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Zhang L, Shen S, Zhang W, Fang Y. What determines informal care need among community-dwelling older adults in China? Results from a longitudinal study. BMC Geriatr 2024; 24:597. [PMID: 38997678 PMCID: PMC11241955 DOI: 10.1186/s12877-024-04843-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/23/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND With an intensified aging population and an associated upsurge of informal care need in China, there is an ongoing discussion around what factors influence this need among older adults. Most existing studies are cross-sectional and do not focus on older people living in the community. Conversely, this study empirically explores the factors that affect informal care need of Chinese community-dwelling older individuals based on longitudinal data. METHODS This study constructed panel data using the China Health and Retirement Longitudinal Research Study (CHARLS) from 2011 to 2018 for analysis. Generalized linear mixed models were used to analyze the factors affecting reception of informal care, and linear mixed models were used to analyze the factors affecting informal care sources and intensity. RESULTS During the follow-up period, 7542, 6386, 5087, and 4052 older adults were included in 2011-2018, respectively. The proportion receiving informal care increased from 19.92 to 30.78%, and the proportion receiving high-intensity care increased from 6.42 to 8.42% during this period. Disability (estimate = 4.27, P < 0.001) and living arrangement (estimate = 0.42, P < 0.001) were the critical determinants of informal care need. The rural older adults reported a greater tendency to receive informal care (estimate = 0.14, P < 0.001). However, financial support from children did not affect informal care need (P > 0.05). CONCLUSIONS At present, there is a great demand for the manpower and intensity of informal care, and the cost of informal care is on the rise. There are differences in informal care needs of special older groups, such as the oldest-old, living alone and severely disabled. In the future, the region should promote the balance of urban and rural care service resources, rationally tilt economic support resources to rural areas, reduce the inequality of long-term care resources, improve the informal care support system, and provide a strong community guarantee for the local aging of the older adults.
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Affiliation(s)
- Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiang An Nan Road, Xiang An District, Xiamen, Fujian Province, China
| | - Shuyuan Shen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiang An Nan Road, Xiang An District, Xiamen, Fujian Province, China
| | - Wenzheng Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiang An Nan Road, Xiang An District, Xiamen, Fujian Province, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiang An Nan Road, Xiang An District, Xiamen, Fujian Province, China.
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Genaro LE, Marconato JV, Tagliaferro EPDS, Pinotti FE, Valsecki Júnior A, Adas Saliba T, Rosell FL. Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:539. [PMID: 38791748 PMCID: PMC11121688 DOI: 10.3390/ijerph21050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 05/26/2024]
Abstract
This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.
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Affiliation(s)
- Luis Eduardo Genaro
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - José Victor Marconato
- School of Medicine, San Francisco University, Bragança Paulista 12.916-900, SP, Brazil;
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Felipe Eduardo Pinotti
- Postgraduate Program in Collective Health in Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Aylton Valsecki Júnior
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
| | - Tânia Adas Saliba
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University, Araçatuba 16.015-050, SP, Brazil;
| | - Fernanda Lopez Rosell
- Department of Community Dentistry, School of Dentistry, São Paulo State University, Araraquara 14.801-903, SP, Brazil; (E.P.d.S.T.); (A.V.J.); (F.L.R.)
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Li M, Shen J, Wang X, Chen Q, Xiaoyan L, Ren L. A theoretical framework based on the needs of smart aged care for Chinese community-dwelling older adults: A grounded theory study. Int J Nurs Knowl 2024; 35:13-20. [PMID: 36495137 DOI: 10.1111/2047-3095.12408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE With technological progress, the integration of aged care with technology is a new challenge. This study developed a theoretical model of smart aged care in the community to meet the diverse needs of community-dwelling older adults. METHODS This qualitative study recruited 22 participants from three communities in Chongqing, China. Through semi-structured interviews and grounded theory, this study analyzed the needs of community-dwelling older adults for smart aged care and identified strategies. RESULTS Nine categories were identified, including five need categories, three important factors, and one outcome objective. Furthermore, four health provider topics were proposed. CONCLUSIONS Although the application of information technology has enhanced convenience and possibilities, its popularity and satisfaction are low. Information technology can be successfully introduced into the lives of community-dwelling older adults only by truly understanding their needs. IMPLICATIONS OF NURSING PRACTICE Smart aged care in the community has positive effects on nursing outcomes for older adults. This study's findings can help caregivers understand the various dimensions of the needs of community-dwelling older adults and relevant influencing factors under smart aged care to increase its popularity and satisfaction. Furthermore, this can promote the integration of intelligent technology and manual services in nursing practice.
