目的:了解独居老人养老意愿并探讨其影响因素,为建立健全社会养老服务体系提供依据。方法:基于2018年中国老年健康长寿影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey, CLHLS)中1 208位独居老人数据,以Andersen理论模型为框架,采用2检验分析不同特征独居老人选择养老模式的差异,运用二元Logistic回归分析方法从倾向性特征、使能资源、需求三方面剖析独居老人养老意愿的影响因素。结果:1 208名独居老人中,绝大多数老人选择社区居家养老,占比92.0 %,仅有8.0 %的老人表示愿意入住机构养老。Logistic回归显示文化程度为小学、经济一般、子女较多的独居老人选择机构养老的意愿更低,OR值均 ＜1且P＜0.05;日常由社会照料、孤独感较多、健康状况一般、日常生活能力受到很大限制的独居老人更倾向于入住机构养老,OR值均 ＞1且P＜0.05。模型Ⅰ～Ⅲ的决定系数R2逐步增大,其中使能因素对模型的贡献度最大。结论:独居老人养老意愿以社区居家养老为主。独居老人的养老意愿受多种因素影响,其中使能因素影响最大。建议除提升社区居家养老服务能力外,还应根据独居老人差异构建多元化、精准化的养老模式以满足老人的需求。
Objective: To understand the willingness to participate elderly care of elderly people who live alone and explore its influencing factors, with the purpose of providing basis for the establishment of a robust social system of elderly care service.Methods: The data of 1 208 elderly people who live alone from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) were collected, using Andersen's model as a framework and 2 test to analyze the difference in the choice of elderly care mode among the elderly with different characteristics. Propensity, enabling resources, and needs were analyzed with binary logistic regression analysis to determine the influencing factors of willingness to participate elderly care of elderly people who live alone. Results: Among the 1 208 elderly living alone, the 92.0 % of elderly people preferred community service for home care, and only 8.0 % of elderly people willing to be admitted to institutional care for elderly. Logistic regression analysis showed that older people with an education level of elementary school, general income level, or having more than one child who live alone had lower willingness to institutional care for elderly (OR＜1,P＜0.05). The elderly living alone who were routinely cared for by related institutions, with more loneliness and poor health status, and very restricted in their ability to perform daily living, were more likely to choose an institutional care for elderly value (OR＞1, P＜0.05). The determination coefficients R2 of models Ⅰ to Ⅲ increased stepwise, among which the enabling factors contributed to the most to the model. Conclusion: The willingness to participate elderly care of elderly people who live alone is mainly preferred to community service for home care. The willingness to participate elderly care of elderly people who live alone is affected by several factors, of which the enabling factors have the greatest influence. In addition to enhance community service for home care, a diverse and precise model of elderly care should be explored to meet the needs of elderly people who live alone.
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