| Objective:To investigate and analyze the satisfaction and needs of commnunity-based care service and its influential factors among home-based elderlies in Shanghai Ling-yun Community, and understand feelings and expectations of care service of elderlies and their family caregivers through in-depth interviews. According to these results and literature analysis, put forward constructive care service framework in community.Methods:The research was composed of two parts.Quantitative study:1500 elderlies aged over 60 years old were interviewed in Ling-yun Community. Service Needs for Home-based Elderly in CommunityQuestionnaire was used.Qualitative study:28 elderlies and 10 family caregivers were interviewed.Results:Quantitative study:l.The elderly population of Ling-yun Community is 21,773. There is a secondary hospital and a primary hospital with seven grassroots clinics, a old service center and ten public service institutions for elderly in Ling-yun Community.2.Chronic disease prevalence was 81.8%.25%of old people was optimistic about their physical conditions, and many of them had several chronic diseases.1091 people were in family supporting, and 77 people in home-based care.611 elderlies had care needs and spiritual solace needs ranked the highest, followed by nursing visit needs and daily-life care needs. Life satisfaction of elderlies was high. Caregivers were mostly their children or spouse.3.1n the acquirement of daily-life care, meals, cleaning and laundry ranked the highest. Further demand mainly concentrated on accompanied going outside, meals and cleaning. In nursing visit, needs of blood pressure monitoring, blood glucose monitoring and medication guidance ranked the highest, and catheter care, oxygen inhalation and hospice care ranked the lowest. Blood pressure monitoring, medication guidance and health consultation had the best acquirement, but rehabilitation guidance, cardiac auscultation and drug injection had the worst acquirement. Nobody was access to oxygen inhalation, catheter care and hospice care. Communicating with family members and peers kept the best acquirement, but it still had the worst. The elderlies’satisfaction of all kinds of service was high.4.Single factor analysis results showed that culture degree, ADL, health condition, sleep condition, economic condition, age and living conditions was related to daily-life care needs(p<0.05). Culture degree, ADL, health condition, sleep condition and age was related to nursing visit needs(p<0.05). ADL and health condition was related to spiritual solace needs(p<0.05). In multiple logistic models, culture degree, ADL, health condition and age were important related factors for daily-life care needs. Health condition, ADL and sleep condition were related factors for nursing visit needs. ADL was related factor for spiritual solace needs.5.69.5% of the elderlies chose home-based care as the preferred way, but 24.6% of them chose institution endowment. The aged preferred their children or spouse as caregivers, followed by full-time carers. Requirements for quality of caregivers focused on patience, taking care for patients, nursing knowledge and so on. Requirements for quality of nurses focused on patience and professional skills.6.The elderlies accepted daily-life care cost range from 0 to 25 yuan/hour. Nearly 50% of them accepted the cost of the 5～20 yuan/hour. They accepted the spiritual solace service cost from 0 to 50 yuan/hour or above.26.2% of them accepted the free service, only 16% of them accepted the cost of 10-15 yuan/hour.Qualitative study:1. Results of interview with the elderlies:The elderlies were in favor of home-based care, but they concerned about current service. They were looking forward to improving the quality of carers, proposed four core quality:good morality, responsibility, education and basic housework skills. They also hoped additional emergency service.2. Results of interview with family caregivers:Affection is family caregivers’driving force. Caregivers concerned about management and service in pension institutions. They wished that community could train carers.Conclusion:Service needs of the elderlies in community is high, and affected by many factors; But all kinds of needs are not fully satisfied, especially nursing visit service; Home-based care is in accordance with the elderlies’will, which is favored by the elderlies; There is still a lot of to do with the present home-based care service; The elderly and their family caregivers propose the requirement of function and quality of home-based care; Propose that build up the home-based care service network center. |
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