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Affiliation(s)
- Miao Li
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Jun Shen
- Nursing Department, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinxia Wang
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Qiu Chen
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Liao Xiaoyan
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Liu Ren
- School of Nursing, Chongqing Nursing Vocational College, Chongqing, China
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Wang J, Huang Y, Zhang Y, Wu F, Wu B. Domestic Helpers as Frontline Workers in Home-Based Long-Term Care in China: Opportunities and Challenges. J Aging Soc Policy 2023; 35:611-630. [PMID: 36453693 DOI: 10.1080/08959420.2022.2120323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 03/30/2021] [Indexed: 12/05/2022]
Abstract
Domestic helpers (also called baomu or jiazhengfuwuyuan in Chinese) enter personal residences to provide care and services. This study explored challenges and opportunities facing the long-term care (LTC) domestic service in urban China from the perspectives and experiences of domestic helpers (n = 25) and their employers (older adults or their family, n = 25), domestic service company managers (n = 8) and industry association staff (n = 6). Challenges identified pertain to the domestic helper-older adult relationship, day-to-day care, training, domestic service company role, and workforce shortages and instability. Opportunities include possibilities for supporting career development and increased access to social welfare and medical assistance, enhancing person-centered care for older adults by helping domestic helpers build core competencies, and establishing peer support and connections through mobile technologies.
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Affiliation(s)
- Jing Wang
- Assistant professor, School of nursing, Fudan University, Shanghai, Yangpu, China
| | - Yahui Huang
- Associate professor, Tourism and social admistration college, Nanjing Xiaozhuang University, Nanjing, Jiangsu, China
| | - Yaqing Zhang
- Chief editor, Editorial Department of Journal of Shanghai Jiao Tong University (Medical Science), Shanghai Jiao Tong University, Shanghai, Minhang, China
- Student, Nursing Management Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, Minhang, China
| | - Fangqi Wu
- Assistant professor, School of nursing, Fudan University, Shanghai, Yangpu, China
| | - Bei Wu
- Associate dean of research/Professor, Rory Meyers College of Nursing, New York University, New York, NY, USA
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Wang Z, Liu Z. Latent classes and related predictors of demand for home-and community-based integrated care for older Chinese adults. Front Public Health 2023; 11:1109981. [PMID: 37427265 PMCID: PMC10326318 DOI: 10.3389/fpubh.2023.1109981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Background Home-and community-based integrated care has been developing rapidly in China in recent years. However, empirical research on the demand from older people is insufficient. Most studies have failed to identify or differentiate the heterogeneity of older people, resulting in poor understanding of their needs and fragmentation of services. This study seeks to identify latent classes of demand for home-and community-based integrated care among older Chinese adults and the predictors that differentiate these demands. Methods From January to March 2021, a questionnaire was administered to older people (aged ≥60 years) in community-based service centers for older people in six districts of Changsha City, Hunan Province. Participants were selected through purposive and incidental sampling. Latent profile analysis was used to categorize older people's demand for home-and community-based integrated care. By extending Andersen's behavioral model of health service use, and running multinomial logistic regression analyses, we explored which factors influenced the latent classes of demand. Results A total of 382 older people were included in the analyses: 64.4% were women and 33.5% were aged 80-89. The demand from older people for home-and community-based integrated care was classified into four latent classes: high health and social interaction demand (30% - 115/382); high comprehensive demand (23% - 88/382); high care service demand (26% - 100/382), and high social participation and low care demand (21% - 79/382). Taking this last class as the reference group, the other three latent classes differed significantly in the factors of predisposition, enabling, need, and perception of aging. Conclusion The demand from older people for home-and community-based integrated care is multifaceted and heterogeneous. Services for older people should be designed with different sub-models of integrated care.
