發(fā)布時(shí)間：2018-10-08 12:52

【摘要】：目的:評(píng)估醫(yī)養(yǎng)護(hù)一體化服務(wù)模式下社區(qū)失能老人現(xiàn)存的健康問題及其對(duì)每個(gè)健康問題的認(rèn)知、所采取的行為、健康問題的狀態(tài)的變化。方法:1.調(diào)查方法:本研究采取便利抽樣的方法,運(yùn)用國(guó)際標(biāo)準(zhǔn)化護(hù)理語(yǔ)言—奧馬哈系統(tǒng)對(duì)杭州市某社區(qū)衛(wèi)生服務(wù)中心簽約醫(yī)養(yǎng)護(hù)一體化服務(wù)的80名失能老人現(xiàn)存的健康問題及其每個(gè)健康問題的認(rèn)知、行為、狀態(tài)進(jìn)行評(píng)估。第一次評(píng)估為失能老人簽約但未接受醫(yī)養(yǎng)護(hù)一體化服務(wù)時(shí),之后評(píng)估每?jī)蓚�(gè)月一次,共四次,每次評(píng)估時(shí)間約1 h、持續(xù)時(shí)間為六個(gè)月。同時(shí),為了使評(píng)估資料更加全面,本研究在完成評(píng)估后增加一個(gè)開放性問題:根據(jù)您自身的情況,您認(rèn)為您主要的健康問題有哪些?2.統(tǒng)計(jì)學(xué)方法:本研究使用描述性分析(均數(shù)、標(biāo)準(zhǔn)差、頻數(shù)、構(gòu)成比)描述社區(qū)失能老人的一般信息,現(xiàn)存的健康問題,社區(qū)失能老人現(xiàn)存的每個(gè)健康問題的認(rèn)知、行為、狀態(tài)情況。社區(qū)失能老人現(xiàn)存的健康問題的認(rèn)知、行為、狀態(tài)的變化情況采用Friedman檢驗(yàn)(簡(jiǎn)稱M檢驗(yàn))。結(jié)果:1.第一次評(píng)估為社區(qū)失能老人剛簽約醫(yī)養(yǎng)護(hù)一體化服務(wù)時(shí),發(fā)現(xiàn)社區(qū)失能老人存在(12.7±3.13)個(gè)健康問題,第二次評(píng)估時(shí)發(fā)現(xiàn)(12.3±2.89)個(gè)健康問題,第三次評(píng)估時(shí)發(fā)現(xiàn)(12.2±2.74)個(gè)健康問題,第四次評(píng)估時(shí)發(fā)現(xiàn)(12.2±2.75)個(gè)健康問題。2.四次評(píng)估中共同存在的常見健康問題(發(fā)生率≥50%的健康問題):環(huán)境領(lǐng)域?yàn)樽≌瑔栴};心理社會(huì)領(lǐng)域?yàn)樯缃粏栴}和精神健康問題;生理領(lǐng)域?yàn)橐曈X問題、口腔衛(wèi)生問題、認(rèn)知問題、神經(jīng)-肌肉-骨骼功能問題;健康相關(guān)行為領(lǐng)域?yàn)樯眢w活動(dòng)問題和個(gè)人照顧問題。3.隨著時(shí)間的推移,簽約醫(yī)養(yǎng)護(hù)一體化服務(wù)的社區(qū)失能老人在社交問題、精神健康問題、口腔衛(wèi)生問題、循環(huán)問題的認(rèn)知得分增加有統(tǒng)計(jì)學(xué)意義(P0.05),循環(huán)問題的行為得分增加有統(tǒng)計(jì)學(xué)意義(P0.05),社交問題、神經(jīng)-肌肉-骨骼功能問題、循環(huán)問題的狀態(tài)得分增加有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.簽約醫(yī)養(yǎng)護(hù)一體化服務(wù)的社區(qū)失能老人的健康問題多(在42個(gè)健康問題中,平均每名失能老人存在約13個(gè)健康問題),社區(qū)失能老人的常見健康問題的行為和狀態(tài)較認(rèn)知差。2.醫(yī)養(yǎng)護(hù)一體化服務(wù)可能有助于改善社區(qū)失能老人的社交問題、精神健康問題、口腔衛(wèi)生問題、循環(huán)問題的認(rèn)知,循環(huán)問題的行為以及社交問題、神經(jīng)-肌肉-骨骼功能問題和循環(huán)問題的狀態(tài)。而尚未發(fā)現(xiàn)醫(yī)養(yǎng)護(hù)一體化服務(wù)對(duì)社區(qū)失能老人其他健康問題的改善效果。
[Abstract]:Objective: to evaluate the existing health problems of the elderly with community disability and the changes of their cognition, behavior and state of health problems under the model of integrated medical and conservation services. Method 1: 1. Methods of investigation: this study adopts a convenient sampling method, An international standardized nursing language-Omaha system was used to evaluate the existing health problems and the cognition, behavior and status of 80 disabled elderly people who were contracted by a community health service center in Hangzhou. The first assessment was for the disabled but did not accept the integrated medical care service, and then every two months, a total of four times, each assessment time is about 1 hour, the duration is six months. At the same time, in order to make the assessment more comprehensive, this study adds an open question to the completion of the evaluation: what do you think are your major health problems based on your own situation? 2. Statistical methods: this study uses descriptive analysis (mean, standard deviation, frequency, composition ratio) to describe the general information about the disabled elderly in the community, the existing health problems, the cognition and behavior of each of the existing health problems of the disabled elderly in the community. Status. The changes of cognition, behavior and state of the existing health problems of the disabled elderly in the community were tested by Friedman test (M test for short). The result is 1: 1. In the first assessment, when the community disabled people signed up for the integrated medical care service, it was found that there were (12.7 鹵3.13) health problems in the community disabled elderly, (12.3 鹵2.89) health problems in the second assessment, and (12.2 鹵2.74) health problems in the third assessment. The fourth assessment found (12.2 鹵2.75) health problems. Common health problems common in the four assessments (health problems with a prevalence rate of more than 50 per cent): residential problems in the environmental field; social and mental health problems in the psychosocial field; visual and oral health problems in the physical field, Cognitive problems, neuro-muscle-bone function problems; health-related behavioral issues: physical activity problems and personal care problems. Over time, the community incapacitated elderly signed up for an integrated medical care service had social problems, mental health problems, oral health problems, The cognitive scores of circulatory problems increased significantly (P0.05), the behavioral scores of circulatory problems increased significantly (P0.05), social problems, neuromusculoskeletal function problems and circulatory problems state scores increased significantly (P0.05). Conclusion 1. The health problems of the disabled elderly in the community were more than those in the community with integrated medical and maintenance services (of 42 health problems, there were about 13 health problems per disabled elderly on average), and the behavior and state of the common health problems of the disabled elderly in the community were worse than that in the community. 2. Integrated health care services may help improve social problems, mental health problems, oral health problems, circulatory problems, behavior of circulatory problems, and social problems in the community. The state of neuromuscular-skeletal problems and circulatory problems. However, the effect of integrated medical and maintenance services on other health problems of disabled elderly in the community has not been found.
【學(xué)位授予單位】：杭州師范大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 孫瑞竹;江俊宏;梁遠(yuǎn)波;彭顯耀;徐祥;張聰;鄭景偉;呂帆;;溫州市社區(qū)老年眼病篩查報(bào)告之一:視力損傷及年齡相關(guān)性白內(nèi)障篩查與轉(zhuǎn)診情況[J];中華眼視光學(xué)與視覺科學(xué)雜志;2016年12期

