Construction And Empirical Study Of The Index System For Assessing The Demand For Elderly Care Services In Medical And Nursing Care Institutions

Objective1.To construct a set of indicators to assess the demand for elderly care services according to Maslow’s Hierarchy of Needs theory,which is consistent with China’s national conditions and reflects the characteristics of medical and nursing care institutions,and to test the reliability and validity.2.To understand the current elderly care service demand in integrated elderly care institutions through empirical research and analyze the related influencing factors.Methods1.Constructing an index system for assessing the needs of elderly care services and conducting reliability tests.(1)The literature analysis method and semi-structured interview method were used to form a pool of entries for the care service demand assessment index system;the Delphi expert correspondence method was used to form a preliminary index system for the assessment of elderly care service demand in medical and nursing care institutions;the weights of each index and the combination weights were determined by the Analytic Hierarchy Process(AHP).(2)Reliability test: 488 older people in Qingdao’s combined medical and nursing care institutions were selected for the survey from June to September 2022 using a multi-stage sampling method,and the entries were further screened using item analysis,exploratory factor analysis,and combined with the group’s opinions;Cronbach’s ɑ coefficient,Cronbach’s ɑ coefficient,folded reliability,and retest reliability were used to test the reliability of the index system;content validity index and exploratory factor analysis were used to test the validity of the index system.2.Empirical study: 391 older people in Qingdao City were selected from October to December 2022 to conduct empirical research;the general situation questionnaire,the "Assessment Scale for the Needs of Nursing Services for the Elderly in Integrated Nursing Institutions" and the "Activities of Daily Living Scale" were used to assess the needs of older people for nursing services,and single factor analysis and multiple linear regression were used to analyze the needs of older people for nursing services.The demand for nursing care services and the factors influencing the market for nursing care services were analyzed using univariate analysis and multiple linear regression.Results1.Results of index system construction:(1)Results of Delphi expert correspondence: the effective recall rates of the two rounds of correspondence questionnaires were 89.29%(25/28)and 100%(25/25),the expert authority coefficients(Cr)were 0.924 and 0.948,and the Kendall’s W coefficients of the two rounds of correspondence were 0.465,0.420 and 0.647 and 0.647,0.412(P<0.001).(2)Weighting analysis results: the results of the weighting of the primary indicators were medical care needs(0.357),daily care needs(0.296),health care needs(0.130),legal aid guidance needs(0.112),hospice needs(0.060),and spiritual comfort needs(0.046),in that order.(3)Reliability test results: the Cronbach’s ɑ coefficient of the total questionnaire of this study was 0.930,the Cronbach’s ɑ coefficient of each dimension was 0.806-0.972,the folded half reliability was 0.737,and the retest reliability was 0.888;the I-CVI was 0.830-1,S-CVI/Avewas 0.937;the exploratory factor analysis was used to evaluate the structural validity of the index system,and the KMO value was 0.963,Bartlett’s sphericity value was 23578.31(p < 0.001),and the cumulative variance contribution rate was66.421% based on the eigenvalues > 1,and six common factors were extracted.The final constructed index system for assessing the demand for elderly care services in medical and nursing institutions includes six primary indicators,28 secondary indicators,and 61 tertiary indicators,with good reliability and validity of the questionnaire.2.Empirical results: The total score of the demand for elderly care services in the combined medical and nursing institutions was(198.52±24.55),and the mean score of the entries was(3.25±0.40),among which the highest scoring dimension was the demand for medical care(3.41±0.37);the lowest scoring size was the demand for hospice care(3.01±0.73).The demand for care services score of the elderly was used as the dependent variable.The variables with statistically significant(P<0.05)univariate analysis were used as independent variables to analyze the factors influencing the demand through multiple linear regression.The results showed that the age of older people(P=0.008),the condition of having chronic diseases(P=0.004),the ability to take care of themselves(P=0.019),the type of health insurance(P=0.028),the number of children(P=0.018)were significant factors influencing the demand for elderly care services.Conclusions1.The index system for assessing the demand for elderly care services in medical and nursing institutions is highly reliable,scientific,and practical.It has comprehensive content and a reasonable structure.2.The overall demand for nursing care services for older people in medical and nursing care institutions is high,among which the medical care issue is the nursing care issue of more concern to older people.The care service needs of the elderly are affected by many factors.Age differences,chronic diseases,number of children,type of medical insurance,and self-care ability should be fully considered when providing care services for older people to provide targeted care services.