| Objective:To understand the current situation and difference of health literacy of the aged in Chongqing community and elderly care institutions,to find out the key points of health education and promotion of the aged in Chongqing community and elderly care institutions,and to put forward the policy Suggestions on health education and promotion of the aged in Chongqing.Methods:1.Development of health literacy assessment questionnaire for the elderly :1.Item development.After sorting out the retrieved literature related to "health literacy of the elderly" and relevant government documents related to "health literacy of the elderly",the questionnaire framework and item pool were proposed on the basis of the national health literacy monitoring questionnaire.The project team developed and initially modified items through focus group interviews.2.Delphi expert consultation.Delphi expert consulting was used to demonstrate the reserved items,data entry was performed by MS Excel,and the data analysis software was IBM SPSS 23.0,which was used to calculate the coordination coefficient and coefficient of variation of the experts participating in the consultation.3.Do a trial survey.A pilot survey was conducted on the draft questionnaire that had been demonstrated by Delphi for two rounds to test the acceptability and completion time of the draft questionnaire for health literacy assessment of the elderly.4.On-site pre-survey.In order to calculate the reliability of the preliminary questionnaire,EpiData 3.1 software was used for data entry,and SPSS 23.0 software was used for data analysis.2.Investigation on health literacy of elderly people living at home in Chongqing community.Using the principle of convenient random sampling,252 questionnaires were collected from 7 communities in Dadukou district,Nanan district,Yuzhong district,Jiulongpo district and Wanzhou district in Chongqing by self-filling and face-to-face survey.SPSS 23.0 software was used for X2 test and logistic regression analysis of the data.3.Health literacy survey of the elderly in Chongqing pension institutions.By adopting the principle of convenient random sampling,154 questionnaires were investigated in 5 pension institutions in Chongqing by self-filling and face-to-face survey.SPSS 23.0 software was used for X2 test and logistic regression analysis of the data.4.A comparative study was conducted on the demographic characteristics,health literacy level in 3 aspects,health literacy level in 8types of health problems,and influencing factors of health literacy in the elderly people who live at home in the community and in nursing institutions in Chongqing.Results:1.Development of health literacy assessment questionnaire for the elderly :1.Item development.Reference for national residents health literacy monitoring questionnaire,the questionnaire was divided three dimensions and eight types of problems,and combining with Chinese citizens health literacy-the basic knowledge and skills,health literacy,66,Chinese citizens of traditional Chinese medicine keeping in good health health literacy article 42,chronic disease prevention and control of core information(in 2012 the national development planning commission),common symptoms of mental illness in the elderly and prevention knowledge questionnaire(national bureau of the ministry of health,disease prevention and control(2010),the elderly mental health assessment guide draft(2018),and other related information,put forward the 88 old people health literacy assessment questionnaire item pool in Chongqing.39 items were removed from the panel discussion and 49 items were retained for Delphi expert consultation.1.2 Delphi expert consultation.In the two rounds of consultation,13 experts from different health fields of the elderly were invited to participate in the consultation.The expert authority coefficient of the two rounds was higher than 1.8,thecoefficient of judgment basis was higher than 2.8,and the coefficient of familiarity was higher than 0.8,indicating that the expert authority was higher.The coefficient of coordination in the first round was 0.147,and that in the second round was 0.153,both of which were statistically significant(P<0.05).In the first round of expert consultation,14 items were deleted without adding items,and 11 items were modified,with a total of 35 items retained.The second round of expert consultation deleted A8,A9,A11,C3 and A4.Therefore,a total of 30 items are reserved in the preliminary draft of the questionnaire.1.3 trial investigation.The respondents had a high degree of cooperation(100%)and could easily understand 30 questions in the questionnaire.The survey time was within 20 minutes and the questionnaire did not need to be modified.1.4 field pre-survey.A total of 48 pre-surveys were conducted.After data analysis,the reliability coefficient of the questionnaire was 0.792,indicating good internal consistency and high feasibility of the questionnaire,and the questionnaire was finalized.2.Investigation on health literacy of elderly people living at home in Chongqing community.The health literacy level of the elderly living at home in Chongqing was 54.89%.The health literacy level of the elderly living at home in chongqing was 58.73% in healthy lifestyle and behavior,56.75% in basic skills and 46.43% in basic knowledge and concept.The health literacy levels of the eight categories were 89.68% in scientific health concept,88.49% in chronic disease prevention and treatment,87.69% in safety and first aid,83.73% in health information,76.19% in mental health,67.46% in traditional Chinese medicine,60.32% in infectious disease prevention and treatment,and 34.52% in basic medical care,respectively.After logistic regression analysis,the results showed that junior middle school(OR = 0.105,95% CI 0.28 ? 