Research On Elderly Health Status And Health Management Countermeasures In Communities In Liaoning Province

Objective: In order to understand the health status and health management status of the elderly in Liaoning Province,this study selected Shenyang and Dalian as sample cities to evaluate the health status of the elderly in the community,find out the influencing factors of the elderly health,combine the quantitative research results and qualitative interviews to analyze the current situation of the elderly health management in the communities of the two cities,further explore the deficiencies of the elderly health management in the community,and combine the objectives and requirements of the national health aging policy,Further put forward health management countermeasures to provide basis for improving the construction of healthy aging in Liaoning Province,and provide reference basis for optimizing health management policies in other cities in the province.Methods: To understand the policies and regulations of the elderly health management in Liaoning Province through the literature,and sort out the health-related influencing factors and health countermeasures based on the health ecological model and community health intervention theory.In Shenyang and Dalian,1 representative community was selected to conduct a questionnaire survey on the elderly.The semi-structured interview method was used to understand the current situation of community elderly health management.Use the basic description method to describe the basic situation and health status of the elderly in the community.Chi-square test was used to analyze the differences of physical weakness and psychological status of community elderly people with different gender,BMI and age.The stratified logistic regression model was used to analyze the influencing factors of health,and the structural equation model(SEM)was used to explore the action path analysis of the factors affecting the health of the elderly.Results:(1)Basic information: There are 1063 respondents,with an average age of 67.5 years,and 58.1% of them are women.54.3% of the elderly are overweight,and57.3% of the elderly have a monthly income of more than 3000 yuan.80.4% of the elderly have spouses and 14.3% live alone.61.2% of the elderly with education level of junior high school or below.Family care accounted for 93.5%,and 89.7% of the elderly were able to take care of themselves.More than 70% of the elderly suffer from chronic diseases(79.2%),about 20% of the elderly have anxiety,and the proportion of the elderly with average self-rated health is the highest(43.9%).(2)Life behavior: more than half of the elderly do not participate in social activities(53.0%),and 57.9% of the elderly participate in physical examination every year.Health care is mainly based on physical exercise,good life rules and diet control.The bad life behaviors of the elderly are 50.3% without personal interest,43.0% without paying attention to nutrition balance,40.2% without exercise,24.4% without good sleep,22.1% smoking,17.5% drinking,and 15.1% not eating breakfast on time.The proportion of women with no personal interest and poor sleep is higher than that of men;The proportion of men smoking and drinking is significantly higher than that of women.(3)Health status: The incidence of physical weakness of the elderly in the community is 9.60%,the detection rate of psychological problems is 16.56%,and the overall detection rate of unhealthy problems is 22.2%.There was a statistical difference between BMI and the incidence of age weakness(p<0.05).(4)Influencing factors: The results of logistic regression model showed that there was a correlation between chronic disease,self-care,anxiety,self-rated health,smoking,drinking,exercise,sleep,eating breakfast on time,marital status,residence,type of caregiver and the health of the elderly(p<0.05).(5)Action path of influencing factors of elderly health: The results of structural equation model show that personal characteristics,life behavior and interpersonal network have an impact on elderly health,and the coefficients of each path have statistical significance(p<0.05).The order of the standardized total effect value of health influencing factors from large to small is: personal status(0.706),life behavior(0.379),and interpersonal network(0.197).Action path: life behavior → elderly health(direct effect value is 0.253),life behavior → personal characteristics → elderly health(indirect effect value is 0.126),interpersonal network → personal characteristics→ elderly health(indirect effect value is 0.197),personal characteristics → elderly health(direct effect value is 0.706).Conclusion: The subjects were mainly young elderly.Hypertension,diabetes and coronary heart disease are common chronic diseases in the elderly.More than half of the elderly lack interests and low social participation.The detection rate of frailty and psychological problems of the elderly is low,and the overall health condition is good.The weakness of the elderly is mainly manifested in the decline of social participation,memory and muscle function of both lower limbs.The detection rate of psychological problems in the elderly is higher in three aspects: worry,mental stress and depression.Chronic disease,self-care,anxiety,self-rated health,smoking,drinking,exercise,sleep,eating breakfast on time,marital status,residence and type of caregivers are the influencing factors of elderly health.Life behavior and personal characteristics have a direct effect on the health of the elderly,and interpersonal network can have an indirect effect on the health of the elderly through personal characteristics.Personal characteristics are the intermediary variables of the action path between life behavior and the health of the elderly.At present,the community elderly health management policy system is not perfect,the policy content focuses on the management of chronic diseases,pays attention to the prevention and health care of the elderly who take care of themselves,and lacks the intervention measures to delay the deterioration of physical and mental health of the elderly.The implementation rules of oral cavity,cognitive decline and mental health are vague.The health assessment process is not perfect,and the performance evaluation system is not perfect.The performance evaluation of community health service institutions based on the performance evaluation index system of basic public health service projects is lack of evaluation indicators and feedback mechanism for the improvement of health results.Therefore,it is necessary to further improve the elderly health management policy,optimize the health management evaluation process,cultivate the elderly healthy life behavior,improve the professional knowledge reserve of health management of community medical staff,guide family caregivers to participate in the elderly health management process,expand the service coverage,and improve the performance evaluation mechanism of community elderly health management..