Establishment Of Grading Prediction Model For Self-care Ability Of Disabled Elderly Based On Self-care Theory

Objective(1)To describe the status quo of self-care ability of disabled elderly people.(2)To explore the predictive factors of self-care ability classification of disabled elderly and the path relationship among them,so as to provide a basis for establishing a scientific evaluation index system of self-care ability classification of disabled elderly.Methods Based on the theory of self-care,this study adopted the General Situation Questionnaire,Physical Self-maintenance Scale(PSMS),SF-12 Quality of Life Scale(SF-12),14 Items Resilience Scale(RS-14),the Exercise of Care Agency Scale(ESCA)and the home self-care ability scale.Seven scales,Family Assessment Device(FAD)and Social Support Rating Scale(SSRS),were used to investigate the disabled elderly from physiological,psychological,social and cultural aspects.Epi Data 3.1 software was used for double entry,IBM SPSS 22.0 was used for data statistical analysis,and AMOS 24.0 software was used to construct and validate the structural equation model.Results The average score of self-care ability of disabled elderly was(103.27±14.80),and the majority of them were middle level,accounting for 806(71.45%).Univariate analysis of demographic characteristics and self-care ability of disabled elderly showed that there was no significant difference in self-care ability among disabled elderly with different gender,religious beliefs,educational level,spouse's living status and monthly income level(P > 0.05);there was difference in self-care responsibility dimension of self-care ability between disabled elderly with different spouse's living status and educational level.There was statistical significance(P < 0.05).The degree of disability of the disabled elderly was mainly partial disability(61.35%)and mild disability(19.50%).There were significant differences in the dimensions of self-care ability and self-care ability among the disabled elderly with different degrees of disability(P < 0.01).The social support level of disabled elderly was mainly medium level(90.96%) and social support score(33.75±6.47).The self-care ability and dimensions of disabled elderly with different social support levels were different,and the difference was statistically significant(P < 0.05).The correlation analysis of social support and self-care ability of disabled elderly showed that the total score of social support was positively correlated with the total score of self-care ability and self-concept,the utilization of support was positively correlated with the level of health knowledge,the subjective support was positively correlated with self-concept,and the objective support was positively correlated with the sense of self-care responsibility.About 3/4 of the disabled elderly are in the middle level of family function.The correlation analysis of family function and self-care ability shows that the total score of family function and the scores of each dimension are negatively correlated with the total score of self-care ability,self-concept,self-care skills and health knowledge level,and negatively correlated with problem solving,communication and self-care responsibility.The correlation analysis between quality of life and self-care ability of disabled elderly showed that besides MH and self-concept,the total score of quality of life and each dimension were positively correlated with the total score of self-care ability and each dimension.There were 116 cases(10.28%)of disabled elderly with high resilience.The results of correlation analysis between mental resilience and self-care ability of disabled elderly showed that there was a positive correlation between mental resilience and total score of self-care ability and each dimension.Structural equation model path analysis structure of self-care ability of disabled elderly shows that social support factors,family function factors,quality of life factors,psychological resilience factors affect self-care ability of disabled elderly through direct or indirect path.Quality of life factors and psychological resilience factors are not only intermediary variables,but also have direct effects on self-care ability of disabled elderly.Conclusion This study describes the status quo of self-care ability of disabled elderly and its influencing factors,and constructs a hierarchical prediction model of self-care ability of disabled elderly by using structural equation model.The results showed that the self-care ability of the disabled elderly was in the middle level,and high educational level,good physiological function,good quality of life and psychological resilience,high level of social support and good family function were conducive to improving the self-care ability of the disabled elderly.Social support factors,family function factors,quality of life factors,psychological resilience factors directly or indirectly affect the self-care ability of disabled elderly.To clarify the predictive factors affecting the classification of self-care ability of disabled elderly and the path relationship and influence weight among the predictive factors can provide a basis for the establishment of the grading assessment tool and the final evaluation index system for disabled elderly,lay a foundation for the establishment of a scientific grading evaluation system of self-care ability of disabled elderly,and provide high-quality and appropriate old-age care services for disabled elderly.It provides the basis for the government and institutions to classify and manage the disabled elderly,integrate the endowment resources,invest in the number of services,and grant subsidies,so as to promote the formation of social equity and mechanism of endowment service supply.