Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China.
J Gerontol B Psychol Sci Soc Sci. 2024 Nov 1;79(11). doi: 10.1093/geronb/gbae146.
Guided by Andersen's behavioral model, the objectives of this study were to (a) examine the associations between individual factors and the intended utilization of home-based long-term care (LTC) services among older adults in China and (b) explore the influence of community support, if any, on these associations.
Using a multistage random sampling approach, we recruited 1,064 older adults in Chengdu, China. Hierarchical regression was employed to investigate the direct effects of individual predictors and community support on the intended use of home-based LTC services. The moderating effect of community support was examined using the Hayes Process.
Two predisposing (i.e., being old and unmarried), 4 enabling (i.e., living alone, having fewer children, and receiving less family and peer support), and 6 need factors (i.e., having more chronic illnesses; decreased performance in instrumental activities of daily living; higher levels of depression, anxiety, loneliness; and a lower self-image of aging), and low community support were significantly associated with increased intended utilization of home-based LTC. In addition, community support moderated the effects of family support (B = -0.20, p < .001), peer support (B = -0.20, p < .001), self-image of aging (B = -0.39, p < .001), depression (B = -0.34, p < .001), and loneliness (B = -0.48, p < .001) on the intended utilization of home-based LTC services.
Policy-makers and practitioners should consider delivering tailored services for older adults and involve the community in the context of enhancing home-based LTC services.
本研究旨在以安德森行为模型为指导，（a）检验个体因素与中国老年人对家庭为基础的长期护理服务的使用意愿之间的关系，以及（b）探讨社区支持对这些关系的影响。
我们采用多阶段随机抽样方法，在中国成都招募了 1064 名老年人。采用分层回归法考察个体预测因素和社区支持对家庭为基础的长期护理服务使用意愿的直接影响。采用 Hayes 过程检验社区支持的调节作用。
两个倾向因素（即年龄较大和未婚）、4 个促成因素（即独居、子女较少、较少获得家庭和同伴支持）和 6 个需求因素（即患有更多慢性疾病；日常生活活动工具性能力下降；抑郁、焦虑、孤独程度较高；以及对衰老的自我形象较低）以及社区支持水平低与增加对家庭为基础的长期护理服务的使用意愿显著相关。此外，社区支持调节了家庭支持（B=-0.20，p<0.001）、同伴支持（B=-0.20，p<0.001）、衰老自我形象（B=-0.39，p<0.001）、抑郁（B=-0.34，p<0.001）和孤独（B=-0.48，p<0.001）对家庭为基础的长期护理服务使用意愿的影响。
政策制定者和从业者应考虑为老年人提供定制服务，并在增强家庭为基础的长期护理服务的背景下让社区参与进来。
