Wangpitipanit Supichaya, Piyatrakul Sangduen, Tongvichean Thida
Division of Community Health Nursing, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Faculty of Nursing, Shinawatra University, Pathum Thani, Thailand.
J Multidiscip Healthc. 2024 Sep 27;17:4519-4530. doi: 10.2147/JMDH.S441501. eCollection 2024.
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted family caregivers of older dependents, leading to fatigue, anxiety, depression, and financial burdens, which in turn diminish their quality of life. This study investigated the integration of community participatory systems in older care to address potential COVID-19 recurrence and develop policy proposals for the integrated care of dependent older people.
An explanatory sequential design was used, with stratified random sampling across six provinces, resulting in a sample of 440 family caregiver dyads and 154 full-time community stakeholders (October 2021--May 2022). Five validated tools were employed, with a content validity of 0.91 and a Cronbach's alpha of 0.69. The data analysis included descriptive statistics and thematic analysis.
Among the 440 primary caregiver households, 42.73% of the older people had moderate dependence, 30.00% had severe dependence, and 27.27% had complete dependence, with common health issues, including chronic illness and comorbidities. Most older adults lived with their children/grandchildren, had insufficient income, and were informed about COVID-19 prevention measures. Family caregivers, predominantly female (average age 54), had multiple underlying conditions and provided an average of 37 hours of care per week, primarily communicating via phones or apps. The 154 stakeholders included public health volunteers and professional nurses, with an average age of 55 years, and were predominantly female (74.55%). They adhered strictly to COVID-19 precautions during their caregiving duties. This study highlights the impact of trust and COVID-19 perceptions on older care, emphasizing the need for specific forms of care, community support, and resources. Perceptions of "trust", "stay home", "self-care", and "distance" significantly influenced care for dependents. The findings will inform health and social workers' planning, operation, and training, addressing the specific care needs of dependent older adults.
This study recommends policy interventions such as budget allocations for essential equipment, better compensation for community work, and the fostering of expertise in elder care. Emphasis is placed on fostering collaborative community agreements.
2019年冠状病毒病（COVID-19）大流行对老年受抚养人的家庭照顾者产生了重大影响，导致疲劳、焦虑、抑郁和经济负担，进而降低了他们的生活质量。本研究调查了社区参与系统在老年护理中的整合情况，以应对COVID-19可能的复发，并为依赖他人照顾的老年人的综合护理制定政策建议。
采用解释性序列设计，在六个省份进行分层随机抽样，得到440个家庭照顾者二元组和154名全职社区利益相关者的样本（2021年10月至2022年5月）。使用了五种经过验证的工具，内容效度为0.91，克朗巴哈系数为0.69。数据分析包括描述性统计和主题分析。
在440个主要照顾者家庭中，42.73%的老年人有中度依赖，30.00%有重度依赖，27.27%有完全依赖，常见健康问题包括慢性病和合并症。大多数老年人与子女/孙辈同住，收入不足，了解COVID-19预防措施。家庭照顾者主要为女性（平均年龄54岁），有多种基础疾病，平均每周提供37小时的照顾，主要通过电话或应用程序进行沟通。154名利益相关者包括公共卫生志愿者和专业护士，平均年龄55岁，主要为女性（74.55%）。他们在照顾职责中严格遵守COVID-19预防措施。本研究强调了信任和对COVID-19的认知对老年护理的影响，强调了特定形式的护理、社区支持和资源的必要性。“信任”“居家”“自我护理”和“距离”的认知对受抚养人的护理有显著影响。研究结果将为健康和社会工作者的规划、运作和培训提供参考，满足依赖他人照顾的老年人的特殊护理需求。
本研究建议采取政策干预措施，如为基本设备分配预算、提高社区工作报酬以及培养老年护理专业知识。重点是促进达成社区合作协议。
