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中国芜湖老年人选择临终关怀服务机构的意愿及影响因素分析:一项横断面研究。

Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study.

机构信息

School of Nursing, Wannan Medical College, Wuhu, Anhui, China.

Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China

出版信息

BMJ Open. 2024 Apr 3;14(4):e083400. doi: 10.1136/bmjopen-2023-083400.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.

DESIGN

The study conducted has a cross-sectional design.

SETTING

The study was conducted at four urban community centres in Wuhu, Anhui Province, China.

PARTICIPANTS

The sample consisted of 642 older adults, with ages ranging from 60 to over (mean age=71.03 years, SD=7.18).

METHOD

This study, based on the Anderson model, developed a questionnaire after conducting a preliminary survey and engaging in several group discussions. The final questionnaire encompassed the basic information, health status, attitude towards hospice care, choice of hospice care institutions and reasons of the older people. A regional population study was conducted using the Logistic regression model to estimate the ORs (OR) of influencing factors selected by hospice services.

RESULTS

38.5% of respondents expressed their willingness to receive hospice care, while 22.3% were unwilling and 39.3% felt ambivalent towards it. The acceptance rate of older people in hospice care increases with higher levels of education and monthly income. 47.0% of older people opted for hospice care in a general hospital ward, indicating that demand for hospice services among older people in Wuhu City is primarily focused on such wards. The univariate analysis revealed significant differences in the willingness of older individuals to accept hospice care services based on gender, age, educational attainment and income levels. Regardless of the location of hospice care, older men had a lower likelihood of being willing to use hospice services compared with older women. The proportion of older women choosing a hospice ward or general hospital was 53.8%, which was higher than that of older men at 42.0%. The proportion of older men choosing a community health service institution was 31.6%, higher than 23.3% of women. The educational level differences significantly influence the older people's inclination towards receiving hospice care.

CONCLUSION

With the ageing population of Wuhu City on the rise, there is an increasing demand for hospice services. In their final journey, older individuals require multilevel hospice care services, which necessitates equipping general hospitals with hospice wards and using community health service centres to meet their specific needs.

摘要

目的

本研究旨在评估中国老年人选择临终关怀服务机构的倾向和决定因素。

设计

本研究采用横断面设计。

地点

本研究在安徽省芜湖市的四个城市社区中心进行。

参与者

样本由 642 名 60 岁以上的老年人组成,年龄范围为 60 岁以上(平均年龄=71.03 岁,标准差=7.18)。

方法

本研究基于安德森模型,在初步调查和多次小组讨论的基础上制定了问卷。最终问卷包括基本信息、健康状况、对临终关怀的态度、选择临终关怀机构的原因和老年人的态度。采用 Logistic 回归模型对选择临终关怀服务的影响因素进行区域人群研究,估计优势比(OR)。

结果

38.5%的受访者表示愿意接受临终关怀,22.3%的人不愿意,39.3%的人对此持中立态度。老年人对临终关怀的接受率随着受教育程度和月收入的提高而增加。47.0%的老年人选择在综合医院病房接受临终关怀,这表明芜湖市老年人对临终关怀服务的需求主要集中在这类病房。单因素分析显示,老年人接受临终关怀服务的意愿因性别、年龄、受教育程度和收入水平而异。无论临终关怀的地点如何,与老年女性相比,老年男性使用临终关怀服务的意愿较低。选择临终关怀病房或综合医院的老年女性比例为 53.8%,高于老年男性的 42.0%。选择社区卫生服务机构的老年男性比例为 31.6%,高于女性的 23.3%。受教育程度差异显著影响老年人接受临终关怀的倾向。

结论

随着芜湖市人口老龄化的加剧,对临终关怀服务的需求也在增加。在生命的最后阶段,老年人需要多层次的临终关怀服务,这需要为综合医院配备临终关怀病房,并利用社区卫生服务中心满足他们的特殊需求。

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