Investigation And Study On The Cognition And Needs Of Home Environment Reform In Elderly Patients With Stroke

[Objective]Through literature research,semi-structured interviews,and expert consultation methods,a questionnaire for the cognition and needs of home environment reform in elderly stroke patients was developed.To investigate the current cognition and needs of the elderly stroke patients in the home environment,and to explore the influencing factors of the cognition and needs of the elderly patients with stroke in the home environment,causing the elderly with chronic diseases and their caregivers to improve the awareness and attention that improving the patients' home environment could greatly improve the patients' self-management ability,improve the sense of acquisition of elderly health management and reduce the care load on the caregivers.[Methods]1.Through the literature research and semi-structured interviews,the preliminary table of the cognition and needs questionnaire for the elderly patients with stroke in the home is constructed,and the formal questionnaire is determined through the consultation of delphi experts and the reliability and validity test.2.Using the method of convenient sampling,from January 2019 to February 2019,a questionnaire survey was conducted among elderly stroke patients in the third-grade hospital of NanJing,JiangSu.The questionnaire consists of the patients' general demographic data questionnaire,the elderly stroke patients'home environment transformation cognition and needs questionnaire.The data was entered and analyzed using Epi Data3.1 and SPSS22.0 statistical software.The general data,cognition and demand scores of elderly stroke patients were statistically described by means of mean,standard deviation and composition ratio.The factors affecting the cognition and demand of home environment reform in elderly stroke patients were analyzed by single factor analysis and t test,chi-square test.multiple stepwise regression analysis and Pearson correlation analysis.[Results]1.Qualitative study results of cognition and needs of home environment reform in elderly stroke patients:Elderly stroke patients have insufficient understanding of the effect of home environment transformation to promote their good living conditions;And the motivation for carrying out home environment transformation is still insufficient.Children's opinions and restrictions on the amount of renovation have become obstacles and difficulties in the transformation of the home environment;At the same time,elderly stroke patients have a high demand for basic safety facilities and green and healthy living environment.2.Expert consultation results of the questionnaire on cognition and needs of the elderly patients with stroke in the home environment:The consulting experts selected by this subject studied the authoritative degree coefficient of two rounds of expert consultants as 0.84;The effective recovery rate of the two rounds of experts' questionnaires both are 100%,and the coefficient of variation of the items is less than 0.3.After two rounds of survey experts' opinions tend to be consistent.3.The reliability and validity test results of the cognitive and needs questionnaire for the elderly patients with stroke in the home environment:The Cronbach's a coefficient of the cognitive module for the elderly patients with stroke is 0.743.the test-retest reliability is 0.870,and the content validity index is 0.89;The Cronbach's a coefficient for the elderly patients with stroke needs is 0.800.the test-retest reliability is 0.950,and the content validity index is 0.93.In this study,the correlation coefficient between cognitive items and cognitive modules in the elderly patients with stroke was between 0.430 and 0.756.The correlation coefficient between the home environment transformation needs and the total score of the demand module for elderly stroke patients was between 0.500 and 0.906.The correlation coefficient between the demand dimension of the home environment transformation and the total score of the demand module of the elderly stroke patients was between 0.779 and 0.942,which was statistically significant(P<0.001),so the questionnaire validity was good.4.Quantitative study of cognition and demand of home environment reform in elderly stroke patients:The cognitive total score of the home environment transformation of elderly stroke patients is 7 points,and the score is 4.67±1.734 points;The total of the needs score is 170 points,and the score 134.96±23.787 points.The results of univariate analysis showed that the educational level in the general situation had a statistically significant effect on the cognitive level of the elderly patients with stroke(P<0.05);The degree of education in the general data,monthly income,payment method of medical expenses and the effect of self-care ability on the demand status of elderly stroke patients were statistically significant(P<0.05).Multiple linear regression analysis showed that different monthly income status,medical expense payment method and self-care ability had statistically significant differences in the demand for home environment reform in elderly patients with stroke(P<0.05).[Conclusions]1.This study shows that elderly stroke patients lack correct understanding of the effects of home environment transformation and living conditions,and also require scientific guidance from professionals,family support,and the government attention.2.This study shows that the main factor affecting the perception of home environment reform in elderly stroke patients is the degree of education;The main factors affecting the needs of home environment reform for elderly stroke patients are monthly income status,medical expense payment methods,and the self-care ability.3.This study shows that there are fewer elderly stroke patients who will go to the home environment after discharge,but elderly stroke patients have special requirements for the home environment.The characteristics of home environment transformation must fully consider the physical function of elderly stroke patients and the psychological needs.It is necessary to organize and carry out research work on the renovation of home environment for the elderly with chronic diseases,make full use of Internet-based information technology,lay the foundation for popularizing and promoting the characteristic design of the elderly home environment transformation,and at the same time the government must subsidize the policy provisions and implementation of funds so that the home environment reform could accepted by every household.