0.388),high school OR vocational high school OR technical secondary school(OR = 0.135,95%CI: 0.030 ? 0.608)were the positive factors influencing the health literacy level of elderly people living at home in Chongqing community,while rural area(OR = 55.971,95% CI: 8.287 ?378.0344)were the negative factors influencing the health literacy level of elderly people living at home in Chongqing community.3.Investigation on the health literacy status of the elderly in old-age care institutions in Chongqing.The health literacy level of the elderly in Chongqing pension institutions was 83.77%,and the health literacy level of the three aspects was 77.92% for healthy lifestyle and behavior,71.43% for basic skills and 59.09% for basic knowledge and concept.The literacy level of the 8 types of health problems was 98.05% for safety and first aid,95.45%for scientific health concept,88.96% for health information,83.12% for mental health,80.52% for traditional Chinese medicine,78.57% for chronic disease prevention and treatment,78.57% for infectious disease prevention and treatment,and 64.29% for basic medical treatment.Logistic regressionanalysis,the results show that the junior high school(OR = 0.214,95% CI:0.082 ? 0.559),high school OR high school OR technical secondary school(OR = 0.210,95% CI: 0.074 ? 0.592),junior college OR bachelor degree and above is the Chongqing endowment institutions,the elderly health literacy level of positive impact factors of rural(OR = 8.174,95% CI: 3.125 ? 21.378)is the endowment institutions in Chongqing the elderly health literacy level of negative factors.4.A comparative study on health literacy of elderly people living at home in communities and nursing homes in Chongqing.According to the analysis,the overall health literacy level of the elderly in old-age care institutions in Chongqing is significantly higher than that of the elderly living at home in the community.The health literacy level of the elderly in old-age care institutions is higher in the three aspects.The health literacy level of the elderly in the three aspects is in the same order from high to low,which is followed by healthy lifestyle and behavior,basic skills,basic knowledge and concepts.Among the 8 types of health problems,the lowest literacy levels of the elderly in Chongqing pension institutions are chronic disease prevention,infectious disease prevention and health(the same literacy levels of chronic disease prevention and infectious disease prevention and health)and basic medical literacy.The lowest literacy levels of the elderly in Chongqing community homes are infectious disease prevention and basic medicalliteracy.The health literacy level of the elderly in old-age care institutions and community homes in Chongqing is the same,both of which are in urban and rural areas.The higher the education level is,the higher the health literacy level will be.The health literacy level of the elderly in rural areas is obviously lower than that in urban areas.Conclusion: t Pension institutions in Chongqing the elderly health literacy levels higher than the community elderly people that occupy the home,in the three aspects of health literacy and eight kinds of health literacy,two groups of the basic knowledge and the concept of literacy and basic medical treatment and the prevention and treatment of infectious diseases are the lowest,in addition to pension agency the chronic disease prevention and control of quality of old people also need to be improved.The influencing factors of health literacy level are the same in both urban and rural areas and the level of education.The elderly health education and promote the work in Chongqing recommendations: 1.The basic knowledge and concepts,basic health care and the prevention and treatment of infectious diseases are the two people health education and promote the focus of the work content,and chronic disease prevention and control of or pension agency the elderly health education and promotion of 2.Farmers and the low cultural level is two people health education and promote the focus of the crowd.3.Healthlectures are held regularly in community elderly residents in community elderly service centers by pension institutions to strengthen health education for the elderly;4.Expand the health education team for the elderly and improve their health education skills.The government can arrange community elderly service centers to recruit health educators,and pension institutions to train health educators,so as to improve the quality of education for the elderly;5.At the social level,health education and promotion can be jointly carried out by the community elderly service center and the community property to provide one-on-one individual health education for the key groups and provide simple training for the families of the key groups to consolidate the health education effect.[not only pension institutions have the responsibility to improve the health literacy of the elderly,but also the government,the society and their families. |
PDF Full Text Request