Study On Influencing Factors Of Empowerment And Mechanism Among Nursing Home Residents

Objective1.To investigate the status of empowerment in nursing home residents.2.To analyzed the influencing factors of empowerment among nursing home residents.3.To establish the structural equation model of influencing factors of empowerment in older adults,and discuss the mechanisms among these factors.MethodsIn this study,464 older adults residing aged 60 years and above across 5 nursing home were enrolled during September 2020 to June 2021 by adopting a convenient sampling method.Data was collected with a general information questionnaire,Barthel Index(BI),the Short Health Anxiety Inventory(SHAI),the Perceived Social,Support Scale(PSSS),the Chronic Illness Resource Scale(CIRS),the Treatment Burden Questionnaire(TBQ),the Long-term Condition Empowerment Scale(LTCES).The data entry and statistical analysis were used SPSS 24.0.The empowerment level of nursing home residents with different characteristics is compared by independent sample t test or one-way ANOVA.Pearson correlation was used to analyze the correlation between each variable and empowerment.And multivariate stepwise regression analysis is used to analyze the factors affecting empowerment.Bootstrap method was used to test the mediating effect of the influencing factors of empowerment.AMOS 26.0 software was used to construct the structural equation model..Bilateral test levelα= 0.05.Results1.The total score of Long-term Condition Empowerment Scale was(156.55±9.64),and the average score of items in each dimension were as follows: life attitude(3.95±0.11),personal-control(3.37±0.42),personal decision-making(3.35±0.26),identity(3.08±0.49),knowledge and understanding(3.79±0.30),and enabling other patients(3.10±0.62).2.Univariate analysis showed that different gender,marriage status,medical insurance type,the number of chronic diseases,number of family members,the use mobile internet had statistically significant effects on social isolation among community-dwelling older adults(all P<0.05).Pearson correlation analysis showed that the score of health anxiety,perceived social support,chronic illness resource,treatment burden,long-term condition empowerment was positively correlated with the total score of long-term condition empowerment(r=0.219,P<0.01;r=0.687,P<0.01;r=0.578,P<0.01;r=0.668,P<0.01).3.Hierarchical regression analysis revealed that the number of chronic diseases,the use mobile internet were risk factors of empowerment,marriage status,perceived social support,chronic illness resource,number of family members was a protective factor(all P<0.05).4.The verified results of Structural equation model:(1)Four paths of heath anxiety to empowerment: "heath anxiety-perceived social support-empowerment","heath anxiety-perceived social support-treatment burden-empowerment","heath anxiety-chronic illness resource-empowerment","heath anxiety-chronic illness resource-treatment burden-empowerment","heath anxiety-treatment burden-empowerment",and the totally indirect affect was 0.244.(2)Two paths of perceived social support to empowerment: "perceived social support-treatment burden-empowerment","perceived social supportempowerment",the direct effect was 0.352,the indirectly affect was 0.207,and the partial mediating effect accounting for 37.03%.(3)Two paths of chronic illness resource to empowerment: "chronic illness resource-treatment burden-empowerment","chronic illness resource-empowerment",the direct effect was 0.185,the indirectly affect was0.101,and the partial mediating effect accounting for 35.31%.(4)One path of treatment burden resource to empowerment: "treatment burden resource-empowerment",the direct effect was 0.296.Conclusions1.The status of empowerment in nursing home residents was at a higher middle level and need to be improved.2.The main influencing factors of empowerment in nursing home residents are gender,marriage status,medical insurance type,the number of chronic diseases,number of family members,the use mobile internet.3.The higher the score of health anxiety,perceived social support,chronic illness resource,treatment burden,the higher the score of long-term condition empowerment.4.The influencing factors model of empowerment in nursing home residents competency highly corresponds to the health empowerment theoretical framework,which suggests that targeted interventions should be relieve health anxiety,enrich chronic disease resources,optimize treatment burden,enhance social support network to improve empowerment ability among elders.