| Objective:Based on the needs of the elderly,This paper is to investigate the current demand for the combination of medical and nursing care services for home-based elderly,explore a feasible integration path of medical and nursing resources,and reasonably integrate medical resources into home care services for the elderly,so as to provide personalized home care services for the elderly and better meet the needs of home care services for the elderly.Methods:A total of 451 community elderly people were surveyed by convenience sampling method using the self-developed questionnaire on Home Care Medical Services and Resource Integration needs of the Elderly based on existing research.SPSS22.0 and AMOS23.0 software were used to test the reliability and validity of the total questionnaire(including AMOS confirmatory factor analysis,exploratory factor analysis and Cronbach’sαcoefficient evaluation).Then,the collected data were analyzed as follows:descriptive statistics were conducted to analyze the basic information of the elderly,the awareness and willingness of the home-based elderly to participate in the combination of medical and nursing care service,the demand of medical and nursing care services for home-based care and the demand of combination of medical and nursing care services for home-based care;Single factor analysis was used to analyze the demand for home care services under different demographic characteristics.Finally,binary logistic regression was used to analyze the core integration coefficient affecting the demand for medical and nursing care services of the elderly.According to the ranking of the integration preference coefficient β,the order of the construction of medical and nursing care integration was proposed,and the path map was constructed.Results:(1)The Cronbach’s αcoefficient of the questionnaire on home care medical services and resource integration needs of the elderly was 0.905.Confirmatory factor analysis:x2/df< 3,RMSEA < 0.08;AVE values of all dimensions were > 0.5,CR values were > 0.7,and absolute values of correlation coefficients among all dimensions were < corresponding square root of AVE.The overall fitting coefficient,convergent validity and discriminative validity of the questionnaire were good.Structural validity: 7 common factors were extracted from exploratory factor analysis,and the cumulative contribution rate was74.121%,indicating good structural validity.(2)In this survey,most of the elderly people suffered from two diseases(30.6 %),while those suffering from three,four or more diseases accounted for 22% and 9.3%,respectively.At the same time,some elderly people at home do not understand(58.50%)the home-based combination of medical and nursing care and their willingness(59.20%)to participate in it needs to be improved.(3)The results of the demand for home care medical services showed that the highest demand was health education services(3.30±0.88),followed by preventive health care services(3.23±0.71)and disease care services(3.17±1.27),among which the demand for physical examination,chronic disease prevention education and chronic disease screening services was the largest.In addition,there were significant differences in the demand for home care services under different demographic characteristics: the demand scores of women in "disease care,rights protection and total demand" were higher than those of men.The married group had lower needs than the widowed and divorced group.(4)The demand results showed that most of the elderly preferred the internal integration of four groups of medical resources,such as prevention health care and rehabilitation nursing,prevention health care and disease care,and the integration of nine groups of medical resources and pension resources,such as health education and life care,disease care and life care.(5)According to the ranking results of the β value of the integration preference coefficient,the priorities of the integration of medical and nursing service resources were as follows: health education and rehabilitation nursing > health education and spiritual comfort > health education and life care > prevention and health care and disease care >prevention and health care and disease care and life care > rehabilitation nursing and life care.Among them,the frequency of life care service is the highest,and it has integration needs with the four types of medical service resources.Conclusion:(1)The Questionnaire on Home Care Medical Services and Resource Integration Needs of the Elderly compiled by this study has been tested for reliability and validity,which shows that it has good reliability and validity.(2)The current situation of high demand for medical services,understanding of and willingness to participate in the combined medical and nursing home care service for the elderly suggest that the propaganda work of the combined medical and nursing home care service should be strengthened.(3)There are significant differences in the demand for home-based combination of medical and nursing care services under different demographic characteristics.It is suggested that the personalized home medical and nursing care needs of the elderly should be met from the perspective of the needs of the elderly.(4)The demand of the elderly for integrated medical and nursing care home care service is mainly reflected in two aspects: medical and medical care(internal integration of medical resources)and medical and nursing care(integration between medical and nursing care resources),among which the demand for medical and nursing care resource integration is the largest,indicating that the integrated medical and nursing care home care service is an irresistible trend.(5)Guided by the needs of the elderly,according to the value of integration preference coefficient β that affects the demand degree of medical and elderly care service resource integration,the order of promoting the construction path of medical and elderly care service resource integration can be put forward,so as to construct the path diagram.It reflects the characteristics of resource aggregation in the process of combining medical and nursing care,and can be used as a reference to provide multi-level and diversified care services for the elderly at home by stages and focuses. |
PDF Full Text Request