Study On Health Self-Management And Health Care Service Needs Of Elderly Residents In Age Care Facilities In Fuzhou

Objectives 1. To understand the current status of health self-management among elderly residents in age care facilities in Fuzhou, to provide the basis for future development of health education and interventions for elderly residents. 2. To understand and analyze the health care service needs among institutionalized elders in Fuzhou, to provide basis for improving the quality of care for the institutionalized elders. MethodThis study was a cross-sectional designed study. A total of 280 elders were conveniently sampled from 12 age care facilities in Fuzhou, and were investigated with general social and demographic questionnaire, ADL inventory, CES-D inventory, self-compiled health self-management questionnaire and health care service needs questionnaire. Use PASW Statistics 18.0 software to analyze all the quantitative data with t-test, ANOVA test, Non-parametric test and multiple stepwise regression analysis. Information collected from the open-ended question was read and classified, then extracted the topics. Results 1. Health self-management status of elderly residents in age care facilities in Fuzhou 1.1 Self-perceived health statusThe minimum self-perceived health value was 10.00, and the maximum was 22.00, the inter-quartile range was 15.00-18.00, and the median value was 16.00. There were statistically significant differences(p<0.05) among elderly residents of their self-perceived health value with different education levels, marital status, per capita monthly income levels and whether have religions. 1.2 Health-related behaviors statusThe minimum self-related behaviors value was 20.00, and the maximum was 43.00, the inter-quartile range was 31.00-38.00, and the median value was 36.00. There were statistically significant differences(p<0.05) among elderly residents of their health-related behaviors value in different sex, age levels, education levels, marital status, per capita monthly income levels and whether have religions. 1.3 Health-related knowledge statusThe minimum self-related knowledge value was 6.00, and the maximum was 16.00, the inter-quartile range was 11.00-15.00, and the median value was 14.00. There were statistically significant differences(p<0.05) among elderly residents of their health-related knowledge value in different education levels, marital status, per capita monthly income levels and whether have religions. 1.4 The correlated relationships of three parts of the score of self-health managementAccording to Spearman correlation analysis, three parts of the score of self-health management questionaire of 280 Fuzhou Institutionalized Elderly correlated to each other(p<0.01). 2. Health care service needs and influencing factors of elderly residents in age care facilities in Fuzhou 2.1 Scores and influencing factorsThe overall mean score of health care service needs was(3.95±0.29), the mean score was(4.35±0.32)for the physical health needs dimension,(4.35±0.32)for the safety needs dimension,(4.30±0.36)for the respect needs dimension,(3.85±0.50)for the love and affiliation needs dimension,(3.42±0.61)for the self-realization needs dimension. The main influencing factors were marital status, self-perceived health status, health-related behaviors, and admission time in age care facilities. 2.2 The main topics of open-ended question(1)Combination of medical care resources and nursing home resources;(2)Improving the quality of care workers in age care facilities;(3)Further enriching the lives of elderly residents and concerning about their psychological care;(4)Enhancing the construction of environment and supporting facilities;(5)Strengthening safety management and health supervision. 3. Other related results 3.1 Reasons for the elderly to live in age care facilitiesAccording to the results of multiple analysis, the reasons were as follows by priority:(1)Health reasons;(2)Accustomed to independence, do not want to trouble their children;(3)No one to take care of them;(4)Housing demolition or other temporary reasons;(5)Other reasons. 3.2 The priority factors that the elderly will consider when they choose an institution to liveAccording to the results of multiple analysis, the factors were as follows by priority:(1)The environment of the institution;(2)Credibility and care service quality of the institution;(3)Prices and the economic factors;(4)Location(transportation, distance from home) factors;(5)Ownership factors(public or private);(6)Whether have friends there;(7)Other factors. 3.3 The most worried health and safety issues among institutionalized eldersAccording to the results of multiple analysis, the most worried health and safety issues among institutionalized elders were as follows by priority:(1)Chronic diseases;(2)Fall;(3)Infections;(4)Psychological problems;(5)Other(pain, Fire safety);(6)Falling out of Bed;(7)Malnutrition;(8)Skin pressure ulcers;(9)Mistakenly taking medicine. Conclusion 1. Health self-management status of elderly residents in age care facilities in FuzhouThe scores of three parts of the health self-management questionnaire were overallat relatively high levels and correlated with each other.Chronic diseases, functional decline and sleeping problems were the most common three problems faced by elderly residents. There was still much room for improvement for elderly residents to relieve their pressure and annoyance, to seek medical advice when they were uncomfortable, to practice their body, to take regular medical examinations and to take medicine according to the advice of doctors and other projects. There were still further space for education and interventions for elderly residents' knowledge on health understanding, the importance of mental illness, prevention and management of chronic diseases such as high blood pressure. Particularly, more attention should be paid to the elderly residents who was male, who was younger elderly living in age care facilities, who had religious belief and low level of education and income,and who was solitary. 2. Health care service needs of 280 elderly residents in age care facilities in FuzhouThe elderly residents' health care service needs level was generally high in this study, security needs dimension scored highest in all dimensions, which indicated that security issues become a primary concern by elderly residents living in age care facilities in Fuzhou. Marital status, self-perceived health status, health-related behaviors status and admission time in age care facilities were the main influencing factors. 3. Recommendations for the development of age care facilitiesFirstly, combination of medical care resources and age care facilities resources, to facilitate the elderly residents to see doctors and to take medicine. Secondly, improving the service quality of care workers in age care facilities, enhancing the standardized training and establishing reward system according to their performance. Thirdly is to strengthen the construction of environment and supporting facilities for elders to live in a comfortable environment. Improve the quality of food, transportation and other services, to facilitate the basic needs of elderly residents. Fourthly, strengthen safety management and health supervision. The fifth is to further enrich the cultural life of elderly residents and concern about their mental health and psychological care.