| Objective To clarify the current situation and demands of community based medical-nursing services for urban disabled elderly.To analyze factors and explore the relationship between multiple variables such as current service situation and their demands.To provide higher quality care for the disabled elderly in their later years,so as to establish the medical-nursing combination system in China and provide the basis and reference for alleviating the process of aging care.Methods A cross-sectional design is used in this study.According to the economic level,the disabled elderly reside in three districts,each contains a street Community Healthcare Service of Hangzhou.The greater Zhejiang province was investigated using general information,the Barthel Index Rating Scale(BI)and rhe Urban Disabled Elderly Medical-Nursing Combination with Community Support Services Current Situation and Demands questionnaire.The data were analyzed with software SPSS19.0.Results ①The average age of the disabled elderly surveyed was 81.53±8.58 years old which belongs to the category of old aged people.And the disabled elderly all suffered from disease,the top five were high blood pressure,cardiovascular disease,cerebrovascular disease,osteoarthritis and diabetes.In disability assessment,the highest proportion was not able independently complete the task of scaling the stairs up and down;②Urban Disabled Elderly Medical-Nursing Combination with Community Support Services Current Situation questionnaire was composed of 6 variables,including 31 items.Cronbach’s alpha coefficient of 0.854,test-retest reliability was 0.943,split-half reliability was 0.726,content validity index was 0.972.The total score of the questionnaire was 155,the average score was 50.56 ±9.32,the basic medical service aspect had the highest score.Only 4 services had a utilization rate over 50%and 22 services had a utilization rate under 20%;③Urban Disabled Elderly Medical-Nursing Combination with Community Support Services Demands questionnaire was composed of 5 aspects,including 36 items.Cronbach’s alpha coefficient of 0.877,test-retest reliability was 0.862,split-half reliability was 0.720,content validity index was 0.964.The total score of the questionnaire was 180,the average score was 112.12±11.28,professional medical care had the highest score,only five services demand rates below 50%;④Multiple linear regression analysis showed that the number of diseases,monthly income and hyperlipidemia were the factors affecting service current situation,and the monthly income,age,endowment models,bronchitis and and district were the factors affecting service demands.Conclusion Urban disabled elderly showed an aging trend,and the health situation was worrying.The urban disabled elderly failed to utilize as many community based medical-nursing combination services as they should,however,the demand for community support services was high.The disabled elderly with high-income,a large number of illnesses and hyperlipidemia received more medical services.And the elderly who were high-income,old age,that chose institutions for the elderly,not suffering from bronchitis and live within less wealthy districts had greater demand for medical services.Community workers should pay attention to the elderly with low-income and other disadvantages to improve and amend services.And the government should step in to promote the creation of care for the disabled elderly and protect the needs and quality of life of disabled elderly. |
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