居家老年人生命质量及其影响因素研究

摘要

目的：调查居家老年人生命质量及其影响因素，为提高居家老年人生命质量提供依据。方法2014年1—5月，采用便利抽样法，对北京市海淀区中关村社区和甘家口社区内250例老年人进行调查。共发放调查问卷250份，回收有效问卷214份，有效率为85.6%。采用自制调查问卷，包括：老年人一般资料问卷、健康问题问卷、养老成本问卷、简易健康状况调查（SF -36）量表及《老年人能力评估》问卷，对老年人生命质量及其影响因素进行分析。结果不同子女状况、文化程度、退休前职业、医疗付费方式、主要经济来源、月平均收入的老年人简易SF -36量表总分比较，差异无统计学意义（P >0.05）。不同性别、婚姻状况、居住情况、身体状况、饮食方式的老年人简易SF -36量表总分比较，差异有统计学意义（ P <0.05）。年龄与简易SF -36量表总分呈负相关（ r =-0.187，P <0.01）。不同月均医疗、药品开销，月均娱乐费用，月均陪护费用老年人简易SF -36量表总分比较，差异有统计学意义（P <0.05）。不同月均饮食费用，月均住房费用，月均日常保健费用，月均水、电、煤气、有线电视、电话费用，其他费用老年人简易SF -36量表总分比较，差异无统计学意义（P >0.05）。月均医疗、药品开销与简易SF -36量表总分呈负相关（r =-0.304，P <0.001）；月均娱乐费用与简易SF -36量表总分无直线相关关系（ r =0.129，P =0.059）；月均陪护费用与简易SF -36量表总分呈负相关（r =-0.145，P =0.033）。老年人疾病指数、日均服药种类、片剂数量与老年人简易SF -36量表总分呈负相关（ r =-0.382、-0.310、-0.380，P <0.01）。未发生不良事件老年人简易SF -36量表总分为（121.1±12.2）分，高于发生不良事件老年人的（113.9±16.0）分（t =3.566，P <0.01）。有注射类药物老年人简易SF -36量表总分为（116.4±9.2）分，无注射类药物老年人简易SF -36量表总分为（119.1±14.1）分，差异无统计学意义（ t =-0.781，P >0.05）。老年人日常生活活动能力（ ADL）总分与老年人简易SF -36量表总分呈正相关（r =0.324，P <0.01），老年人精神状态总分、感知觉与沟通总分、社会参与总分与老年人简易SF -36量表总分呈负相关（r =-0.196、-0.324、-0.435，P <0.01）。多因素分层回归分析结果显示，社会参与总分、疾病指数、身体状况对居家老年人生命质量有影响（P <0.05）。结论促进老年人的社会参与、减少多种疾病及并发症的发生是提高老年人生命质量的重要措施。%Objectjve To investigate the situation and influential factors of the quality of life of the elderly at home with the aim of providing evidence for valid life quality promotion measures. Methods From January to May in 2014,by using convenience sampling,data were collected from the elderly at home in Zhongguancun Community and Ganjiakou Community in Beijing Haidian District. 250 questionnaires were distributed in which 214 ones were available with the 85. 6% effective rate. Self- designed questionnaire was used which contained the general information questionnaire,health problems questionnaire, pension costs questionnaire,the 36 - item Short - Form Health Survey Questionnaire( SF - 36)and competency assessment questionnaire of the elderly. Results Comparison of SF - 36 total scores with different fertility condition,educational level, career before retire,medical payment means,main source of income and average monthly income showed no statistical significance(P > 0. 05). But the elderly with different gender,marital status,housing condition,physical status and dietary habit presented statistically significant SF - 36 total scores(P < 0. 05). Age was negatively correlated with SF - 36 total score (r = - 0. 187,P < 0. 01). The difference of SF - 36 total scores with different average monthly medical treatment and drug -purchasing expense,entertainment expense,accompanying expense was significant( P < 0. 05). The elderly with different average monthly diet,housing,health care,water,electricity,gas,cable TV,telephone expenses and other expenses showed no statistically significant SF - 36 total scores( P > 0. 05) . The average monthly medical treatment and drug - purchasing expense were negatively correlated with SF - 36 total score( r = - 0. 304,P < 0. 001). There was no significant correlation between the average monthly entertainment expense and SF - 36 total score(r = 0. 129,P = 0. 059),while the accompanying expense was negatively correlated with SF - 36 total score( r = - 0. 145,P = 0. 033) . The disease index,daily drug -administrative type and tablet number were negatively associated with SF - 36 total score(r = - 0. 382, - 0. 310, - 0. 380,P< 0. 01). The SF - 36 total score of elderly without adverse event(121. 1 ± 12. 2)was significantly higher than that with adverse event(113. 9 ± 16. 0,t = 3. 566,P < 0. 01). The SF - 36 total score of elderly without drug injection(119. 1 ± 14. 1)was not significantly different with that with drug injection(116. 4 ± 9. 2,t = - 0. 781,P > 0. 05). The ADL total score was positively correlated with the SF - 36 total score(r = 0. 324,P < 0. 01),while the total scores respectively in mental status,perception, communication and social participation were negatively associated with SF - 36 total score(r = - 0. 196, - 0. 324, - 0. 435, P < 0. 01). The social participation total score,disease index and physical status could remarkably influence the quality of life of the elderly(P < 0. 05). Conclusjon Promoting the social participation of the elderly and reducing the types of disease and complication they suffer from contribute to the improvement of quality of life.