| Objective：To obtain the status of the service and management in the nursing homes ofXi’an,including facilities,staffing, service conditions,quality of nursing assistants staff andmanagement. To obtain the current situation of the quality of life for the elderly and toexplore the correlation between the quality of life and level of service in the nursinghomes of Xi’an.Methods:1. The cross-sectional study of the service and management in the nursing homes27nursing homes were selected by random cluster sampling and investigated byself-designed status questionnaire to evaluate the status of software and hardware in thenursing homes.By clustering sampling,we selected the administrative staff,doctors,nurses,care givers in the27nursing homes.When they agreed to participate in inour study,258workers were randomly selected and investigated by self-designed staffquestionnaire to grasp demo-social characteristics and professional training situation. Data was analyzed by SPSS13.0, methods including descriptive analysis,t-test,Analysis ofVariance(ANOVA) and Chi-square test.2. Correlation research on elderly people’s life quality and level of service andmanagement in the nursing homes:A total of561elderly people during the27nursing homes were selected by stratifiedrandomly sampling investigation. Questionnaires included the36-Item Short-Form HealthSurvey(SF-36), self-designed questionnaire for elderly. Data was analyzed by SPSS13.0,and descriptive analysis,t-test, ANOVA,multiple liner regression analysis methods wereused to describe the status of elderly people’s life quality and to analysis the correlationbetween the quality of life and level of service and management in the nursing homes.Results:1. Status of the service and management in the nursing homes of Xi’anMostly nursing homes in Xi’an were small or medium-scale,74.0%were less than200beds;the average occupancy rate was50.5%;Fee was reasonable but lack of uniformstandard charges; Service environments in the majority of nursing homes can meet therequirements; function positioning in the nursing homes was not clear,various elderly weremixed inhabited;nursing homes provide daily care for elderly,but lack of phychologicalcare、cultural and recreational activities、physical exercise and health education; staffingratio lack of nursing assistants, nursing assistants and the elderly ratio of about1:7.0;nursing homes lacking various types of professionals, such as the rehabilitation division,psychologists, legal counselors and social workers were all less than1%; majority ofnursing staffing were with lower educational level,77.0%of primary education,84.2%NoTitle,8.3%was practitioners,90.8%were temporary appointment;50%of managers aretertiary qualifications, non-management major.85.2%of the nursing home had a separatemedical room,74.1%had doctors,59.3%had nurses, able to provide basic health careservices;70%of the nursing home services was not included in the basic medicalinsurance; Xi’an nursing home staff training situation was not optimistic, especially poorin the training of nursing assistants, more than75%of the nursing staff had not received formal training in the past five years. Management personnel, medical staff, nursingassistant member that required professional trainers accounted for91.3%,91.9%,79.6%.Nursing assistants’ most in need of training were life care technical knowledge, nursingsafety knowledge, elderly special care, nutrition knowledge, psychological care.2. Correlation between the quality of life and level of service in the nursing homes ofXi’anThe elderly’s quality of life score of49.20～145.40(average114.64±18.48).Thegrade distribution that fell on good，moderate，and poor levels were53.2%,44.3%,2.5%respectively. The quality of life among this sample population remains at a middle andover level.After data analysis with univariate, about26factors affecting the quality of life of theelderly, they were: gender, monthly income, social insurance, the prevalence of chronicdiseases, whether suffering from chronic diseases, satisfaction with the organization, thenursing home size and occupancy rate,nursing home whether had doctors, nurses,qualified nusing assitants, nutritionists, rehabilitation teachers, psychologists, legalconsultants, job classification for nursing assistants, nursing training,and nursing homeswere with or without medical room, whether medicare, with or without health records,whether psychological care, rehabilitation care, organizing recreational activities,organizing social activities, legal counseling and hospice care.Multiple regression analysis were done by using quality of life as dependent variable,statistical significance factors in the univariate analysis as independent variable.At last,7factors had statistical significance:medical room, qualified nursing assistants, jobclassification for nursing assistants, phychological care, rehabilitation care, recreationalactivities, hospice care service were the main factors that contributed to the quality of lifeamong elderly in nursing homes.Conclusion:1. The service and management in the nursing homes of Xi’an meeted the basic needsof the elderly, even though, there were many problems that need to solve.They were shortage of beds, functional orientation is not clear, inadequate health services, lack ofprofessional staff, too single and too simple service,insufficient number of nursingassistants member, the low level of professional old-age care.2. Most staff believed they need to be trained, the staff of different types had differenttraining needs.Nursing assistants’ most in need of training were life care technicalknowledge, nursing safety knowledge, elderly special care, nutrition knowledge,psychological care.3. The quality of life among this sample population remains at a middle and overlevel.4. Medical room, qualified nursing assistants, job classification for nursing assistants,phychological care, rehabilitation care, recreational activities, hospice care service werethe main factors that contributed to the quality of life among elderly in nursing homes. |
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