CAJ | 학술논문

背景国内大型城市中老年人口迅速增加,常见的养老方式有3种:传统居住家中由家人照料的方式(传统养老),以家庭为核心结合社区养老服务的方式(居家养老)以及居住养老院的方式(机构养老).不同养老方式对城区老人生活质量、社会支持和心理状况影响的系统评估,目前尚缺乏.假设与传统养老或机构养老的老人相比,居家养老老人的生活质量较好,获得的社会支持较多,心理问题较少.方法采用整群抽样方法,抽取3种养老方式,即传统养老、居家养老和机构养老,年龄在65岁及以上的老人各100名,进行生活质量综合评定问卷(36-item Medical Outcome Study Short Form health survey,SF-36)、社会支持评定量表(Social Support Rating Scale,SSRS)和90项症状清单(Symptom Checklist 90,SCL-90)的评定.结果 3组间性别构成、婚姻状态、月收入以及受教育程度均无显著意义的差异,但是传统养老组的平均年龄稍大.居家养老组和传统养老组SF-36中8个纬度的平均得分均高于机构养老组.居家养老组(A)的社会支持评定量表(SSRS)的评分也高予传统养老组(B)和机构养老组(C)[依次为36.8(4.4)分、25.3(6.7)分以及20.0(30.4);F2,297=12.78,P<0.001;A>B>C]根据SCL-90评分,居家养老组和传统养老组老人的心理症状比机构养老组的程度轻[依次为129.9(38.7)分、131.6(28.4)分以及139.0(31.2)分,F2,297=8,98,P=0.004;A,B<C]传统养老组中SCL-90中躯体化、人际关系、偏执、精神病性的分量表得分高于居家养老组.校正人口学资料后,上述差异仍有统计学显著意义.结论与传统养老或机构养老方式的老人相比,居家养老方式的老人自我报告的稳固的社会支持更多.与养老机构者比,居住家中的老人(居家养老和传统养老)生活质量好,心理症状轻.今后需要前瞻性队列研究来验证实这些横断面研究的结果.
배경 국내대형성시중노년인구신속증가,상견적양로방식유3충:전통거주가중유가인조료적방식(전통양로),이가정위핵심결합사구양로복무적방식(거가양로)이급거주양로원적방식(궤구양로).불동양로방식대성구노인생활질량、사회지지화심리상황영향적계통평고,목전상결핍.가설 여전통양로혹궤구양로적노인상비,거가양로노인적생활질량교호,획득적사회지지교다,심리문제교소.방법 채용정군추양방법,추취3충양로방식,즉전통양로、거가양로화궤구양로,년령재65세급이상적노인각100명,진행생활질량종합평정문권(36-item Medical Outcome Study Short Form health survey,SF-36)、사회지지평정량표(Social Support Rating Scale,SSRS)화90항증상청단(Symptom Checklist 90,SCL-90)적평정.결과 3조간성별구성、혼인상태、월수입이급수교육정도균무현저의의적차이,단시전통양로조적평균년령초대.거가양로조화전통양로조SF-36중8개위도적평균득분균고우궤구양로조.거가양로조(A)적사회지지평정량표(SSRS)적평분야고여전통양로조(B)화궤구양로조(C)[의차위36.8(4.4)분、25.3(6.7)분이급20.0(30.4);F2,297=12.78,P<0.001;A>B>C]근거SCL-90평분,거가양로조화전통양로조노인적심리증상비궤구양로조적정도경[의차위129.9(38.7)분、131.6(28.4)분이급139.0(31.2)분,F2,297=8,98,P=0.004;A,B<C]전통양로조중SCL-90중구체화、인제관계、편집、정신병성적분량표득분고우거가양로조.교정인구학자료후,상술차이잉유통계학현저의의.결론 여전통양로혹궤구양로방식적노인상비,거가양로방식적노인자아보고적은고적사회지지경다.여양로궤구자비,거주가중적노인(거가양로화전통양로)생활질량호,심리증상경.금후수요전첨성대렬연구래험증실저사횡단면연구적결과.
Background:In large Urban centers in China three common methods have evolved to provide services to the rapidly increasing numbers of elderly residents:traditional family support in the home;supplemental home visits by community service workers;and residential nursing homes for the elderly.The differential effects of these services on the quality of life,social support and psychological functioning of the urban elderly have not been systematically assessed.Hypothesis:The elderly receiving home visit services have a higher quality of life,better social support and lesspsychological symptoms than those who only receive family support or who have moved to live in nursing homes.Methods:Using cluster sampling methods,persons 65 years of age or older receiving thtee types of services-community-based home services,traditional family support,and residential home placement-were identified (100 persons for each type)and administered the 36-item Medical Outcome Study Short Form health survey(SF-36),the Social Support Rating Scale(SSRS)and the Symptom Checklist 90(SCL-90).Results:There were no significant differences in gender,marital status,monthly income or educational level between the three groups but the mean age of the residential home residents was somewhat higher.The mean scores for all eight subscales on the SF-36 were higher in the community-based services group and traditional family support group than in the residential home group,but there were no significant differences between the communitysupport group and the traditional family support group.The mean(SD)SSRS social support measure was higher in the community-based home services(A)subjects than in the family support(B)and residential home(C)groups [36.8(4.4),25.3(6.7)and 20.0(30.4),respectively;F2,297=12.78,P<0.001;A>B>C] and the overall level of psychological symptoms assessed by SCL-90 was lower In the community-based home services subjects and family support subiects than in the residential home subjects [129.9(38.7),131.6(28.4)and 139.0(31.2),respectively;F2,297=8.98,P=0.004;A,B<C]The mean score of some of the SCL-90 subscales-somatization,interpersonal sensitivity,paranoid ideation,and psychoticism-were significantly higher in the family care group than in the community services group.These differences all remained significant after adjustment for demographic variables.Conclusion:Compared to elderly residents receiving traditional family support or those who have moved to residential homes,those provided community-based social services in their own homes report more robust social support networks.The quality of life and psychological health of elderly who stay in their own homes or in the homes of their relatives are better than those of elderly residents who move to a residential home.Prospective cohort studies are needed to confirm these cross-sectional results.