Kempen G I, Suurmeijer T P
Department of Health Sciences, State University of Groningen, The Netherlands.
Soc Sci Med. 1991;32(1):77-81. doi: 10.1016/0277-9536(91)90130-5.
Most explanatory research into the utilization of home care for the elderly has been carried out in a cross-sectional design with multiple regression as the main method of analysis. For methodological reasons we chose another design in a project called 'Professional home care and informal help for the elderly', which has been conducted in the northern part of the Netherlands. Two types of causal variables were distinguished to detect influencing factors on professional home care utilization among the elderly, other than physical limitation: person-bound variables and social network variables. A Mokken Scale analysis for Polychotomous items (MSP) was used to measure the level of physical limitation and a matching procedure to compare 'users' and 'non-users' of professional home care. With regard to person-bound variables, sex, whether or not a person was living alone and the level of the elderly person's income appeared to play a role in the utilization of home care: the user group comprised significantly more women, more elderly living alone and more persons on a low income. Contrary to the findings in other Dutch research, depression and feelings of loneliness did not seem to discriminate between the two groups. With regard to social network variables, the size and structure of the social network was more or less identical in both groups. The non-users network lives slightly closer. In general, the small differences found between the groups were to the non-users' advantage. Moreover, the non-users received more informal and private care with ADL and IADL activities.
大多数针对老年人家庭护理利用情况的解释性研究都是采用横断面设计，并以多元回归作为主要分析方法进行的。出于方法学上的原因，我们在荷兰北部开展的一个名为“老年人的专业家庭护理和非正式帮助”的项目中选择了另一种设计。除身体限制外，区分了两类因果变量以检测影响老年人专业家庭护理利用情况的因素：个人相关变量和社会网络变量。使用多分类项目的莫肯量表分析（MSP）来衡量身体限制水平，并采用匹配程序来比较专业家庭护理的“使用者”和“非使用者”。关于个人相关变量，性别、是否独居以及老年人的收入水平似乎在家庭护理的利用中发挥了作用：使用者群体中女性明显更多，独居的老年人更多，低收入者更多。与荷兰其他研究的结果相反，抑郁和孤独感似乎并未在两组之间产生差异。关于社会网络变量，两组的社会网络规模和结构大致相同。非使用者的社交网络住得稍近一些。总体而言，两组之间发现的细微差异对非使用者有利。此外，非使用者在日常生活活动（ADL）和工具性日常生活活动（IADL）方面得到了更多的非正式和私人护理。
