| Objectives:1Based on the conceptual framework of the International Classification of Functionality,Disability and Health and Maslow ’s hierarchy of needs theory,a grading index system for long-term care needs assessment of the elderly in the main urban area of Chongqing is constructed,and on this basis,design questionnaires to carry out empirical indicators surveys to verify the reliability and stability of the assessment tools,providing data support for the next step to achieve the classification of the long-term care needs of the elderly.2 Define the level of long-term care needs of the elderly in the main urban area of Chongqing,describe the long-term care needs of the elderly and the corresponding levels of care services,and provide a basis for the formation of a unified grading standard for long-term care needs assessment of the elderly in Chongqing.Method:1 Based on the conceptual framework of the International Classification of Functionality,Disability and Health and Maslow’s hierarchy of needs theory,through literature analysis and semi-structured interviews,an initial graded index system for long-term care needs assessment of the elderly in the main urban area of Chongqing was formed.2 Screen and evaluate the final items of the grading index system through 2 rounds of expert consultation of 19 experts in each round,and calculate the index weight value by the expert scoring method.3 On the basis of the index system,after two rounds of consultation with five experts,a grading questionnaire for long-term care needs assessment of the elderly in the main urban area of Chongqing was formed.A stratified random sampling method was used to select 464 senior citizens from 4 communities and 5 nursing homes in Yuzhong District,Jiulongpo District,Dadukou District,Banan District from the nine administrative districts in the main city of Chongqing.The reliability and validity of the questionnaire were evaluated through consistency reliability,half-reliability,project analysis,content validity,and structural validity.4 According to the results of the questionnaire survey,the rank sum ratio comprehensive evaluation method is used to initially determine the level of long-term care needs of the elderly,and on this basis,the level boundary value is established through debugging.5 On the basis of the formation of the needs assessment grade standard,the corresponding analysis is used to focus on the main care issues of the elderly with different care needs grades.Result:1 Combined with literature analysis,semi-structured interviews and discussion results of the research group,the initial graded index system for the long-term care needs assessment of the elderly in the main urban area of Chongqing includes four first-level indicators of physical function,activity ability,mental state and social function,10 Two second-level indicators and 37 third-level indicators.2 The recovery rate of the two rounds of expert inquiry forms is 100%,the expert authority coefficient is 0.945,and the expert coordination coefficient of all levels of indicators is 0.394-0.453(P <0.05).The final established demand assessment grading index system includes physical function and self-care Ability,mental state,social function 4 first-level indicators,12 second-level indicators,40 third-level indicators.3 The hierarchical questionnaire for the assessment of long-term care needs of the elderly includes 4 parts: physical function,self-care ability,mental and psychological status,and social function,with a total of 40 items.The effective recovery rate of the assessment questionnaire is98.28%,the total internal consistency coefficient and the half-reliability are0.890 and 0.809,the internal consistency coefficient of eachsub-questionnaire is 0.641 ～ 0.808;the content validity index of the questionnaire is 1,and the correlation coefficient between each dimension and the total score of the subquestionnaire was 0.464 ～ 0.956;Confirmatory factor analysis showed that the questionnaire model fits well,and the structure of each questionnaire is stable.4 The long-term care needs of the elderly in the main urban area ofChongqing are divided into three levels,specifically: the questionnaire evaluation score is lightly dependent in the range of 0 to 31.9 points,moderately dependent in the range of 32 to 58.9 points,and severe dependence in the range of 59 to 159 points.5 Mildly dependent elderly have a relatively high proportion of problems with drug management and refusal to care.Moderately dependent elderly people have a high concentration of balance,attention,depression,and social activities involved in care issues.Heavily dependent elderly have a high concentration of eating,grooming,bathing,toileting,dressing and undressing,and special care items.Conclusion:1 The grading index system for long-term care needs assessment of the elderly in the main urban area of Chongqing constructed in this study includes physical function,self-care ability,mental state,social function,4first-level indicators,12 second-level indicators,40 third-level indicators.Translated into a questionnaire application,it shows good reliability andvalidity,and can be used as an evaluation tool for dynamic monitoring of elderly care needs in different long-term care environments in Chongqing.2 This study is based on the empirical data and the evaluation criteria for long-term care needs of the elderly in the main urban area of Chongqing include three levels: mild dependence,moderate dependence,and severe dependence.The higher the assessment score of care needs,the higher the degree of care dependence.Moreover,the content of long-term care services for the elderly with different levels of care dependency is different,which is conducive to guiding caregivers to classify the elderly for long-term care and management. |
