居家老年慢性病患者生命质量与社区护理需求的关系

目的 了解居家老年慢性病患者生命质量及其对社区护理服务需求的情况,分析它们之间的关系及影响因素,为改进该人群社区护理内容和方式提供依据.方法 利用中文版SF-36量表及自制的社区护理需求调查问卷,采用随机整群抽样的方法,对抽取的2个社区1 856例符合调查标准的居家老年慢性病患者（慢性病组）和1 110 例健康老年人群（对照组）进行调查.结果 慢性病组SF-36量表的8个维度及生理健康和心理健康综合评分均显著低于对照组（P＜0.05）;控制人口学因素后,各维度评分慢性病组均显著低于对照组（P＜0.01）;年龄、婚姻状况、文化程度、月收入与该人群生命质量存在关联.居家老年慢性病患者选择到社区医疗中心就诊占41.8%;对社区护理服务各项需求率均低于50%.影响社区护理需求的主要因素是婚姻状况、职业、医疗支付形式、月收入、患慢性病种数及生活自理能力.除GH维度与定期体检领域外,居家老年慢性病患者生命质量各维度与社区护理各领域需求呈负相关（P＜0.05）.结论 该社区居家老年慢性病患者生命质量较健康老年人群低,对社区护理服务需求利用度不高,其生命质量和社区护理需求之间呈负相关,应针对性地提供相应的社区护理项目,以提高老年慢性病患者的生命质量.

Relationship between Life Quality and Community Nursing Demand in Elderly Chronic Disease Patients Living at Home

Objective To understand the quality of life of elderly chronic disease patients living at home and their demand for community nursing, and to analyze the relationship between life quality and community nursing demand and their influencing factors for improving the community nursing content and method. Methods A total of 1 856 elderly chronic disease patients living at home and 1 110 healthy elderly subjects from two communities were selected using random cluster sampling and were investigated by SF-36 questionnaires and self-made questionnaires. Results Compared with healthy elderly subjects, SF-36 eight dimension scores, comprehensive body scores and comprehensive mental scores significantly decreased in elderly chronic disease patients （P〈0.05）. After controlling for demography factors, each dimension scores in elderly chronic disease patients were also lower than those in healthy elderly subjects（P〈0.01）. The age,marital status, education degree and monthly income were correlated with the quality of life among elderly chronic disease patients living at home. Community health care center visit rate was 41.8% and community nursing demand rate was less than 50% among elderly chronic disease patients living at home. The major factors influencing community nursing demand were marital status, occupa- tion,medical payment form, monthly income, number of chronic diseases and self-care ability. There was a negative correlation between each dimension of life quality and the demand for com- munity nursing （except GH dimension and periodic physical examination,P〈0.05 ）. Conclusion Elderly chronic disease patients living at home have a lower quality of life than healthy elderly, and have a low demand for community nursing. Furthermore,the quality of life of elderly chronic disease patients is negatively correlated with the demand for community nursing. Targeted com- munity nursing projects should be provided for improving the quality of life of elderly chronic dis- ease patients living at home.