Institute of Health Service Research, 200642Ningbo College of Health Sciences, Ningbo, China.
College of Public Health, 27117University of South Florida, Tampa, FL, USA.
Dementia (London). 2022 Jul;21(5):1699-1713. doi: 10.1177/14713012221094979. Epub 2022 May 9.
To describe the perceived and unmet needs for health and social services and their relative importance among families coping with dementia in urban China.
We used data from a cross-sectional survey conducted between 2018 and 2019 in two cities in eastern China. Trained staff conducted structured interviews of family caregivers of people living with dementia at home to obtain individual characteristics as well as types of service needs of families coping with dementia. Service needs and utilization in 24 types of services across five domains (daily living, medical/nursing, rehabilitation, mental health, and other) were examined. Descriptive statistics were used to describe characteristics of the dyads and the ranking of services based on the percentage of respondents with perceived/unmet needs.
A total of 170 (87.6%) family caregivers completed the interviews. The mean age of the care recipient was 77.2 years (range: 60-102) and 65.3% were female. The mean age of family caregivers was 58.4 years (range: 28-90), and 57.1% were female. The top five services used by the care recipients were: primary care, medication management, housekeeping, activities of daily living assistance, and adult day service. The five services with the most unmet needs were: legal assistance (42.7%), hospice care (44.7%), respiratory secretion management (expectoration) (57.6%), life enrichment activities (65.4%), and companion care (67.0%). Except for transportation and dressing/grooming, working and nonworking caregivers reported similar relative importance of service needs.
The findings suggest that people living with dementia and their family require a wide range of services and supports to live in the community. Future research and policy efforts should target the unmet needs of families to improve dementia care in the community and promote aging-in-place.
描述城市中应对痴呆症的家庭的健康和社会服务需求以及未满足需求,并评估其相对重要性。
我们使用了 2018 年至 2019 年在中国东部两个城市进行的横断面调查的数据。训练有素的工作人员对家中患有痴呆症的患者的家庭照顾者进行了结构性访谈,以获取个人特征以及家庭应对痴呆症的服务需求类型。检查了五类(日常生活、医疗/护理、康复、心理健康和其他)共 24 种服务的服务需求和利用情况。基于有感知/未满足需求的受访者的百分比,使用描述性统计来描述对子的特征和服务排名。
共有 170 名(87.6%)家庭照顾者完成了访谈。照顾对象的平均年龄为 77.2 岁(范围:60-102 岁),其中 65.3%为女性。家庭照顾者的平均年龄为 58.4 岁(范围:28-90 岁),其中 57.1%为女性。照顾对象使用最多的前五项服务是:基层医疗、药物管理、家政服务、日常生活活动辅助和成人日间服务。需求未得到满足最多的五项服务是:法律援助(42.7%)、临终关怀(44.7%)、呼吸分泌物管理(咳痰)(57.6%)、生活充实活动(65.4%)和同伴照顾(67.0%)。除了交通和穿衣/梳妆外,有工作和无工作的照顾者报告的服务需求相对重要性相似。
研究结果表明,痴呆症患者及其家庭需要广泛的服务和支持才能在社区中生活。未来的研究和政策工作应针对家庭的未满足需求,以改善社区中的痴呆症护理并促进就地养老。