The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Zhejiang Chinese Medical University, Hangzhou, China.
PeerJ. 2022 Sep 7;10:e14004. doi: 10.7717/peerj.14004. eCollection 2022.
The problem of global aging was becoming increasingly prominent. At present, the empty nest and miniaturization of family structure reduce the function of home-based elderly care.
A questionnaire survey was conducted on 347 elderly people in multiple communities and nursing homes in eastern coastal cities of China, and 13 institutional staff members of eight nursing institutions that carried out the medical-nursing integration model were interviewed as the research objects. The survey mainly focuses on the basic characteristics of the elderly, the family support system, and the acceptance of medical care and health care. The influencing factors were screened by t test, univariate analysis and multivariate logistic regression analysis. SPSS software was used to test the reliability and validity of the questionnaire, and the Crobach's was 0.792, which can be considered that the questionnaire had good internal reliability. The classification of the questionnaire was reasonable, the reliability of the questionnaire was high, and the internal consistency of the scale was high. According to KMO and Bartlett test, KMO = 0.826, χ2 = 853.731, the degree of freedom was 36, and the value was 0.000.
The proportion of male and female respondents was 48.1% and 51.9% respectively. Multivariate logistic regression analysis results showed that gender had no statistical significances on the degree of support for combine medical and health care in the elderly ( > 0.05). The results showed that gender, age, marital status, medical insurance type and old-age insurance type had little effect on the support of the combination of medical care and health care for the elderly ( > 0.05). Compared with the control group with education below primary school, the elderly with bachelor's degree or above are more willing to support the combination of medical care and health ( < 0.05). The registered residence type is more obvious than that of the urban residents ( < 0.05). Compared with the enterprise employees in the control group, the elderly who were employed as migrant workers before retirement were more willing to support the combination of medical care and health ( < 0.05). From the perspective of family monthly income, the elderly with family income ≥10,000 RMB have more obvious support for the combination of medical care and health than the elderly with family monthly income <3,000 RMB in the control group ( < 0.05). In terms of the degree of understanding, the degree of understanding and support in different degrees are significantly higher than that in the control group ( < 0.05).
Through multivariate logistic regression analysis, education level, registered residence, pre-retirement occupation and family income are more obvious for the elderly to support medical care and health. It is necessary to increase investment in elderly activity centers, actively carry out activities.
全球老龄化问题日益突出。目前，空巢家庭和家庭结构小型化降低了家庭养老功能。
采用问卷调查的方法，对我国东部沿海城市多个社区和养老院的 347 名老年人，以及开展医养结合模式的 8 家养老机构的 13 名机构工作人员进行调查，调查内容主要包括老年人的基本情况、家庭支持情况、对医疗护理和保健的接受程度等。采用 t 检验、单因素分析和多因素 logistic 回归分析筛选影响因素。采用 SPSS 软件对问卷进行信度和效度检验，克朗巴赫's 系数为 0.792，可认为问卷内部信度较好。问卷分类合理，信度较高，量表内部一致性高。根据 KMO 和 Bartlett 检验，KMO=0.826，χ2=853.731，自由度为 36，P 值为 0.000。
男、女受访者比例分别为 48.1%、51.9%。多因素 logistic 回归分析结果显示，性别对老年人对医养结合的支持程度无统计学意义（P＞0.05）。结果显示，性别、年龄、婚姻状况、医疗保险类型和养老保险类型对老年人对医养结合的支持程度影响较小（P＞0.05）。与小学及以下文化程度的对照组相比，文化程度为本科及以上的老年人更愿意支持医养结合（P＜0.05）。户籍类型比城镇居民更为明显（P＜0.05）。与对照组的企业员工相比，退休前从事农民工职业的老年人更愿意支持医养结合（P＜0.05）。从家庭月收入来看，家庭月收入≥10000 元的老年人比对照组家庭月收入＜3000 元的老年人对医养结合的支持度更为明显（P＜0.05）。从认知程度来看，不同程度的认知和支持程度明显高于对照组（P＜0.05）。
通过多因素 logistic 回归分析，文化程度、户籍、退休前职业、家庭收入等因素对老年人支持医养结合的程度更为明显。有必要加大对老年人活动中心的投入，积极开展活动。
