Tsukada Noriko, Saito Yasuhiko
Nihon University Graduate School of Business, 4-8-24 Kudan-Minami, Chiyoda-ku, Tokyo 102-8275, Japan.
J Cross Cult Gerontol. 2006 Sep-Dec;21(3-4):121-37. doi: 10.1007/s10823-006-9028-9.
The purpose of this study was to examine the factors related to the reluctance of older Japanese people to utilize home help services and day services. Home help services consist of three different types of services (i.e., assisting in bathing and toileting, doing household choirs, such as cooking and laundry, and counseling) and are provided by visiting home helpers at the homes of older people. Day services are services (e.g., providing bathing and meals, monitoring the health status of older people, and counseling) that are provided at day service centers in the community to improve the physical and psychological functioning of older people and to help the burden of caregiving of family members. The data used in the study came from the first wave of the Nihon University Japanese Longitudinal Study of Aging, conducted in November 1999 (and again in March 2000 for those people who had been unable to respond to the initial survey). Face-to-face interviews were conducted with a national probability sample of 6,700 people aged 65 and older. Logistic regression analyses were used to analyze factors that were thought to be related to older people's reluctance to use services. Approximately, one half of the respondents indicated reluctance to use home help services, and one quarter of the respondents showed reluctance to use day services. Respondents who were female and who lived in urban areas showed a higher probability of feeling reluctant about using both home-help and day services. Also, respondents who had had caregiving experience using these two types of services showed a lower probability of feeling reluctant about using the services. Furthermore, respondents who were older and had income showed a higher probability of feeling reluctant about using day services, whereas those who had had caregiving experience and who participated in social activities showed a lower probability of feeling reluctant about using day services. According to the 1999 survey, there were still many older Japanese people who felt reluctant about using either type of care service. But it is expected that the quality of services under Kaigo Hoken (the mandatory public long-term care social insurance system) will improve further and that older people's attitudes toward service utilization will change for the better. In the meantime, professional service providers will have to be sensitive to older people's perceptions about service utilization if they would like to continue to contribute to the improvement process of Kaigo Hoken as a positive force.
本研究的目的是调查与日本老年人不愿使用居家护理服务和日间服务相关的因素。居家护理服务包括三种不同类型的服务（即协助洗澡和如厕、做诸如做饭和洗衣等家务以及咨询），由上门护理人员在老年人家里提供。日间服务是在社区日间服务中心提供的服务（例如提供洗澡和餐饮、监测老年人的健康状况以及咨询），以改善老年人的身体和心理机能，并帮助减轻家庭成员的护理负担。本研究使用的数据来自1999年11月进行的日本大学日本老龄化纵向研究的第一波调查（对于那些无法回应初始调查的人，于2000年3月再次进行调查）。对6700名65岁及以上的全国概率样本进行了面对面访谈。使用逻辑回归分析来分析被认为与老年人不愿使用服务相关的因素。大约一半的受访者表示不愿使用居家护理服务，四分之一的受访者表示不愿使用日间服务。女性受访者以及居住在城市地区的受访者对使用居家护理服务和日间服务感到不情愿的可能性更高。此外，有过使用这两种服务的护理经历的受访者对使用这些服务感到不情愿的可能性较低。此外，年龄较大且有收入的受访者对使用日间服务感到不情愿的可能性更高，而有过护理经历且参加社会活动的受访者对使用日间服务感到不情愿的可能性较低。根据1999年的调查，仍有许多日本老年人对使用任何一种护理服务都感到不情愿。但预计介护保险（强制性公共长期护理社会保险制度）下的服务质量将进一步提高，老年人对服务利用的态度也将向好的方向转变。与此同时，如果专业服务提供者希望继续作为积极力量为介护保险的改进进程做出贡献，就必须对老年人对服务利用的看法保持敏感。
