Bhan Nandita, Madhira Pavitra, Muralidharan Arundati, Kulkarni Bharati, Murthy Gvs, Basu Sanjay, Kinra Sanjay
Public Health Foundation of India, Plot 47, Sector 44, Gurgaon, India.
Indian Institute of Public Health Hyderabad, Hyderabad, India.
BMC Geriatr. 2017 Jul 19;17(1):156. doi: 10.1186/s12877-017-0544-y.
India's elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers. We examined perceptions of health needs of the elderly across local stakeholders in an urbanizing rural area.
The qualitative study was conducted among participants in the Andhra Pradesh Children and Parents Study (APCAPS) site in Rangareddy district, Telangana. We collected data using focus group discussions and interviews among communities (n = 6), health providers (n = 9) and administrators (n = 6). We assessed stakeholders' views on the influence of urbanization on health issues faced and interventions for alleviating these challenges. We used a conceptual-analytical model to derive themes and used an inductive approach to organizing emerging codes as per a priori themes. These were organized as per thematic groups and ranked by different authors in order of importance. Bronfebrenner's theory was used to understand stakeholder perspectives and suggest interventions within four identified spheres of influence - individual, household, community and services.
Stakeholders reported frailty, lack of transport and dependence on others as factors impacting health access of the elderly. Existing public health systems were perceived as overburdened and insensitive towards the elderly. Urbanization was viewed positively, but road accidents, crime and loneliness were significant concerns. Interventions suggested by stakeholders included health service outreach, lifestyle counseling, community monitoring of healthcare and engagement activities.
We recommend integrating outreach services and lifestyle counseling within programs for care of the elderly. Community institutions can play an important role in the delivery and monitoring of health and social services for the elderly.
印度老年人口正以前所未有的速度增长，大多数老年人生活在农村地区。老年人及照料者面临着与老龄化、社会网络变化以及公共卫生基础设施有限相关的健康挑战。我们调查了一个正在城市化的农村地区当地利益相关者对老年人健康需求的看法。
这项定性研究在特伦甘纳邦兰加雷迪区安得拉邦儿童与父母研究（APCAPS）项目点的参与者中开展。我们通过焦点小组讨论以及对社区（n = 6）、医疗服务提供者（n = 9）和管理人员（n = 6）进行访谈来收集数据。我们评估了利益相关者对城市化对所面临健康问题的影响以及缓解这些挑战的干预措施的看法。我们使用一个概念分析模型来提炼主题，并采用归纳法按照先验主题来组织新出现的编码。这些编码按照主题组进行整理，并由不同作者按照重要性进行排序。运用布伦芬布伦纳的理论来理解利益相关者的观点，并在四个确定的影响领域——个人、家庭、社区和服务中提出干预措施。
利益相关者报告称，身体虚弱、缺乏交通工具以及依赖他人是影响老年人获得医疗服务的因素。现有的公共卫生系统被认为负担过重且对老年人缺乏关怀。城市化被视为积极的，但道路交通事故、犯罪和孤独是重大问题。利益相关者建议的干预措施包括医疗服务外展、生活方式咨询、社区对医疗保健的监测以及参与活动。
我们建议将外展服务和生活方式咨询纳入老年人护理项目。社区机构在为老年人提供和监测健康及社会服务方面可以发挥重要作用。