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Affiliation(s)
- Zhenyu Wang
- School of Government, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhihan Liu
- School of Public Administration, Central South University, Changsha, Hunan, China
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Fu Y, Guo Y. Community environment moderates the relationship between older adults' need for and utilisation of home- and community-based care services: The case of China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3219-e3232. [PMID: 35253309 DOI: 10.1111/hsc.13766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/13/2022] [Accepted: 02/10/2022] [Indexed: 06/14/2023]
Abstract
This study explores the moderating influence of perceived and objective community environments on the relationship between older adults' home- and community-based care (HCBC) needs and their actual utilisation of such care. We selected 5,668 older adults in two cities in China and adopted latent class analysis to descriptively explore the patterns of their HCBC need and utilisation. Structural equation modelling was used to determine factors related to the patterns of need and utilisation of HCBC services, and to explore the moderating roles that the perceived and objective community environments had on the effect of long-term care need on its utilisation. The results descriptively showed that older adults' patterns of HCBC need and utilisation appear to be embedded within two broader latent categories: a high-need/use group and a low-need/use group. Among participants who were satisfied with their community or who lived in areas with high accessibility to HCBC services, HCBC need could predict HCBC use. Our integrated conceptual framework proved to be applicable, thus enriching the theoretical models in explaining HCBC-related behaviours. The results have strong implications for urban planners, policymakers, and programme managers who seek to support older people and provide elderly care services in communities.
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Affiliation(s)
- Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Yingqi Guo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159332. [PMID: 35954687 PMCID: PMC9368037 DOI: 10.3390/ijerph19159332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022]
Abstract
Population aging has increased the demand for elderly care worldwide. The home-based elderly care system plays an important role in meeting this demand in developing countries. The quality of home-based elderly care is associated with the job satisfaction of caregivers in home-based elderly care programs, which has rarely been studied. This paper explores the factors that affect the job satisfaction of these elderly caregivers, including personal characteristics, working conditions, employment status, training, caregiver–client relationships, welfare, work experience, and burnout. It utilizes data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over the period from May to September 2021. This paper selected a sample of elderly caregivers (n = 285) to examine their job satisfaction. The results show that gender, age, marital status, how they earned the job, relation with clients, social insurance, and work experience are significantly associated with the job satisfaction of in-home elderly caregivers, and their job satisfaction is negatively associated with their burnout levels. However, training and working conditions have no significant effect on the job satisfaction of in-home elderly caregivers, which is different from previous studies on formal care workers, such as nurses, in the institutional care system.
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Du Q, Gong N, Hu Q, Chen G, Xie J, Luo L, Cheng Y, Zhang M. Why do older adults living alone in cities cease seeking assistance? A qualitative study in China. BMC Geriatr 2022; 22:540. [PMID: 35768784 PMCID: PMC9241305 DOI: 10.1186/s12877-022-03217-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Against the background of an aging population, older adults living alone in cities are increasingly dependent. However, their use of home and community-based services in China is unsatisfactory. This study attempted to figure out why older adults living alone in cities do not actively seek assistance in China. Methods In-depth interviews were conducted. A total of 29 older adults were recruited. Content analysis was used to analyze the interview data. Results Three themes were identified. (1) Desire for independence, despite hardship: The lives of older adults involve many inconveniences, but they preferred to solve problems by themselves, instead of asking for help; (2) Desire to not overburden jiaren (meaning family in Chinese): older adults did not want to disturb families or burden children with caring responsibilities. Moreover, previous experience of failing to obtain care made them reluctant to seek help from jiaren; (3) Desire to not bother wairen (meaning people other than family in Chinese): The lack of trust caused by being unfamiliar with wairen, and the fear of being a burden to others if they were not able to reciprocate, made older adults reluctant to seek help from wairen. Conclusions Changes in social, economic, and demographic structures have led to gradual failure of family care. Older adults accustomed to an “acquaintance society” have not yet adapted to seeking help from the community. When addressing the problem of care for older adults living alone in cities, it is important to focus on the profound impact of social change.
