Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan, Nigeria.
PLoS One. 2023 Oct 16;18(10):e0292939. doi: 10.1371/journal.pone.0292939. eCollection 2023.
Ageing in Place is the emerging social policy drive for long-term care coordination of older persons globally. This decision may be the only viable option in many low- and middle-income countries like Nigeria. Nevertheless, the risk of older persons being 'stuck in place' is high if their preferences are not considered or other alternatives are neither acceptable nor available. This study determined factors associated with the preferred care setting among community-dwelling older persons and explored their views about their choices.
The study utilised a mixed-methods approach. Participants were older persons (≥ 60 years) in a selected rural and urban community in Oyo State, south-western Nigeria. Quantitative data were collected using an interviewer-administered, semi-structured questionnaire and analysed using Stata version 14 at p<0.05. Qualitative data collection involved 22 Focus Group Discussions (FGD). The discussions were audiotaped, transcribed verbatim and analysed thematically using ATLAS.ti version 8. Selected quotations were used to illustrate themes.
1,180 participants (588 rural vs 592 urban) were interviewed with a mean age of 73.2 ±9.3 years. More rural participants preferred to AIP (61.6%) compared to urban participants (39.2%), p = 0.001. Factors associated with the decision for rural participants were older age [OR:2.07 (95%CI:1.37-3.14)], being male [OR:2.41(95%CI:1.53-3.81)] and having assistance at home [OR:1.79 (95%CI:1.15-2.79)]. In comparison, significant factors for urban participants were older age (≥70years) [OR:1.54(95%CI:1.03-2.31)] and home-ownership [OR:5.83 (95%CI:3.82-8.91)]. The FGD revealed that the traditional expectation of reciprocity of care mostly influenced the desire to AIP. Advantages include improved social connectedness, quality of care, community participation and reduced isolation. Interestingly, participants were not opposed to the option of institutional care.
Ageing in place is preferred and influenced by advanced age and home ownership in our setting. Information provided could guide age-friendly housing policies and community-based programmes for the care of older persons.
就地养老是当前全球老年人长期护理协调的新兴社会政策趋势。在尼日利亚等许多中低收入国家，这可能是唯一可行的选择。然而，如果老年人的偏好没有得到考虑，或者其他选择既不可接受也不可用，那么他们被“困在原地”的风险就很高。本研究旨在确定与社区居住老年人首选护理地点相关的因素，并探讨他们对选择的看法。
本研究采用混合方法。参与者为来自尼日利亚西南部奥约州一个选定的农村和城市社区的老年人（≥60 岁）。使用访谈者管理的半结构式问卷收集定量数据，并在 p<0.05 时使用 Stata 版本 14 进行分析。定性数据收集涉及 22 个焦点小组讨论（FGD）。讨论内容被录音、逐字转录，并使用 ATLAS.ti 版本 8 进行主题分析。选择了一些引语来说明主题。
对 1180 名参与者（588 名农村参与者与 592 名城市参与者）进行了访谈，平均年龄为 73.2±9.3 岁。与城市参与者（39.2%）相比，更多的农村参与者更倾向于就地养老（61.6%），p=0.001。与农村参与者的决定相关的因素是年龄较大（OR：2.07（95%CI：1.37-3.14））、男性（OR：2.41（95%CI：1.53-3.81））和在家中获得帮助（OR：1.79（95%CI：1.15-2.79））。相比之下，对城市参与者而言，重要因素是年龄较大（≥70 岁）（OR：1.54（95%CI：1.03-2.31））和拥有住房（OR：5.83（95%CI：3.82-8.91））。焦点小组讨论显示，传统的互惠护理期望主要影响了就地养老的愿望。其优势包括改善社会联系、护理质量、社区参与和减少孤立感。有趣的是，参与者并不反对机构护理的选择。
在我们的研究中，就地养老是首选，并且受到年龄和住房所有权的影响。提供的信息可以指导适合老年人的住房政策和以社区为基础的老年人护理方案。
