Investigation And Analysis Of Long-term Care Needs Of Disable Elderly People

Objective:1.Compile a questionnaire on long-term care needs of elderly with living disability is useful for the government to formulate long-term care policies and measures for the disabled elderly at home.2.This research aims to form such schedule of survey and collect the relevant data by investigating the long-term care needs of incapacitated elderly in Kunshan City,accessing the living status of disabled community,and by analyzing the related influencing factors of the choice of future places for the elderly.Methods:Qualitative researchAccording to the interview catalogue,we respectively interview some relevant personnel,including home disabilities(9 people),caregivers(9 people),managements of medical institutions(6 people)about the long-term nursing needs and related knowledge(the interview guide can be found in the appendix).According to the results of the interview data we extract theme on these three kinds of people in long-term care needs,which helps to provide elementary dates for the preparation of questionnaire.Forming questionnaireFirstly,we sort out the preliminary direction of the nursing needs investigation by using the dates above.Secondly,according to the content of the interviews,we review the relevant literatures of a large number of long-term care needs surveys at home and abroad,understand the latest research progress of relevant master data.Then we initially screen out the relevant items of the main data.The basic item pool is determined after repeatedly analyzes of summarizes,organizes and merges made by research group.Researches conducted the first round of expert consultation to form the "Pre-survey Form for Long-Term Care Needs for the Disabled Elderly at Home".Informed consents,investigator's manuals and so on were also included.Guided by the table of "Suzhou Long-term Care Insurance Disability Rating Assessment Parameter",40 pre-investigators from disabled families in a community in Kunshan City were selected.Based on the pre-survey 1 data,the expert group conducted a second round of expert consultation to improve and revise the pre-survey.During the two rounds of expert consultation,all dimensions and items were screened by the boundary value method.Carry out pre-survey 2.Combining the above steps,the form of the "Long-term Care Needs Survey for the Disabled Elderly at Home" was finally formed.Research object and sampling methodThe study objects were the elderly disabled in Kunshan City.They were randomly selected from 4 city management films,3 development zones,8 communities in 2 towns or homeless families.Regional samples Covered all administrative districts of Kunshan City by stratified sampling.Cross-sectional surveyCommunity health service center technicians were selected as investigators.They carried out surveys of long-term care needs of elderly disabled families in Kunshan City from June 22 to July 22,2018.Under the guidance of "Suzhou Long-term Care Insurance Disability Rating Assessment Parameter Table".1020 elderly people's disability level was assessed,1011 of them were evaluated as mild or above disability level.1011 questionnaires were granted,1011 questionnaires were collected,the recovery rate was 100%,and 1000 were valid questionnaires,the effective rate was 98.91%.5.Data analysisStatistical analysis of data was calculated by SPSS 23.0 statistical software.Results:Disability levelThis study evaluated 1000 elderly people with disability in Kunshan who had mild or above disability grades,mainly with mild disability,a total of 872(87.2%),and a moderate grade of 81(8.1%),and 47 people(4.7%)with severe disability.Pension surveySurvey suggests that 907 people(90.7%)were willing to choose home for retirement place during their old ages in the future;636 people(63.6%)want to be taken care of by their families;736 people(73.6%)can afford to pay less than 1000 yuan per month;430 people(43.0%)were willing to be provided life care by the community health service center;672 people(67.2%)indicated that they could not accept paid care services,365 people of them(36.5%)believe that poor economic is the main reason.661 persons(66.1%)were very satisfied or satisfied with the current state of life;684 people(68.4%)were very satisfied or satisfied with the elderly care services provided by the comnunity,such as free meals,haircuts and house cleaning.The greatest difficulties encountered by 365 home-based people(36.5%)was acute illness or aggravation.Life care needs survey people(10.8%)),excretion care(107 people(10.7%)),diet care(50 people(5.0%))are considered items that are needed or are in great need?Medical care needs surveyChronic disease care(64Travel care(341 people(34.1%)),cleaning care(131 people(13.1%)),daily care(1088 people(64.8%)),knowledge of disease prevention(606 people(60.6%)),Chinese medicine care(255 people(25.5%)),long-term bed care(153 people(15.3%)),rehabilitation care,professional medical care(88 people(8.8%))are considered as very needed or needed care items.Psychological nursing needs surveyPsychological counseling(549 people(54.9%))and identity skills training(387 people(38.7%))are considered to be needed or very needed.While 434(43.4%)people think that hospice care is very necessary or necessary.Necessity and training contents of nursing skills training for carers575 people(57.5%)believe that caregivers are "very necessary" or "necessary" to be trained nursing skills,such as medication guidance(812 people(81.2%)),life care(876 people(87.6%)),diet care(732 people(73.2%)),long-term bed rest care(476 people(47.6%)),related disease health education(450 people(45.0%)),accident response skills(329 people(32.9%)).Analysis of factors influencing the choice of future places for the elderlySeven factors including statistically significant disability grade,education level,medical expenses payment method,monthly income,number of children,caregivers and life satisfaction were included in the disordered multi-class logistic regression analysis.Reference to the choice of medical institutions for the elderly.The result shows factors such as participating in medical insurance,having 2 or more children,life satisfaction as satisfaction or general,made the aged disability to increase the possibility of home-based care for the aged in the future(OR>1.0,P<0.05);Factors such as having one or more children,life satisfaction as satisfaction,made the aged disability to increase the possibility of the nursing home for the aged in the future(OR>1.0,P<0.05).Factors such as the caregiver being their wife or children make the elderly at home less likely to choose home care in the future(OR<1.0,P<0.05);Factors such as the caregiver being their wife or children make the elderly at home less likely to choose the nursing home in the future(OR<1.0,P<0.05).Conclusion:The number of potential middle-aged and severely disabled elderly people is huge in the future,and their long-term care needs should be highly valued by the state.The long-term care needs of elderly disabled families are huges including life care needs,medical care needs,and psychological care needs.The caregiver is mainly one immediate family member.Home disabled elderly people are most willing to choose relatives to provide care for themselves,at the same time,they are also willing to choose their home as the place for old age.Which indicates that the current and future long-term care of the elderly disabled will mainly be committed by The family.Combining various factors,the country must attach great importance to the construction of the old-age health service system,accelerate the study of policies and systems related to long-term care,and provide high-quality life for the disabled elderly under the strong support of the long-term care insurance system,and help to solve practical problems for the families of the elderly.