A Study On The Safety Assessment Of Home Environment And The Willingness Of Home Modification Of The Deviceaided Elderly Under The "Home Care" Model

Objective: To understand the ability of the device-aided elderly with home care in Urumqi,the current situation of home environment safety and the willingness of home modification and analyze its influencing factors,and to explore the strategies of home modification for the elderly with different ability levels,so as to provide scientific basis for promoting home modification.Methods: A total of 332 device-aided elderly people who met the inclusion and exclusion criteria in eight communities and four districts of Urumqi were selected as the research objects by stratified cluster sampling method.Questionnaire survey and field investigation were used to investigate the ability of the elderly,the safety of the home environment and the willingness of home modification.Linear regression analysis was used for multivariate analysis of quantitative data,and logistic regression was used for multivariate analysis of categorical data.The relationship between observed variables and latent variables and the relationship between latent variables were analyzed by structural equation model.Results: A total of 332 device-aided elderly people were surveyed in this study,including 157 males(47.3 %)and 175 females(52.7 %),with an average age of(83.58 ± 6.41)years.(1)Impaired ability of the device-aided elderly: 66.6 %of the elderly were mildly impaired,and 33.4 % were moderately and severely impaired.The first three items with the most serious impairment of activities of daily living were up and down stairs,body cleaning and flat walking ability.The first three items of mental state and social participation ability were financial management,spatial orientation and memory ability.The top three impairments of perception and communication ability were hearing,vision and communication ability.The regression analysis results show that the ability of the elderly who are mainly taken care of by others and who are less satisfied with their selfrated health status is more severely damaged,while the ability of the elderly who have a larger housing area and a larger amount of pension is less damaged.(2)The safety situation of home environment for the device-aided elderly: The average score of home environment for the elderly was 101.35 ± 8.02,and the scores of each dimension from low to high were:doors and windows(1.40 ± 0.29),toilets(1.96 ± 0.24),kitchens(2.17 ± 0.25),living rooms(2.21 ± 0.25),bedrooms(2.40 ± 0.28),and home clothing(2.71 ± 0.29).Regression analysis showed that the larger the housing area,the better the self-rated home environment and the more familiar with home modification,the higher the safety score of the home environment for the elderly.The more the number of people with reduced mobility at home,the lower the home environment safety score of the elderly;(3)The willingness of the device-aided elderly to modify: 238 people(71.7 %)are not willing to modify,22 people(6.6 %)are not concerned about the modification,and 72 people(21.7 %)are willing to modify.Through the structural equation model,the influencing factors of the willingness to modify are analyzed.The economic status factor(0.49)has the greatest impact on the willingness to modify,of which the direct effect is 0.35,and the indirect effect through the home environment factor is 0.14.The second is the home environment factor(-0.34).The third is the cognitive level factor(0.29),of which the direct effect is 0.25,and the indirect effect through the home environment is 0.04.The home environment plays an intermediary role in the two potential variables of economic status and cognitive level.Conclusion: The ability of the device-aided elderly in Urumqi is mainly slightly damaged,and the safety of the home environment is at a moderately low level.Home environment has a certain impact on the ability.There are many unsafe projects at home,and the home environment needs to be further improved,especially for the elderly families with poor self-assessment environment and a large number of people with mobility difficulties at home.The cognition and willingness of home modification are low.The relevant departments should actively promote the home modification work through multi-party publicity and solving the transformation funds.This study explored the modification strategies for the device-aided elderly with different ability levels,which can provide reference for relevant departments to improve the evaluation and implementation efficiency of home modification.