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Affiliation(s)
- Qianqian Du
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, Guangdong, China
| | - Qin Hu
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Guicheng Chen
- Guangzhou Tianhe District Qizhi Social Work Service Center, Guangzhou, Guangdong, China
| | - Jingyue Xie
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China
| | - Lan Luo
- Huangpu District Hongshan Street Community Health Service Center, Guangzhou, Guangdong, China
| | - Yu Cheng
- The Seventh Affiliated Hospital Sun Yat-Sen University, No.628, Zhenyuan Road, Xinhu Street, Guangming New District, Shenzhen, Guangdong, China.
| | - Meifen Zhang
- School of Nursing, Sun Yat-Sen University, No.74, Zhongshan Road II, Guangzhou, Guangdong, China.
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Tang Z, Wang N. Will Downward Intergenerational Housing Support Increase Parents' Expectations for Old-Age Care from Adult Children? Evidence from China. J Appl Gerontol 2022; 41:2084-2095. [PMID: 35527691 DOI: 10.1177/07334648221099001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Toward a background of young people's decreasing housing affordability and parents' increasing involvement in intergenerational housing support, this study investigates how such support influences parents' expectation of future care from adult children. Using data from the China Health and Retirement Longitudinal Study, we found that, in general, middle-aged/older adults who provided adult children financial housing support were more likely to expect old-age care from them. The help-receiving child was more likely to be an expected caregiver than the other children in multi-children families. Moreover, the reciprocal relationship was most prominent among the 1950s cohort, compared with the pre-1950s and the post-1950s cohorts. Our study broadly contributes to understanding how modernization reshapes intergenerational relationships and family members' expectations of commitments toward each other. It also informs the design of a comprehensive multi-level care system for older adults in China.
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Affiliation(s)
- Zequn Tang
- School of Sociology and Political Science, 34747Shanghai University, Shanghai, China
| | - Ning Wang
- School of Social and Public Administration, 47860East China University of Science and Technology, Shanghai, China
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Li Y, Sun Y, Li J, Jia J. Patterns and Predictors of Preparation for Future Care Among Older Rural Chinese Adults: A Latent Profile Analysis. J Appl Gerontol 2021; 41:207-216. [PMID: 34886703 DOI: 10.1177/0733464820964148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify profiles of preparation for future care (PFC) among older rural Chinese adults. A total of 481 older adults were recruited. PFC was evaluated using Preparation for Future Care Needs and respondents' social services knowledge. Information on individual characteristics, physical health indicators, mental health, and support system was collected. Four profiles of PFC were identified: scarce-preparation (22.42%), high-avoidance/low-action (26.91%), moderate-preparation (44.17%), and high-avoidance/high-action (6.50%). The scarce-preparation and high-avoidance/low-action profiles had the lowest levels of social services knowledge. Multinomial logistic regression showed that older adults in moderate-preparation and high-avoidance/high-action profiles had fewer illnesses, exercised more frequently, and had higher loneliness levels compared with those in the scarce-preparation profile. Compared with high-avoidance/low-action persons, high-avoidance/high-action persons had fewer illnesses, exercised more frequently, and had lower self-esteem and higher loneliness levels. People who performed poorly in physical health indicators and well in mental health need to increase PFC.
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Affiliation(s)
- Yuqin Li
- Shandong University, Jinan, China
- Shandong Management University, Jinan, China
| | | | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
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Zhu S, Zhu H, Zhang X, Liu K, Chen Z, Yang X, Sun C, Xie W, Xu Q, Li W, Pang D, Cui Y, Wang H. Care needs of dying patients and their family caregivers in hospice and palliative care in mainland China: a meta-synthesis of qualitative and quantitative studies. BMJ Open 2021; 11:e051717. [PMID: 34740931 PMCID: PMC8573656 DOI: 10.1136/bmjopen-2021-051717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the care needs of dying patients and their family caregivers in hospice and palliative care in mainland China. METHODS A search for English and Chinese quantitative and qualitative studies was performed using the following English databases: PubMed (Medline), CINAHL and PsycINFO, as well as Chinese databases: SinoMed and CNKI. The records were independently screened by two reviewers and critiqued using Joanna Briggs Institute Critical Appraisal tools. All quantitative data were transformed into qualitative data, which were converted into textual descriptions. Due to the diversity of included studies, a three-step analysis was performed: narrative summary, thematic analysis and presentation of integrated results in a narrative form. The qualitative findings were pooled using the meta-aggregation approach. RESULTS The literature search identified 2964 papers after removing duplicates, from which 18 were included (9 quantitative and 9 qualitative studies). All studies were conducted in mainland China. Quantitative studies involved cross-sectional surveys, and qualitative studies involved interviews for data collection. Two synthesised results of patients' needs were identified, including needs to be comfortable and experience a good death. Another two synthesised results of family caregivers' needs included needs to care for and improve the quality of life of patients, and to care for themselves well. CONCLUSION This study identified that patients and family caregivers have an increasing demand for professional care at the end of life. Professionals, especially nurses, should enact a patients' demand-centred practice to overcome the challenges of organisation, education, emotion and communication to provide high-quality end-of-life care.
