| Objective:This study integrated the community organization theory and health management science to construct the “SMG” health management model,which is suitable for empty-nest elderly.We took the empty-nest elderly in Shanxi province as the study population to study the health management characteristics and influencing factors for empty-nest elderly,and to evaluate the effect of the application of health management model.This study aimed to provide an innovative method to deal with the problems of “aging” and “empty nest” in the society,and to provide the basis for improving the quality of life for the empty-nest elderly and updating the health service model for the grassroots.Methods:This study selected 4901 empty-nest elderly from 11 cities in Shanxi Province as the study subjects using multistage random cluster sampling method.We employed the HPLP-C,SF-36,and SSRS scales as the research instruments.The descriptive analysis was used to analyze the general demographic characteristics of the empty-nest elderly.Independent samples t-test and variance analysis were used for the comparison of the scores from each scale by various general demographic characteristics among the empty-nest elderly.The influence factors were explored by multiple stepwise regression models.This study also selected 396 empty-nest elderly from 3 communities in Taiyuan City as the intervention study subjects using stratified random cluster sampling method.The intervention study subjects were divided into intervention group and control group.After the implementation of a seven-month “SMG” health management,the effectiveness of the model application was evaluated.The difference of demographic characteristics between intervention group and control group was compared by Chi-square test.Independent samples t-test was employed to compare the scores of each scale between the intervention group and the control group.Paired samples t-test was used to compare the scored of each scale before and after intervention.The system of health information collection for empty-nest elderly is based on the platform of Windows 2008 Server,used B/S structure and PHP language,and employed the MySQL database to complete the design and implementation of relevant functions and module.Results:The results of demographic characteristics and influencing factors analyses showed that the study population was aged 60 to 70 years old.The number of males(2546)and females(2355)was similar.More empty-nest elderly were living in rural areas than that in urban areas.Most empty-nest elderly were living with their spouses.In addition,75.54% of the participants were relatively empty nest.The total score of health promotion lifestyle of the study population was 105.29 ± 19.68,which was at a moderate level.For the average score of each scale,the nutrition score(2.84)was the highest,and the health responsibility score(2.21)was the lowest.Except for gender(P=0.955),empty nest(P=0.539),current employment(P=0.483),and frequency of alcohol consumption(P=0.107),the scores of health promotion lifestyle among the empty-nest elderly were statistically significantly different for other demographic characteristics(P<0.001).Multivariate regression analysis showed that 12 factors,including participation of social activities,community satisfaction,and education level,were the main influencing factors of healthy lifestyle for the empty-nest elderly.In terms of quality of life,the scale scores of SF-36 among our study population were statistically significantly different from those of the national population aged 65 and above(P<0.001),with exception of body pain(BP)(P=0.311).Except for empty nest(PCS P=0.238,MCS P=0.089)and smoking status(PCS P=0.091,MCS P=0.241),the scores of quality of life among the empty-nest elderly were statistically significantly different for other demographic characteristics(P<0.001).Multivariate regression analysis showed that 16 factors,including self-care,chronic diseases,and age,were the main influencing factors of physical component summary(PCS)for quality of life of the empty-nest elderly.On the other hand,a total of 14 factors,including self-care,monthly income,and regularity of three meals per day,were the main influencing factors of mental component summary(MCS)for quality of life of the empty-nest elderly.The scores of each scale for social support among the study population were statistically significantly different as compared to the national normal population.In addition,the scale score of objective support was lower than the national norm,while the scale score of subjective support,scale score of support utilization,and total score are higher than the norm.When we compared the social support of the empty-nest elderly by different demographic characteristics,the scores of social support requirement scale(SSRS)were statistically significantly different for various demographic characteristics(P<0.05),with exception of gender(P=0.703)and current employment(P=0.429).Multivariate regression analysis showed that 11 factors,including widowed,relationship between husband and wife,and relationship with children,were the main influencing factors of social support for the empty nest elderly.The results of model evaluation demonstrated that there was no statistically significantly difference in gender,age,education level,marital status,living pattern,empty nest,monthly income,social activities participation,self-care,and chronic diseases between intervention groups and control groups in the Yingze District,the Jiancaoping District,and the Jinyuan District(P>0.05).The participants were homogeneous between intervention groups and control groups.The health promotion of lifestyle had improved among the empty nest elderly in the Yingze District,the Jiancaoping District,and the Jinyuan District after the implementation of health management.The changes in the total score of health promotion of lifestyle,score of health responsibility scale,and score of interpersonal support were the most obvious.The changes in score of self-actualization scale and score of stress management scale were small,and some results of nutrition and physical activity were not statistically significantly different.The quality of life had also improved among the empty-nest elderly in the Yingze District,the Jiancaoping District,and the Jinyuan District after the implementation of health management.Among the scales of SF-36,the changes in MCS,RE,VT,SF,and MH were the most obvious,the changes in GH and BP were small,and the changes in PF,RP and PCS were not statistically significant.Moreover,the social support had improved among the empty-nest elderly in the Yingze District,the Jiancaoping District,and the Jinyuan District after the implementation of health management.For each scale of the SSRS,the changes in the total score,objective support,and support utilization were the most obvious,and some results of the subjective support were not statistically significant.Conclusions:This study selected the empty-nest elderly as the study population.We have explored the health characteristics and risk factors and screened out the essential aspects of the implementation of health management among the empty-nest elderly through the analysis of characteristics and influencing factors.Based on these findings,we have introduced the community organization theory into the health management,and built an integration of self-management,mutual management,group management,that is the “SMG” health management model.The findings of this study proved the applicability of community organization theory in health management and the effectiveness of model intervention plan through the intervention study.The “SMG” health management model can effectively improve the health status of the empty-nest elderly through the system of intelligent health information collection for the empty-nest elderly,which was independently researched and developed.The study findings provide an effective method to deal with the problem of “aging” and “empty nest” in China,and have certain scientific value and practical significance. |
PDF Full Text Request