中国浙江省老年护理的困境：一项定性研究。
Dilemmas in caring for older adults in Zhejiang Province, China: a qualitative study.
机构信息
The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, Room 1001, Comprehensive Building of Medical School, 866 Yuhangtang Rd., Xihu District, Hangzhou, Zhejiang Province, 310058, People's Republic of China.
School of Medicine, Tongji University, Shanghai, People's Republic of China.
出版信息
BMC Public Health. 2019 Mar 15;19(1):311. doi: 10.1186/s12889-019-6637-0.
BACKGROUND
Owing to the increase in life expectancy and sickliness, caring for older adults has become a major challenge in China, where the traditional care system is disintegrating and community- and home-based care have been introduced to respond to this 'silver wave'. However, there is limited knowledge of the dilemmas associated with caring for older adults and the acceptability of community- and home-based care for this population.
METHODS
Participants were recruited from Xihu District, Hangzhou, from June to July 2017. In-depth interviews were conducted using semi-structured questionnaires. Audio recording, verbatim transcription, and thematic analysis were conducted.
RESULTS
A total of 64 older adults from four communities were interviewed. Half of the participants had multiple chronic diseases. The very old individuals and those with severe diseases and in poor financial conditions were observed to be struggling the most. Health status, financial capability, and personality were the main factors affecting the care process. Participants cited the following reasons for staying away from nursing homes: misunderstanding, negative environment, a sense of shame, loneliness, and financial limitations. Community- and home-based cares are popular forms of old-age care; however, some participants exhibited a lack of knowledge about such services.
CONCLUSION
A multi-layered old-age care system is urgently needed for older adults in Zhejiang Province. Further, it is important that such a system integrates the care provided through community- and home-based services with that offered by nursing homes. Community- and home-based care for older adults needs to be prioritised, and the quality of care provided in nursing homes should be improved.
背景
由于预期寿命的延长和疾病的增多，照顾老年人在中国已成为一个重大挑战，传统的护理体系正在瓦解，社区和家庭护理已被引入以应对这一“银发浪潮”。然而，对于照顾老年人所面临的困境以及社区和家庭护理对这一人群的可接受性，我们知之甚少。
方法
参与者是 2017 年 6 月至 7 月从杭州市西湖区招募的。采用半结构式问卷进行深入访谈。进行音频记录、逐字转录和主题分析。
结果
共对四个社区的 64 名老年人进行了访谈。参与者中有一半患有多种慢性病。最困难的是那些非常高龄、患有严重疾病和经济状况不佳的人。健康状况、经济能力和个性是影响护理过程的主要因素。参与者提到远离养老院的原因有：误解、负面环境、羞耻感、孤独感和经济限制。社区和家庭护理是老年人护理的流行形式；然而，一些参与者对这些服务缺乏了解。
结论
浙江省迫切需要为老年人建立多层次的养老体系。此外，将社区和家庭服务提供的护理与养老院提供的护理相结合非常重要。需要优先考虑为老年人提供社区和家庭护理，并提高养老院的护理质量。
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