社会学视角下老年人的医疗和照顾需要研究

发布时间：2018-03-28 14:13

本文选题：老年人　切入点：卫生服务需求　出处：《中国全科医学》2017年07期

【摘要】：目的了解老年人的医疗和照顾需要,探索影响老年人感知医疗和照顾需要及其寻求和使用服务的促成和阻碍因素。方法从2016年5月深圳市罗湖区黄贝岭社区老年人综合健康评估的100例参加者中选择8例老年人为本研究对象,生于1918—1952年,年龄64~98岁;其中男3例,女5例。采用民族志研究方法,研究者是关注社区老年人健康和福祉的黄贝岭社区健康服务中心的全科医生。结果 (1)老年人经历过并正在经历重大的社会变迁。(2)婚姻关系中女性老年人多为照顾和服从者角色,忽略或否认自己的需要,女性"老老人"多失去配偶支持。(3)老年人多子女,子女与老年人的代际关系复杂。(4)大多老年人表现出自主和自理的愿望,并身体力行。不情愿让保姆进入家庭,是出于对服务质量、自身安全、自身价值的平衡考虑。(5)女性有较多社区伙伴和参与社区活动,男性则多存在社会隔绝。老年人的信息来源多为媒体或口耳相传,正式信息比较少。(6)老年人对医院表现为恐惧和逃避,老年人更倾向于社区医疗服务,他们与社区医护人员的互动取决于全科医护服务的连续性和主动性。(7)老年人多共病且病情复杂,但与老年人感知需要和服务利用没有必然的联系。相对于病种而言,其自身定位和健康信念在寻求和利用服务上具有更大的影响。结论全科医学服务应该关注老年人的生活经历、家庭和朋友、社区和环境、健康信仰、对医学服务的体验,这对于理解他们的寻助行为和服务利用有重要意义。老年服务设计和提供者应该注意到,婴儿潮之前出生的老年人更具有传统的文化和信念,有特定的需要表达、行为和互动方式,并且要特别关注男性老年人的社会隔离问题。在发展就地养老和医养结合时,应关注老年人家庭内横向和纵向关系、他们与家庭外的互动方式,以及这些互动的促成或阻碍作用。老年人对医院和养老院服务的恐惧和回避,以及对社区医护人员关系的渐进发展,提示应该加强社区医护人员综合评估和理解老年人需要的能力,并以躯体-心理-社会模式来给老年人提供具有文化敏感性和响应性的服务。民族志方法是从社会学角度对服务对象的观察和分析,为服务系统的设计提供了独特的信息依据,并符合全科医学的整体人和以人为本观点,有助于给居民提供更好质量的服务。
[Abstract]:Objective to understand the health care for the elderly and elderly care needs, explore the impact of perceived health and care needs and seek and use services and contributed to the hindering factors. 8 cases of the elderly in this study selected 100 participants methods from May 2016 Shenzhen city comprehensive health Luohu District Huangbeiling elderly community assessment, born in 1918 - 1952, age 64~98 years old; male 3 cases, female 5 cases. Ethnographic research methods, researchers Huangbeiling attention of elderly people in community health and well-being of the community health service center of the GP. Results (1) the elderly experienced and are experiencing great social changes. (2) women aged in order to take care of their role in marriage and obedience, ignore or deny their own needs, "the old man" women lost their spouse support. (3) children aged, intergenerational relations between children and elderly complex (4). Most of the elderly People show autonomy and self desire, and personally. Reluctant to let the nanny into the family, for their own safety, quality of service, the value of their own balance. (5) women have more community partners and participate in community activities, men are social isolation. The elderly information source to the media or word of mouth officially, less information. (6) the elderly to the hospital to escape and fear, old people tend to community health services, community health workers and their interaction on the continuity and initiative to care family. (7) among the elderly, comorbidity and complex condition, but with the elderly perceived needs and service utilization are not necessarily linked. Compared with the disease, its location and health belief in seeking and have a greater effect on the use of services. General medical services should be concerned about the conclusion of life of the elderly home experience. Family and friends, the community and the environment, health beliefs, medical service experience, to understand their help seeking behavior and service utilization. It is of great significance for elderly service design and providers should pay attention to the baby boomers before the elderly has more traditional culture and belief, there is a specific need expression, behavior and interactive way, and social isolation problems of the elderly male. Special attention in the development of local pension and medical support combined, attention should be paid to the elderly family in the horizontal and vertical relations, the way they interact with the family, and these interactions promote or hinder effect. The elderly services of hospitals and nursing homes fear and avoidance, as well as the relationship between community medical staff of the progressive development, it is suggested that we should strengthen community health personnel comprehensive evaluation and understanding of the needs of the elderly, and the physical psychological social model for elderly People with cultural sensitivity and responsiveness of service. The method of ethnography is observation and analysis of the service object from the angle of sociology, provides unique information basis for the design of service system, and in accordance with the overall general medicine and people-oriented idea, can provide better quality of service to the residents.

【作者单位】：广州医科大学公共卫生学院;广东省深圳市罗湖医院集团黄贝岭社区健康服务中心;
【分类号】：R197.61;D669.6

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