Study On The Ability Assessment Of The Elderly And The Construction Of Care Service Index In Pension Institution In Chengdu

Objective1.The ability level assement of the elderly in pension institutions aims to understand the current status of the elderly ability levels and analyze its influencing factors,so as to provide empirical data for the construction of care service index in pension institutions.2.Conduct qualitative interviews with elderly of different ability levels in pension institutions,aiming to understand the commonalities and differences in the care needs of elderly with different ability levels.And guided by the actual needs of care recipients,it provides a factual basis for scientifically conustructing care service index for pension institutions.3.Based on the results of ability level assement and qualitative interviews,combined with the analysis of the literature,the expert Delphi method is used to construct the elderly care service index in pension institutions,and define the dimensions of the elderly care services,as well as the specific care items and connotations in each dimension.Thus,provide reference for pension institutions develop care services,and government purchases and subsidies care services.Methods1.355 elderly people from 7 pension institutions in Chengdu were selected for questionnaire survey with a convenient sampling method.The survey tools are Survey Table of Basic Information for the Elderly in Chengdu's Pension Institutions and Comprehensive Evaluation Form for the Health and Function of the Elderly in Chengdu's Pension Institutions.The content of the survey is the basic information of the elderly,health-related information,and the status of ability assessment.2.Based on the literature review and expert discussions,the outline of semi-structured interviews was drawn up.Following the principles of maximum differentiation and information saturation in qualitative research,semi-structured interviews were conducted with 12 elderly people.3.On the basis of literature analysis,questionnaire survey and interviews with people,a pool of expert consultation questionnaire items was constructed,and an expert consultation questionnaire on care service indexes for pension institutions was initially formed.Two rounds of Delphi questionnaire consultation were conducted for 15 experts.4.Use Excel2010 to double-enter data,and use SPSS23.0 to statistically analyze the data.Choose the appropriate statistical method according to the type of data,as follows:(1)If the basic data of the research object is measurement data,use the mean ± standard deviation to describe,if it is counting data,use the frequency and composition ratio describe.(2)Use chi-square test to analyze the distribution of the ability level of the elderly in Chengdu pension institutions.(3)Use rank-sum test(Mann-Whitney U test for two groups,KW/H test for multiple groups)),ordered multi-class logistic regression analysis to explore the influencing factors of the ability level of the elderly in Chengdu pension institutions.(4)Use the mean of importance,standard deviation,and coefficient of variation to process the consultation results of the elderly care service indexes for the pension institutions,and the mean value of importance <4 or coefficient of variation> 0.3 is used as the index screening standard.In this study,P<0.05 was considered statistically significant.Results1.The average age of the 355 elderly surveyed in pension institutions was(82.87±8.41)years old,mainly concentrated in the age group of 80-89 years old,90 years old and above.79.77% of the elderly have no spouses.The prevalence of chronic diseases of the elderly was 88.17%.The top five chronic diseases were hypertension(48.45%),diabetes(29.86%),coronary heart disease(19.44%),cataract(17.18%),and chronic bronchitis(14.65%).The ability level assessment of the elderly in pension institutions was as follows: 1.97% was intact,64.51% was mild disability,13.52% was moderate disability,and 20.00% was severe disability.2.Univariate analysis showed that age(years),number of chronic diseases,long-term use of drugs,health self-assessment status,pressure ulcers in the past 30 days,choking in the past 30 days,and life-threatening events in the last 3 months were the factors could impact the ability levels of the elderly in the pension institutions(P<0.05).3.Ordered multi-class logistic regression analysis showed that age,long-term use of drugs,health self-assessment status,choking in the past 30 days,and life-threatening events in the past 3 months were important influencing factors of elderly ability levels(P<0.05).4.The results of semi-structured interviews showed that the care needs of elderly people with intact and mild disability included: dietary care needs,room hygiene care needs,personal hygiene care needs,medical and health care needs,safety care needs,mental comfort care needs,participation in the management of pension institutions care needs,and the care needs to improve the care ability of caregivers.The care needs of moderately disabled elderly were dietary care needs,room hygiene care needs,personal hygiene care needs,activity care needs,medical and health care needs,safety care needs,mental comfort care needs and hospice care needs.The care needs of severely disabled elderly included: dietary care needs,personal hygiene care needs,activity care needs,medical care needs,mental comfort care needs,and the care needs to improve the care ability of caregivers.5.Through two rounds of expert Delphi questionnaire consultation,the opinions of the experts tended to be the same,and the elderly care service indexes of the pension institutions in Chengdu were determined,including five first-level indexes(daily life care dimension,medical and nursing care dimension,health management care dimension,spirit psychological care dimension,tranquility care dimension),and 33 secondary-level indexes.The response rate and effective rate of the two rounds of expert consultation were 100%.The authoritative coefficients of the experts were 0.86 and 0.84.The coordination coefficients of the experts were 0.189 and 0.203(P<0.05).Conclusions1.355 surveyed elderly in pension institutions have varying degrees of impairment,with mild disability as the main type,followed by severe disability and moderate disability.The ability status of elderly with higer age,long-term use of drugs,poor self-assessment of health,choking in the past 30 days,and life-threatening events in the last 3 months are even worse.2.The 12 elderly interviewed with different ability levels have daily care needs(diet care needs,personal hygiene care needs,room hygiene care needs),medical and nursing care needs,and spiritual comfort care needs(emotional support care needs,leisure and entertainment Care needs).However,affected by their own abilities,the care needs of the elderly at different levels of ability are different,as follows: The elderly with intact ability and mild disability have greater needs for self-care,leisure and entertainment care,and participation in the management and care of elderly care institutions;The elderly with moderate disabilities have greater demands for active care,medical and nursing care,and mental comfort care;the elderly with severe disabilities have greater demands for daily care,medical and nursing care.3.The elderly care service indexes in pension institutions constructed by this study,including 5 first-level indexes and 33 second-level indexes,which are highly reliable,scientific,and reasonable,and can provide reference for the pension institutions to carry out various care service projects and the government purchase of care services.