School of Health Services Management, Southern Medical University, 1023 Shatai Road, Guangzhou, 510515, China.
Qual Life Res. 2019 May;28(5):1293-1303. doi: 10.1007/s11136-019-02107-x. Epub 2019 Jan 16.
To analyze health-related quality of life (HRQoL) and related factors among elderly persons receiving community-based home care and institutional care in Guangzhou, a large city of mainland China.
A representative sample of 1600 subjects aged 60 years and over residing in communities and nursing homes was randomly selected through stratified sampling. The 12-item Short Form Health Survey version 2 (SF-12v2) was used to assess HRQoL.
In total, 1014 elderly persons under different aged care models responded to the survey (response rate 63.4%) and 1000 were eligible for data analyses. Compared with the elderly receiving community-based home care or private institutional care, those in public institutional care had the lowest scores on the physical component summary (PCS, 36.89 ± 10.44) and the mental component summary (MCS, 47.16 ± 11.14). Number of chronic diseases, loneliness, and age were the most common significant factors (P < 0.05) affecting PCS and MCS. The interaction term between aged care model and number of chronic diseases significantly affected PCS (β = - 0.165, P < 0.05), indicating a stronger association between these factors for participants receiving community-based home care than institutional care. The interaction term between aged care model and loneliness had a significant effect on MCS (β = 0.189, P < 0.05), indicating a weaker association between loneliness and MCS for participants receiving community-based home care.
This study found poor HRQoL among the elderly in Guangzhou. The main factors associated with the physical and mental HRQoL of elderly persons included number of chronic diseases, loneliness, age, and education level. It also revealed the moderating effects of aged care model on HRQoL, suggesting specific health management strategies for elderly in community-based home care and institutional care, respectively.
分析广州市社区居家养老和机构养老老年人的健康相关生活质量（HRQoL）及其相关因素。
采用分层抽样方法，随机抽取广州市社区和养老院 1600 名 60 岁及以上老年人作为代表性样本。采用 12 项简式健康调查量表第 2 版（SF-12v2）评估 HRQoL。
共有 1014 名不同养老模式的老年人对调查做出了回应（回应率 63.4%），其中 1000 人符合数据分析条件。与接受社区居家养老或私人机构养老的老年人相比，接受公立机构养老的老年人在生理成分综合评分（PCS，36.89±10.44）和心理成分综合评分（MCS，47.16±11.14）方面得分最低。慢性病数量、孤独感和年龄是影响 PCS 和 MCS 的最常见重要因素（P<0.05）。养老模式与慢性病数量之间的交互项对 PCS 有显著影响（β=-0.165，P<0.05），表明社区居家养老模式下这些因素与参与者之间的相关性更强。养老模式与孤独感之间的交互项对 MCS 有显著影响（β=0.189，P<0.05），表明社区居家养老模式下孤独感与 MCS 之间的相关性较弱。
本研究发现广州市老年人 HRQoL 较差。影响老年人身心健康的主要因素包括慢性病数量、孤独感、年龄和教育程度。还揭示了养老模式对 HRQoL 的调节作用，分别为社区居家养老和机构养老的老年人提供了具体的健康管理策略。
