照顾者与社区卫生专业人员对残疾老年人家庭医疗服务看法的比较：一项在中国北京开展的横断面研究
Comparison of the caregivers' and community health professionals' views on home health care services for disabled older adults: a cross-sectional study in Beijing, China.
作者信息
Xu Xiaojingyuan, Zhao Chunyan, Wang Meirong, Chen Xiaolei, Shao Shuang, Du Juan
机构信息
School of General Practice and Continuing Education, Capital Medical University, Beijing, 100069, China.
Community Health Service Center, Beijing University of Posts and Telecommunications, Beijing, 100876, China.
出版信息
BMC Health Serv Res. 2021 Apr 26;21(1):389. doi: 10.1186/s12913-021-06400-9.
BACKGROUND
In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients' homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China.
METHODS
A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs.
RESULTS
We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers' demands on home nursing services were significantly higher than those of health guidance services (Z = - 7.725, P < 0.001). Most of the 224 health professionals chose "health professionals' personal safety cannot be guaranteed" as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals' attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = - 10.081, P < 0.001). For home nursing services, health professionals' attitude scores were lower than the caregivers' demand scores (Z = - 4.960, P < 0.001), while for health guidance services, health professionals' attitude scores were higher than the caregivers' demand scores (Z = - 8.373, P < 0.001).
CONCLUSIONS
Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs.
背景
在社会老龄化日益加剧的时代，部分老年人的医疗保健可以在患者家中提供，家庭保健服务（HHCSs）的需求也在增加。本研究旨在确定中国北京社区卫生专业人员与残疾老年人照料者对家庭保健服务的看法之间是否存在差距。
方法
在中国北京进行了一项包含两项比较问卷调查的横断面研究。一项调查针对残疾老年人的照料者，另一项调查针对社区卫生服务机构（CHSIs）的卫生专业人员。采用t检验和Wilcoxon符号秩检验来探讨照料者和社区卫生专业人员对家庭保健服务看法之间的潜在差异。
结果
我们收到了来自照料者的370份有效问卷和来自卫生专业人员的224份问卷。在370名照料者中，314名（84.9%）愿意为老年人申请家庭保健服务，但只有20.5%（N = 76）的人获得了家庭保健服务。超过80%的照料者接受每次自付费用低于100元。照料者对家庭护理服务的需求显著高于健康指导服务（Z = -7.725，P < 0.001）。在224名卫生专业人员中，大多数人选择“卫生专业人员的人身安全无法得到保障”作为限制提供家庭保健服务的一个问题（N = 151，40.8%）。卫生专业人员对家庭护理服务的态度明显不如对健康指导服务的态度积极（Z = -10.081，P < 0.001）。对于家庭护理服务，卫生专业人员的态度得分低于照料者的需求得分（Z = -4.960，P < 0.001），而对于健康指导服务，卫生专业人员的态度得分高于照料者的需求得分（Z = -8.373，P < 0.001）。
结论
照料者和卫生专业人员对家庭保健服务的看法存在差距。与提供健康指导服务意愿较高的卫生专业人员相比，照料者更需要家庭护理服务。应实施可行的政策来保障卫生专业人员的权益，并为家庭保健服务培训合格的卫生专业人员。
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