社区环境如何影响老年人功能发挥:基于人-环境匹配视角的质性研究  

Impact of community environment on functional ability in the elderly:a qualitative study based on a person-environment fit perspective

作　　者：张红赛 肖树芹[1] 马鲜 董璐琪 Zhang Hongsai;Xiao Shuqin;Ma Xian;Dong Luqi(School of Nursing,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学护理学院,北京100069

出　　处：《中华现代护理杂志》2025年第13期1713-1720,共8页Chinese Journal of Modern Nursing

摘　　要：目的基于人-环境匹配视角探讨社区环境对老年人功能发挥的影响。方法本研究采用描述性质性研究方法。应用目的抽样法,于2024年1—5月选取北京市2个社区卫生服务中心及其下属卫生站服务的老年人为受访者。基于人-环境匹配理论制订访谈提纲,采用半结构式访谈法收集资料,应用主题分析法分析资料。结果共访谈16名社区老年人,最终确定4个主题:(1)环境对个体能力的多维补偿(无障碍、便利环境补偿运动能力下降;支持性物理环境补偿视力、活力下降;社会支持补偿认知功能的下降;适老化环境提升归属感和安全感);(2)个人偏好与社区环境的一致性(活动多样性满足个性化需求;环境稳定性确保生活掌控感;适老化数字环境满足老年数字需求);(3)感知环境的个人影响因素(居住时长;个人健康状况;个人社会关系);(4)人-环境不匹配的应对方式(提升个体能力;利用辅具促进自我赋能;主动居家适老化改造;自我心理调适)。结论社区医护人员应重视环境的作用,充分考虑老年人的个体特征和需求偏好;特别关注对环境感知较差的老年人,鼓励老年人采取积极的应对方式适应环境。Objective To explore the impact of community environment on the functional ability in the elderly based on a person-environment fit perspective.Methods The descriptive qualitative research method was used.Applying the purposive sampling method,elderly people attending two community health centers and their subordinate health stations in Beijing were selected as respondents from January to May 2024.An interview outline was developed based on the person-environment fit theory,and semi-structured interviews were used to collect information.Thematic analysis was used for data analysis.Results A total of 16 community elderly people were interviewed,and four themes were finalized,including multidimensional compensation of the environment for individual competence(accessible and convenient environments compensate for declining motor abilities,supportive physical environments compensate for declining vision and vitality,social support compensates for declining cognitive abilities,and age-friendly environments enhancing a sense of belonging and security),congruence of personal preferences with the community environment(diversity of activities to meet individualized needs,environmental stability to ensure a sense of control over life,age-friendly digital environments to meet the digital needs of the elderly),personal influencing factors of the perceived environment(length of residence,personal health status,personal social relations),and coping styles with person-environment mismatches(enhancement of individual capabilities,use of assistive devices for self-empowerment,proactive home age-friendly adaptation,self-psychological adjustment).Conclusions Community healthcare workers should emphasize the role of the environment and give full consideration to the individual characteristics,needs and preferences of the elderly people,and pay special attention to the elderly people who have a poor perception of the environment and encourage them to take positive coping styles to adapt to the environment.

关 键 词：老年人 社区卫生服务 人-环境匹配 功能发挥 质性研究 

分 类 号：R47[医药卫生—护理学]