| The aged population is a major issue faced by all countries in the world.China is the country with the largest population in the world at present.Due to the increase of age,the decline of physiological function and the continuous improvement of health management awareness,the elderly's demand for health care and pension services is increasing.For a long time China's two systems of health care and pension care run independently,and the phenomenon of separation of “medicine” and “pension care” is serious.And the elderly's needs for health care services are difficult to obtain adequate attention.It is necessary to build the patterns of integration of medical and pension care to meet the elderly's needs of the medicine,pension,rehabilitation and care.The domestic research on the elderly integration of medical and pension care is inadequate,and lacks assessment tools,so the purpose of this study was to develop a questionnaire under the guidance of integration of medical and pension care,which involves the integration of medical,pension,rehabilitative and nursing integrated services for the elderly.In addition,the demand of the elderly was investigated so as to classify the needs of the elderly and accurately to grasp the demands for personalized service,which may help the service providers provide the targeted services for the aged.Part ?THE DEVELOPMENT OF NEEDS QUESTIONNAIRE OF THE INTEGRATED SERVICES FOR MEDICINE,PENSION,REHABILITATION AND CARE OF COMMUNITY ELDERLYObjectiveThe purpose of the research was to determine the content of elderly's medicine,pension,rehabilitation and care service needs,draw up the questionnaire of the integrated services for medicine,pension,rehabilitation and care of community elderly,test its reliability and validity,and to provide tools for the evaluation of the needs of the community elderly.Method1.Literature research: Data of the elderly's medicine,pension,rehabilitation and care service needs were obtained from Pub Med,CNKI,Wan Fang and VIP database to establish service demand items.2.Qualitative interviews: 12 medical staff and old people selected from the Cai Yuan street community of Taishan District of Tai'an were interviewed from February to March 2017 to learn the elderly's needs of medicine,pension,rehabilitation and care from different angles,with the contents summed up.3.Expert consultation: After the first draft of questionnaire was formed,the content validity of the questionnaires were evaluated by 16 experts in two rounds.4.The reliability and validity test: The questionnaire was used to investigate 102 elderly people in three communities in Tai'an of the elderly's needs of medicine,pension,rehabilitation and care.Content validity index and structural validity were evaluated,and the reliability of the questionnaire was evaluated by Cronbach,s alpha coefficient and half reliability.Result1.The items and dimensions of the questionnaire of the integrated services for medicine,pension,rehabilitation and care of community elderly are included of 51 items and 7 dimensions.All the items were scored by four-level scoring system,such as "very unnecessary"(1points),"no need"(2 points),"need"(3 points),"very need"(4 points).The scoring range is 51~204 points,the higher the score is,the higher the demand for the elderly is.2.The validity and reliability of the questionnaire(1)ValidityContent validity: item level content validity(0.875~1),content validity of the concordance scale was 0.83,and the content validity of the average scale was 0.98.Structure validity: exploratory factor analysis showed that the load factor was above 0.3,so 7 final common factors were extracted respectively,including the community public health service and general services,health education,pension services,rehabilitation services,family beds,service charges.They explain the total variance was 63.078%.(2)ReliabilityInternal consistency reliability: the Cronbach's alpha coefficient of the total questionnaire was 0.919,and the Cronbach's alpha coefficients of each dimension were 0.617,0.707,0.808,0.661,0.672,0.615 and 0.618,respectively.The split half reliability of the total questionnaire split half reliability was 0.865.The questionnaire has good reliability and validity.ConclusionThe questionnaire consists of 51 items and 7 dimensions.It has good validity and reliability,and may be used to evaluate the level of service demand for the elderly.Part ?THE PRELIMINARY APPLICATION OF THE NEEDS QUESTIONNAIRE OF THE INTEGRATED SERVICES FOR MEDICINE,PENSION,REHABILITATION AND CARE OF COMMUNITY ELDERLYObjectiveThe aim of the questionnaire survey was to describe the status and influencing factors of the integrated service needs of medicine,pension,rehabilitation and care of the community elderly.MethodA questionnaire survey was conducted among 310 elderly people from three communities in Tai'an and the questionnaire of the integrated services needs for medicine,pension,rehabilitation and care of community elderly,to describe the current situation of the community elderly and analyze the influencing factors.Result1.The status quo of the integrated services needs for medicine,pension,rehabilitation and care of community elderlyThe highest score of 310 participants was 188 points,the lowest was 120,average was(159.46±10.11),and the average needs for the project was(3.13±0.20).The moderate needs of the elderly accounted for 73.54%,and the height needs of the elderly accounted for 10%;the scores in the rehabilitation service needs was the highest(3.33 ±0.31),followed by family sickbed needs(3.20±0.29),while the lowest was service charge(2.90±0.37).2.The influencing factors of the integrated services on medicine,pension,rehabilitation and care for community elderly(1)Single factor analysis of variance showed that age,education level,occupation,self-rated health status,whether feeling sick in the first two weeks before investigation,and whether there existing chronic diseases diagnosed by doctors in the first half year,quantity of chronic diseases,frequency of hospitalization one year prior to a survey,types of medication,and major care-providers were of statistical significance.(2)Multiple regression analysis showed that age,education level,self-rated health status and number of chronic diseases fell into multiple regression equation(P< 0.05).Therefore,age,education level,self-rated health status and number of chronic diseases are the influencing factors of the integrated services needs on medicine,pension,rehabilitation and care for community elderly.Conclusion1.The needs of the elderly are of moderate level or above(83.54%).Among all dimensions,the sequence is as follows: rehabilitation services>family services>public health services>health education>general services>pension services>toll services.2.The influencing factors of the integrated services needs for medicine,pension,rehabilitation and care of community elderly include age,education level,self-rated health status and number of chronic diseases. |
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