Study On Care Need And System Of Quality Evaluation For Disabled Elderly

ObjectiveBased on the care needs of disabled elderly in different dysfunction, we establish the grading care standard preliminary, which helps to meet health requirements, improve quality of life and provide more high quality care service. Besides, we explore the care service quality evaluation index, to develop content of care quality evaluation, make long-term care service system for disabled elderly more perfect, and improve the quality of care.MethodsThe methods of this study included literature reviewing, questionnaire investigation and Delphi method. Using convenience sampling method, we conducted one survey to 500 disabled elderly from two community health service institutions and one elderly home in Beijing. Another questionnaire survey was conducted to 25 nursing specialists from 5 hospitals and 2 elderly homes in Beijing. Based on the analysis of care needs of disabled elderly in different dysfunction, combining ADL instrument, we established the grading care standard preliminary. After collecting and analyzing the valid questionnaires of two rounds of Delphi method, we tentatively set the quality evaluation index of care service for disabled elderly.Results1. The need rate of meal preparation is 100% for different degree of disabled elderly, and the need rate of morning care, hour of sleep care, shampooing hair, perineal care is above 80%. With the dysfunction aggravating in disabled elderly, the need rate of bath in bed, getting dressed or undressed, replacing lying position, urinary incontinence care, feeding and watering, indwelling catheter care and nasogastric care increases gradually.2. There was significant difference between service requirements (P<0.05) in addition to the meal preparation for disabled elderly in different dysfunction.3. There was significant difference of time needs between morning care, hour of sleep care, shampooing hair, bath in bed, bathing, perineal care, getting dressed or undressed, assisting to stand, accompanying, replacing lying position, assisting in the bathroom, urinary incontinence care and nasogastric care (P<0.05) for disabled elderly in different dysfunction.4. There was significant difference between time needs of daily life service, catering service and care service for disabled elderly in different dysfunction (P<0.05). Compared between two groups, there was significant difference of time needs in every group (P<0.05) in addition to extremely mild and mild dysfunction disabled elderly.5. According to calculating the weight, the importance of each quality of three level indicator elements is about one-third.6. Care personnel quality, special nursing skill and nursing safety have the highest weight in elements, link and terminal quality.7. Through two rounds of Delphi methods, we initially identified content of quality evaluation for disabled elderly care. It includes 3 first level indicators,14 second level indicators and 80 third level indicators.Conclusion1. According to the degree of dysfunction in disabled elderly and care needs, the grading care standard can be established preliminary, so as to provide corresponding levels of care services, help to meet health requirements and improve quality of life.2. The specialists’activity, authority and concentration of their opinions are quite high. The content of quality evaluation for disabled elderly care provides a basis for improvement in life quality and development of long-term care service for disabled elderly.