A Study On The Effect Of Community Care Capacity On The Home-based Care Quality For Disabled Elderly At Home

Objective:By constructing a community care capacity indicator system,a localised community care capacity scale is developed.The empirical study will be used to analyse the community care capacity,the degree of meeting the care needs of elderly people with disabilities and the quality of care at home,to reveal the role of community care capacity on the quality of care at home,and to provide theoretical guidance for the next step of intervention for elderly people with disabilities at home from the community perspective.Methods:This study mainly adopts a combination of quantitative and qualitative methods.（1）Development of community care capacity scale:（1）Literature research and semi-structured interviews:initial construction of the community care capacity indicator system;（2）Delphi and literature research methods:the initial indicator system was validated and revised through two rounds of expert consultation to finally establish a scientific and standardized community care capacity indicator system and further develop the pre-test community care capacity scale;（3）Expert consultation and questionnaires:the official version of the community care capacity scale was formed.（2）The role of community care capacity on the home-based care quality for the disabled elderly:Questionnaire survey method:A whole-group sample of 58 communities in Shihezi city and a simple random sample of 580 family caregivers of older people with disabilities in 58 communities in Shihezi city were used to conduct a questionnaire survey to understand the current situation of community care capacity,the degree of meeting the needs for family care of older people with disabilities and the home-based care quality through descriptive analysis;the role of community care capacity on the home-based care quality of older people with disabilities was investigated through correlation analysis,Monte Carlo simulation method and hierarchical regression method.Results:（1）Community care capacity scale development:（1）Through literature research and semi-structured interview method,a community care capacity indicator system consisting of 4 primary indicators,11 secondary indicators,24 tertiary indicators and 24 tertiary indicator descriptions of community human capital,community physical capital,community economic capital and community social capital was initially constructed;（2）Through Delphi method and literature research method,a community care capacity indicator system consisting of 4 primary indicators,10 secondary indicators,22 tertiary indicators and 22 tertiary indicator descriptions was finally constructed.（3）Through expert consultation and questionnaire survey,a community care capacity scale comprising 4 primary dimensions,10 secondary dimensions,22 tertiary dimensions and 40 items was finally developed,with a content validity（S-CVI）of0.917 and a Cronbach’s alpha coefficient of 0.959 and a retest reliability of 0.923.（2）The role of community care capacity on the home-based care quality for older people with disabilities:（1）The questionnaire method showed that the mean score of community care capacity items was（1.644±0.625）,with a low overall level.The mean score for the item on the degree of satisfaction of home care needs of older adults with disabilities was（0.459±0.253）,which was a low level of satisfaction of care needs;the mean score for the item on the home-based care quality was（2.228±0.333）,which was at a medium level;（2）the correlation analysis and Monte Carlo simulation method revealed that community care capacity,the degree of satisfaction of home care needs of older adults with disabilities and the home-based care quality were positively correlated（r=0.338,P<0.001;r=-0.427,P<0.001;r=-0.505,P<0.001）;the degree of satisfaction of home care needs of older people with disabilities partially mediated the relationship between community care capacity and home-based care quality(γ₀₁^c’=0.206,P<0.01),with a mediating effect of 51.7%.Conclusions:（1）The community care capacity scale developed based on theoretical and empirical studies has good reliability and validity and can be used to measure community care capacity.（2）The community care capacity and the degree of satisfaction of home care needs of the elderly with disabilities are low,and the quality of home care is moderate.（3）Community care capacity not only affects the quality of home care directly,but also affects the quality of home care by influencing the degree of satisfaction of care needs of older people with disabilities.