2 馬曉雯;杜佳敏;謝紅;;基于居家養(yǎng)老服務(wù)的適老化改造研究進(jìn)展[J];中國(guó)護(hù)理管理;2016年12期

3 覃朝暉;劉培松;王問海;王玉沐;薛佳殷;胡亞杰;郭天歌;郭靖;;蘇北農(nóng)村老年人健康狀況及健康自評(píng)的影響因素[J];中國(guó)老年學(xué)雜志;2016年23期

4 江克忠;陳友華;;親子共同居住可以改善老年人的心理健康嗎?——基于CLHLS數(shù)據(jù)的證據(jù)[J];人口學(xué)刊;2016年06期

5 齊玉玲;張秀敏;史秀欣;胡雨亭;高航;李偉;;城市社區(qū)老年人社會(huì)支持現(xiàn)狀及影響因素研究[J];中國(guó)全科醫(yī)學(xué);2016年25期

6 李蕾;孫菲;湯哲;刁麗軍;;老年人生活自理能力與健康自評(píng)的相關(guān)性研究[J];首都醫(yī)科大學(xué)學(xué)報(bào);2016年04期

7 黃波;王桂榮;;醫(yī)養(yǎng)一體化護(hù)理模式對(duì)老年卒中后遺癥期患者康復(fù)的影響[J];護(hù)理學(xué)雜志;2016年13期

8 陳柳柳;鄧仁麗;陳蘇紅;張江輝;段梅杰;;養(yǎng)老機(jī)構(gòu)失能老人護(hù)理服務(wù)需求調(diào)查研究[J];護(hù)理與康復(fù);2016年06期

9 白慧婧;孫建琴;陳敏;謝華;徐丹鳳;王彥;;老年人四肢骨骼肌肌量和功能的初步研究[J];中華老年醫(yī)學(xué)雜志;2016年05期

10 靳修;張紅;蘆鴻雁;;西部農(nóng)村老年患者家庭照護(hù)能力的縱向研究[J];護(hù)理學(xué)雜志;2016年09期

相關(guān)碩士學(xué)位論文 前5條

1 陸夢(mèng)玲;城市失能老人社會(huì)支持現(xiàn)狀與社會(huì)工作介入研究[D];安徽大學(xué);2016年

2 蔣楠楠;失能老人家庭照護(hù)質(zhì)量及其影響因素的分析[D];蚌埠醫(yī)學(xué)院;2015年

3 紀(jì)莉萍;太極拳與健步走對(duì)70歲以上高齡老年人靜態(tài)平衡能力的比較研究[D];蘇州大學(xué);2014年

4 易景娜;護(hù)士主導(dǎo)的全科團(tuán)隊(duì)家訪服務(wù)對(duì)居家高齡老人健康狀況影響的研究[D];復(fù)旦大學(xué);2012年

5 吳茜;武漢市老年公寓公共空間中高齡者社交行為研究[D];華中科技大學(xué);2006年

，

本文編號(hào)：2256820