| ObjectiveIn the context of population aging,a telecare intervention program for disabled elderly in rural areas was formulated,and the implementation effect of the telecare program for rural disabled elders was discussed,so as to provide an empirical basis for carrying out remote care for disabled elders in rural areas in China.MethodsThis research was divided into four parts:The first part was qualitative study of telecare cognitive experience of disabled elderly and caregivers in rural areas.The purpose sampling method was used to select 12 rural disabled elderly and 12 rural disabled elderly caregivers to conduct semi-structured interviews to explore the awareness and needs of telecare for rural disabled elderly and family members.Semi-structured interview method was used to collect data,and Colaizzi's seven-step analysis method was used to analyze data.The second part was the analysis of telecare intention and influencing factors of disabled elderly caregivers in rural areas.Through literature review,interview analysis and field research,the questionnaire on willingness to use rtelecare for disabled elderly in rural areas was revised based on the questionnaire on willingness to use of intelligent health management system developed by the research group in the early stage,and its internal consistency was determined through pilot.It was convenient to select 276 rural disabled elderly caregivers to conduct a questionnaire survey to understand their willingness to use telecare and analyze its influencing factors.The third part was study on the design of telecare program for disabled elderly in rural areasThrough literature review,analysis of interview results and investigation of caregivers' willingness,the telecare program for disabled elderly in rural areas was initially developed,and the implementation program for telecare for disabled elderly in rural areas was further improved and revised by Delphi expert consulting method.The fourth part was the implementation effect study of telecare program for disabled elderly in rural areas.?This part is an experimental study.Construct the telecare information platform according to the intervention plan,30 disabled elderly and their carers of 10 villages were selected,and in accordance with the village were randomly divided into control group and intervention group,the intervention group based on the telecare platform to implement telecare program,the control group conventional village doctor for rural disability elderly home care and health management.Before and after intervention,Barthel index rating scale(BI),The Medical Outcomes Study 36-item Short Form Health Survey(sf-36),The elderly physical incapacity screening Form,and The Life Space Assessment(LSA)were used to collect the data of the two groups of disabled elderly people.?This part is a qualitative study,objective to sample 5 disabled elderly and their caregivers,semi-structured interview method was used to collect data,and Colaizzi's seven-step analysis method was used to analyze data.ResultsThe first part:according to the needs and expectations of telecare of disabled elders and caregivers in rural areas,five themes were abstract:the subject's perception of the telecare,usage intention for telecare,look for rtelecare mode has a specific way(care content should be practical,care should be diversified,village doctor should be involved in the telecare,the communication should popular and easy to understand,telecare platform should be convenient,telecare can communicate at any time),they have specific expectations for telecare(tele-health education,tele-online counseling,telenursing rounds,tele-health management,and emergency online rescue).Expectations for the implementation of telecare(setting up a multidisciplinary team with special persons in charge,taking village doctors as the "link" for offline follow-up,and giving play to the role of village committees).The second part:the score of telecare intention of rural disabled elderly caregivers ranged from 68 to 163,with an average score of 115.84±17.32.The average score of items was 3.13±0.47,indicating a high willingness to use telecare.The score in relation to the elderly,children,family income,the elderly care situation,wether to use a network to get health knowledge difference was statistically significant(P<0.05),the ability of elderly people and whether to use a network to get health knowledge as the important influence factors(P<0.05).The third part:After the preliminary development of telecare intervention program for rural disabled elderly,after two rounds of Delphi expert consultation,the final construction of rtelecare intervention program for rural disabled elderly have 15 items.Including 4 modules:online consultation,tele-health management,tele-nursing rounds,tele-health education.The fourth part:?Experimental research:the baseline data of the disabled elderly in the intervention group and the control group were comparable(P>0.05).After three months intervention,the intervention group according to two independent sample t test analysis of SF-36 score and living space score higher than the control group,the weak score of intervention group was lower than the control group difference has statistical significance(P<0.05);Paired sample t test showed that the scores of SF-36 of the disabled elderly in the intervention group were improved,the scores of the disabled elderly in the intervention group were decreased,with statistically significant differences(P<0.05).?Qualitative research:four themes related to the experience of rural disabled elderly and caregivers participating in telecare were analyzed,include:improving the enthusiasm of active participation in learning health knowledge,improving anxiety and tension,improving awareness of care,and reducing the loneliness of disabled elderly.ConclusionRural disability elderly telecare intervention program can improve the quality of life of disabled elderly in rural areas,improve the weakness of the disabled elderly and improve the care ability of caregivers,for the domestic rural disability elderly long-term care to provide new care approach and measures to suggest further disability elderly in rural areastelecare. |
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