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Affiliation(s)
- Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xintong Zhang
- Emergency, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Kouying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zumei Chen
- China Jiliang University Hospital, Hangzhou, Zhejiang, China
| | - Xiaowen Yang
- Nanjing Medical University Library, Nanjing, Jiangsu, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Vocational Institute of Commerce, Nanjing, Jiangsu, China
| | - Weiping Xie
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiying Li
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
- Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University Health Science Centre, Beijing, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Wang
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Zeng Y, Que S, Lin C, Fang Y. The Expected Demand for Elderly Care Services and Anticipated Living Arrangements Among the Oldest Old in China Based on the Andersen Model. Front Public Health 2021; 9:715586. [PMID: 34676193 PMCID: PMC8523921 DOI: 10.3389/fpubh.2021.715586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/20/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: The first aim of this study was to explore expected demands of the oldest old and their determinants for different types of elderly care services. The second aim was to investigate preferred choices of living arrangements among the oldest old and the influencing factors. Methods: Data of 4,738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression analysis was performed to analyze the relationship between the expected elderly care services and living arrangements and other influencing factors. The odds ratios were calculated to indicate the relationship between the influencing factors and the dependent variables. Results: From the descriptive analysis results, we found that the oldest old showed high anticipated needs for home visits (83.5%) and health education (76.4%). Further, there existed a huge imbalance between the supply and demand of care services for the aged. Living with children is still the most important way of providing for the oldest old. The regression results showed that the expected demands for elderly care services and anticipated living arrangements among the oldest old in China are influenced by age, residence, housing property rights, economic status, loneliness, and activities of daily living (ADLs). The oldest old who are older without housing property rights, childless, and have restricted ADLs were more frequently observed to live in long-term care institutions. Conclusions: There is an inequality of the supply and expected demand for elderly care services, and living with children is still a preferred choice of the Chinese oldest old. Our findings indicate that when planning how to promote elderly care services among the oldest old, it is important to consider their expectations, especially for the subgroup that is relatively disadvantaged. Related policies should be developed to offer incentives to family caregivers when they live with the oldest old.
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Affiliation(s)
- Yanbing Zeng
- School of Public Health, Capital Medical University, Beijing, China.,Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Shuang Que
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Chenxi Lin
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- Key Laboratory of Health Technology Assessment, School of Public Health, Xiamen University, Xiamen, China.,State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Meng D, Xu G, Davidson PM. Perceived unmet needs for community-based long-term care services among urban older adults: A cross sectional study. Geriatr Nurs 2021; 42:740-747. [PMID: 33872858 DOI: 10.1016/j.gerinurse.2021.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to explore the perceived unmet needs for community-based long-term care services among older urban adults in China. We analyzed the cross-sectional data of 5,201 urban community respondents ≥65 years of age from the seventh wave of the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The chi-squared automatic interaction detection technique was used to examine the variables associated with older adults' unmet needs for four common types of community-based services: personal care, grocery shopping, home visits, and psychological consulting. We found that the majority of the older adults perceived that they needed the four services, but only 9%-27.4% of the respondents reported that their perceived needs were met. There was a high prevalence of unmet community-based service needs (51.3%-55.5%) among urban older adults in China. Factors associated with unmet needs included depression status, ADL (activities of daily living) limitations, self-rated health, number of surviving children, educational attainment, and marital status. The results suggest that policy makers should develop services targeting specific segments of the older population, increasing the adequacy of services provided.
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Affiliation(s)
- Dijuan Meng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu, China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, Jiangsu, China
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