Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
BMC Geriatr. 2011 Dec 2;11:81. doi: 10.1186/1471-2318-11-81.
The proportion of older people is increasing rapidly in Vietnam. The majority of the elderly live in rural areas. Their health status is generally improving but this is less pronounced among the most vulnerable groups. The movement of young people for employment and the impact of other socioeconomic changes leave more elderly on their own and with less family support. This study aims to assess the daily care needs and their socioeconomic determinants among older people in a rural setting.
In 2007, people aged 60 years and older, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance System (DSS). They were interviewed using structured questionnaires to assess needed support in activities of daily living (ADLs). Individuals were interviewed about the presence of chronic illnesses that had been diagnosed by a physician. Participant socioeconomic characteristics were extracted from the FilaBavi repeat census. The repeat census used a repeat of the same survey methods and questions as the original FilaBavi DSS. Distributions of study participants by socioeconomic group, supports needed, levels of support received, types of caregivers, and the ADL index were described. Multivariate analyses were performed to identify socioeconomic determinants of the ADL index.
The majority of older people do not need of support for each specific ADL item. Dependence in instrumental or intellectual ADLs was more common than for basic ADLs. People who need total help were less common than those who need some help in most ADLs. Over three-fifths of those who need help receive enough support in all ADL dimensions. Children and grandchildren are the main caregivers. Age group, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, poverty status, and chronic illnesses were determinants of daily care needs in old age.
Although majority of older people who needed help received enough support in daily care, the need of care is more demanded in disadvantaged groups. Future community-based, long-term elderly care should focus on instrumental and intellectual ADLs among the general population of older people, and on basic ADLs among those with chronic illnesses. Socioeconomic determinants of care needs should be addressed in future interventions.
越南的老年人比例正在迅速增加。大多数老年人居住在农村地区。他们的健康状况总体上有所改善，但最弱势群体的改善程度较低。年轻人为就业而流动以及其他社会经济变化的影响，使得更多的老年人独居且家庭支持减少。本研究旨在评估农村老年人的日常护理需求及其社会经济决定因素。
2007 年，从 FilaBavi 人口监测系统（DSS）中随机选择了 2240 户、60 岁及以上的居民进行访谈。使用结构化问卷评估日常生活活动（ADL）中需要的支持。个体被问及已被医生诊断出的慢性疾病。参与者的社会经济特征从 FilaBavi 重复普查中提取。重复普查使用与原始 FilaBavi DSS 相同的调查方法和问题进行重复。按社会经济群体、所需支持、获得的支持水平、照顾者类型和 ADL 指数描述研究参与者的分布情况。进行多变量分析以确定 ADL 指数的社会经济决定因素。
大多数老年人不需要每项特定 ADL 项目的支持。在工具性或智力 ADL 方面依赖的情况比在基本 ADL 方面更常见。需要全面帮助的人比在大多数 ADL 中需要一些帮助的人少。在所有 ADL 维度中，需要帮助的人中有超过五分之三的人得到了足够的支持。子女和孙子女是主要的照顾者。年龄组、性别、教育程度、婚姻状况、家庭组成、工作状况、家庭规模、居住安排、居住区域、家庭财富、贫困状况和慢性疾病是老年人日常护理需求的决定因素。
尽管大多数需要帮助的老年人在日常生活中得到了足够的支持，但在弱势群体中对护理的需求更大。未来基于社区的老年人长期护理应关注一般老年人的工具性和智力 ADL，关注慢性病老年人的基本 ADL。未来的干预措施应解决护理需求的社会经济决定因素。
