabled elderly people from 15 communities in Nanjing were recruited. Barthel Index（BI） and Functional Activities Questionnaire（FAQ） were used to screen disabled elderly people from nursing homes and families. Disabled elderly people were then investigated in terms of their unmet ADL needs. Propensity score matching was used to balance the general information of disabled elderly people living in nursing homes and families after using demographic questionnaire,and differences in unmet ADL needs between two groups were explored. Results The total quantity of unmet ADL needs and the quantity of unmet Instrumental Activities of Daily Living（IADL） needs for disabled elderly people in families were significantly less than those in nursing homes（P<0.05）. Significant differences were identified in dressing,toileting,ambulating,walking up and down stairs,financial management,doing housework and cooking（P<0.05）.Conclusion Living in families is superior to living in nursing homes in satisfying ADL needs,nursing homes should take more efficient actions to improve their services.

Key words: Nursing Homes, Family, Disabled Elderly People, Activities of Daily Living, Unmet Need, Propensity Score Matching, Geriatric Nursing

摘要：

目的 对比养老机构与居家失能老年人日常生活活动需求未满足状况的差异,为失能老年人选择适合自己的养老模式提供参考。方法 便利抽取南京市11所养老机构的258名失能老年人与15个社区的303名居家失能老年人,使用Barthel指数和功能活动问卷对其进行失能鉴定。使用一般资料调查表和未满足需求评估表对失能老年人进行调查,采用倾向值匹配法平衡养老机构与居家失能老年人的一般资料后,分析两者日常生活活动需求未满足状况的差异。结果 居家失能老年人总的日常生活活动需求未满足数量与工具性日常生活活动需求未满足数量均少于养老机构失能老年人,差异具有统计学意义（P<0.05）;养老机构与居家失能老年人在穿衣、如厕、平地行走、上下楼梯、平衡收支、琐事、做饭等方面需求未满足率的差异具有统计学意义（P<0.05）。结论 居家养老模式在满足失能老年人日常生活活动需求方面更具优势,养老机构应采取有效措施改善自身服务水平。

关键词: 医护疗养所, 居家, 失能老年人, 日常生活活动, 未满足需求, 倾向值匹配, 老年护理学