老年精神障碍人群社区延续照护需求调查及社会干预对策  

Survey on the need of continuum of care in community elderly mental disorder patients and social interventions strategy

作　　者：张建华[1] 丁玉琴[2] 明玉霞 杨泗学 

机构地区：[1]江苏省连云港市第四人民医院连云港市精神病防治院院部,222002 [2]江苏省连云港市中医院预防保健科,222004 [3]江苏省连云港市第四人民医院护理部,222002 [4]江苏省连云港市第四人民医院精神科,222002

出　　处：《中华现代护理杂志》2014年第19期2345-2348,共4页Chinese Journal of Modern Nursing

基　　金：国家中医药管理局重点学科、南京中医药大学中医护理学开放课题

摘　　要：目的：通过对老年精神障碍疾病出院患者追踪调查，提出社区长期延续照护及社会干预对策。方法采用入户调查法，以2010-2012年525例老年精神障碍疾病出院患者为研究对象，采用老年抑郁量表（ GDS）和日常生活活动能力量表（ ADL）对该人群社区和家庭长期照护及医疗护理服务供需情况进行调查。结果525例出院老年精神障碍患者经GDS量表测量，得分1～10分者86例，视为无郁症，占40％；11～20分者79例，显示轻度抑郁，占36．74％；21～30分者50例，显示重度抑郁，占23.25％。 ADL得分＜35分者422例，提示个人自理能力存在不同程度障碍者，占80．38％；40～100分者103例，提示部分或者完全能够自理，占19．62％。525例老年精神障碍疾患者群社区延续照护，主要依靠家庭，由家庭成员照护占68．95％，由保姆或者钟点工照顾者占11．43％，由养老机构和医疗机构专业护理人员进行照护占19．62％。社区老年人长期照护需求和医疗护理服务供给相比有很大差距。结论老年精神障碍疾患者群的长期照护和社会支持问题是老年学领域亟待解决的民生问题，应依据实际情况给予社会性干预。Objective By tracking survey of the mental disorder patients discharged from hospital , in order to propose continuum of care and social interventions strategy .Methods Using household survey method , totals of 525 elderly mental disorder patients from 2010 to 2012 were selected and surveyed using the Geriatric Depression Scale （GDS） and the Activities of Daily Living （ADL）.Results Totals of 525 cases of senile mental disorders in community were surveyed with GDS .Totals of 86 patients scored 1 to 10 points, regarded as without depression, accounting for 40%.Totals of 79 patients scored 11 to 20 points, regarded as mild depression , accounting for 36.74%.Totals of 50 patients scored 21 to 30 points, regarded as severe depression , accounting for 23.25%.Totals of 422 patients （80.38%） had ADL score under 35 points, with different degree of lack of personal living capacity .Totals of 103 patients （19.62%） had ADL score between 40 to 100 points, with part or complete personal living capacity .Totals of 525 patients mainly depended on home care , within which 68.95%were taken care of by their family members and 11.43%were cared for by servants or hourly employee .Others （19.62%） were at nursing institution or hospitals taken care of by professional nurses .There was a big gap between the demand and supply of medical care service in community elderly long term care .Conclusions The problem of long-term care and social support of senile mental disorder patients is urgent , and based on the actual situation, we need to propose the corresponding social intervention strategies .

关 键 词：老年人 精神障碍 社区护理 需求 社会干预 

分 类 号：R473.2[医药卫生—护理学]