| Objectives:To investigate the current pensionservice status and weak management processes of pensionservicefor the empty nest elderly among communities in the West Lake District of Hangzhou.Furthermore,to explore the effectiveness of the Service modelof "Health and Dependence"forthe old people living alone designedby one of the Center forCommunity Health Service in the West Lake District of Hangzhou.Lastly,toprovide evidence-based pension service strategies for strengthening the standardized management processes and establishing a long-term service mechanism for the empty nest elderly in the West Lake area of Hangzhou.MethodsIn this study,one community health service center and three community health service stations(including four communities)managed by the administrative department of the West Lake District of Hangzhou were selectedfrom April 2014 to November 2015.Random sampling method was employed to recruit 200 empty nest elderly whose age was over 65.Participants were recruited into the intervention group and the control grouprespectively based on their door number,single or plural.The intervention group and the control group were set up to facility the comparison between the old people who received the designed care service program and routine care separately.During the study process,18 subjects were excluded because of death,rejection or long-term Long term hospitalization.Eventually,A total of 182 subjects were enrolled in data analysis including 89 in intervention group and 93 in control group.There are 39 male(43.8%)and female 50(56.2%)among intervention group and 40 male(43.0%)and female 53(57%)among control group.Demographic characteristics such as age,sex,monthly income,education,chronic disease condition and living condition were surveyed.The average age of all participants is 77.54±5.6.The data of mental health condition,sense of loneliness and satisfaction towards care service were measured by General Health Questionnaires(GHQ-12),UCLA scale and satisfaction questionnaire in 6th and 12th month after participants enrolled in this study respectively.T test,x2 and repeated measure statistical analysis method were used to analyze the data of the two groups at different time points.The difference was considered statistically significantly withP<0.05.ResultThere were no significant differences on the age,sex,annual income,educational attainment and living conditionsbetween the intervention group and the control group.The difference was statistically significant regarding hypertension,diabetes and other diseasesbecause of P<0.05.The physical health condition of intervention group was worse than control group.According to previous research,people with worse physical health were more likely to suffer mental disorder or diseases.Thus,it is rational to continue the intervention study.The results showed that the total scores of GHQ-12 of intervention group was less than the control group at both the 6th month and the 12th month.The p value was less than 0.05 through t test showing that the difference between the intervention and control group was statistically significant.Put it another way,the mental health status of the intervention group was better than that of the control groupindicating that the use of the "Health + Dependence" service was more effective than routine care service.The difference between the intervention group and the control group was statistically significant(P<0.05),indicating that the loneliness of the elderly in the intervention group was significantly higher than that in the control group in 6th month.Based on the prior hypothesis that the mental health of the intervention group was poorer,previous studies showed that the elderly with chronic diseases had higher sense of loneliness than those without chronic diseases.And the sense of old people's loneliness may increase with time going by gradually.What is more,the old people in intervention group felt uncertain about the long-term existence of this "Health + Dependence" service.The elderly felt more lonely during the absence of care service.Consequently,the condition of the elderly was not improved in 6th month.In the 12th month,the mean score of UCLA loneliness scale in the control group was higher than the intervention group,P =0.038<0.05,indicating that there was significant difference between the two groups.It was revealed that the elder of the intervention group was less lonely than the control group.At the same time,the frequency of this routine service was less than "Health +Dependence" service which may result in the increase of loneliness among control group.50 people were randomly sampled from two groups to completed the community service satisfaction survey after one year intervention respectively.The survey showed that 96%(48)and 64%(32)were satisfied with the performance of on-site care service from the medical staffs,and 92%(46)and 80%(40)were satisfactory for the medical staff of the Center for Community Health,and 86%(43)and 78%(39)contented with the overall evaluation of community health service centers(sites)in intervention group and control group respectively.Regarding the frequency of accepting service,44(88%)of old people from intervention group expected once a month,4(8%)expected once a week,and 2(4%)thought that once every three months,while the responses of the control group were 33(66%),13(26%)and 4(8%).ConclusionGenerally,the overall situation of care service for elder people in the West Lake District is good.The Pension Service Mode of "Health and Dependence"forthe Empty Nest Elderly(ENE)designed by one Center for Community Health Servicewas greatly superior to the traditional community health service model.The relative advantages are as follows:(1)professional team service attempting to meet the tailored needs of the elderly;(2)clear and specific goals for service providing;(3)a special funds(40,000 yuan)to support the care service program.It was demonstrated that in general,the mode of "Health + Dependence" service model was better than the conventional care service for the old people with respect to improving mental health condition,reducing the sense of loneliness and increasing satisfactions.Compared with routine care service,Pension Service Mode of "Health and Dependence" was more likely to increase the sense of satisfaction and security.This research was supervised by the experts with authority in this area,and the results was accepted and commended by relevant department of our government.It has been confirmed that the service modepractice conducted in our study was professional,specific,and operable whichwas suitable for promotingin more communities. |
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