延续性护理视角下阜阳市失能老人“医养结合”机构养老意愿及其影响因素研究

Willingness toward “Medical-Nursing Combination” Institutional Eldercare and Its Associated Factors among Disabled Older Adults in Fuyang: A Perspective of Continuity of Care

摘要: 目的：了解阜阳市失能老人对“医养结合”机构养老的意愿，分析其相关因素，为完善失能老人养老服务提供参考。方法：采用多阶段分层抽样，于2024年3~9月对阜阳市3个区和5个县60岁及以上失能老人进行问卷调查。采用《老年人“医养结合”机构养老意愿调查问卷》收集资料，第三部分基于计划行为理论测量行为态度、主观规范和知觉行为控制3个维度。采用χ²检验和t检验进行单因素分析，采用二元Logistic回归分析机构养老意愿的相关因素。结果：共回收有效问卷952份，愿意选择“医养结合”机构养老者530人(55.7%)。多因素Logistic回归显示，文化程度为初中(OR = 1.692)和高中及以上(OR = 2.391)、家庭月收入 ≥ 4000元(OR = 2.086)、中度失能(OR = 1.753)和重度失能(OR = 2.669)、了解“医养结合”(OR = 1.839)，以及行为态度(OR = 1.864)、主观规范(OR = 1.569)、知觉行为控制(OR = 1.467)得分较高者机构养老意愿较高，居住在农村者意愿较低(OR = 0.656) (均P < 0.05)。结论：阜阳市失能老人“医养结合”机构养老意愿处于中等水平，与文化程度、家庭月收入、失能程度、对“医养结合”的了解程度及计划行为理论3个维度相关。提示可从延续性护理角度改进养老服务，相关措施的效果尚需干预性研究验证。

Abstract: Objective: This paper aims to investigate the willingness toward medical-nursing combination (MNC) institutional eldercare among disabled older adults in Fuyang and to analyze its associated factors. Methods: From March to September 2024, a multistage stratified sampling survey was conducted among disabled adults aged 60 years and over in three districts and five counties of Fuyang. The Questionnaire on Older Adults’ Willingness for MNC Institutional Eldercare was used; its third part measured behavioral attitude, subjective norm and perceived behavioral control based on the theory of planned behavior. Chi-square test and t test were used for univariate analysis, and binary logistic regression was used to identify associated factors. Results: A total of 952 valid questionnaires were analyzed; 530 respondents (55.7%) were willing to choose MNC institutional eldercare. Multivariable logistic regression showed that junior high school education (OR = 1.692), senior high school or above (OR = 2.391), monthly household income ≥4000 CNY (OR = 2.086), moderate disability (OR = 1.753), severe disability (OR = 2.669), awareness of MNC (OR = 1.839), and higher scores on behavioral attitude (OR = 1.864), subjective norm (OR = 1.569) and perceived behavioral control (OR = 1.467) were associated with greater willingness, whereas rural residence (OR = 0.656) was associated with lower willingness (all P < 0.05). Conclusion: The willingness toward MNC institutional eldercare among disabled older adults in Fuyang is at a moderate level and is associated with education, income, disability severity, awareness of MNC and the three dimensions of the theory of planned behavior. Improving eldercare services from the perspective of continuity of care is suggested, and the effect of related measures needs to be verified by interventional studies.