Willingness to pay integrated medical and elderly care services among the elderly in Hohhot City / 预防医学

Objective@#To investigate the willingness to pay integrated medical and elderly care services and identify the influencing factors among the elderly in Hohhot City, Inner Mongolia, so as to provide insights into promoting integrated medical and elderly care services.@*Methods@#The elderly at ages of 60 years and older were sampled using a convenient sampling method from public venues in four districts of Huimin, Saihan, Yuquan and Xincheng in Hohhot City from June to December 2021. Basic characteristics, health and disease burdens, social support and willingness to pay integrated medical and elderly care services were collected, and factors affecting the willingness to pay integrated medical and elderly care services were identified among the elderly using a multiple linear regression model. @*Results@#A total of 1 008 valid questionnaires were recovered, with an effective recovery rate of 96.74%. The respondents included 519 men (51.49%) and 489 women (48.51%), and had a mean age of (69.47±6.42) years. The monthly average fees of willingness to pay integrated medical and elderly care services were (2 076.49±36.79) Yuan, and there were 636 participants with 2 000 Yuan and less monthly average fees of willingness to pay integrated medical and elderly care services (63.10%). Multiple linear regression analysis showed that place of residence (β=180.832), satisfaction with housing (satisfied, β=-140.760), physical self-care ability (completely self-care: β=-238.244; mostly self-care: β=-254.557), burdens of disease diagnosis and treatment (able to afford: β=452.488; partly afford: β=228.626), monthly income (β=347.144), expenses of medications (β=0.019) and total score of social support (β=17.116) were factors affecting the willingness to pay integrated medical and elderly care services among the elderly. @*Conclusions@#The willingness to pay integrated medical and elderly care services among the elderly in Hohhot City is associated with place of residence, monthly income, satisfaction with housing, physical self-care ability, burden of disease diagnosis and treatment, expenses of medications and social support.

Caracterização fonoaudiológica de idosos ativos institucionalizados / Speech, language and hearing sciences characterization of institutionalized active seniors

Objetivo: Investigar as condições estruturais e funcionais relativas à comunicação (audição/equilíbrio/voz/linguagem e demais processos cognitivos) e à alimentação (motricidade orofacial) de idosos ativos institucionalizados. Métodos: trata-se de um estudo qualitativo transversal junto a onze idosos entre sessenta e 74 anos, de ambos os sexos, residentes em uma Instituição de Longa Permanência para Idosos. Todos foram submetidos à triagem auditiva vocal e à avaliação do equilíbrio corporal, motricidade orofacial e da linguagem verbal. Resultados: na triagem auditiva, foi constatado o predomínio de perda auditiva assimétrica de grau leve/moderado. Na avaliação do equilíbrio, foram identificadas alterações na maioria dos avaliados, sendo a instabilidade e a preferência visual os tipos de alteração mais evidentes. Na triagem vocal, constatou-se diminuição dos tempos máximos de fonação em todos os idosos, loudness alterada em aproximadamente um terço dos idosos, foco vertical discretamente laringofaríngeo e qualidade vocal rouco-soprosa na maioria dos sujeitos. Na avaliação da respiração, constatou-se maior ocorrência de diminuição da capacidade vital, modo respiratório nasal e tipo respiratório misto. Quanto aos demais aspectos da motricidade orofacial, identificou-se um maior número de idosos com alterações estruturais e/ou funcionais: a tensão diminuída dos órgãos fonoarticulatórios; além disso, a mastigação e a deglutição foram identificadas como típicas. No que se refere aos aspectos linguístico-cognitivos, não foram evidenciadas alterações de fala; parte dos avaliados apresentou dificuldades nas coordenadas espaço-temporais e mais da metade em processos inferenciais. A maioria dos idosos conseguiu realizar operações de subtração com um dígito. Considerações finais: as condições fonoaudiológicas dos idosos triados justificam ação integral da Fonoaudiologia, visto que, mesmo no envelhecimento ativo, há aspectos orgânicos e linguístico-cognitivos que merecem ser acompanhados oportunamente, visando à qualidade de vida. (AU)

Objective: to investigate the structural and functional conditions concerning the communication (hearing/balance/voice/verbal language and other cognitive processes) and feeding (orofacial motricity) of institutionalized active elderly. Methods: this is a transversal qualitative study with 11 subjects, between 60 and 74 years, of both genders, living in a institutionalized active elderly. All elderly underwent hearing and vocal screening and evaluation of body balance, oral motricity and verbal language. Results: in a hearing screening, the predominance of asymmetric hearing loss of mild/moderate degree was verified. In balance evaluation difficulties were identified in most participants, and the instability and visual preference were the most evident items. In screening vocal, a decrease in the maximum phonation time was observed in all elderly, altered loudness in approximately one thirths of the elderly, vertical focus discreetly laryngopharyngeal and hoarse-breathy vocal quality in most subjects. In the evaluation of breathing, a higher incidence of decreased vital capacity, nasal and mixed breathing were observed. In other aspects of oral motricity, most elderly presented structural and/or functional alterations of orofacial motricity: the decreased lip tension, cheeks and tongue; Furthermore, Typical mastication and swallowing were found t, respectively. Regarding a cognitive-linguistic aspects, speech features were not observed, part of the participants had difficulties in relation to space-time coordinates and over half in inferential processes. Most elderly could perform operations of subtraction with one digit. Final remarks: the conditions of the screened elderly justify the integral action of Speech, Language and Hearing Sciences, whereas, even in active aging, there are organic and cognitive-linguistic aspects that deserve to be followed opportunely, aiming the quality of life. (AU)

Effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with ;mild cognitive impairment in elderly care institution / 中国实用护理杂志

Objective To explore the effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with mild cognitive impairment in elderly care institution. Methods A total of 66 cases with mild cognitive impairment elderly that previously were screened out from two pension institutions in Taiyuan city as the research objects. According to the endowment institutions where the objects of study dwelled was divided into control group (34 cases) and intervention group (32 cases). The intervention group accepted nursing of Traditional Chinese Medicine plan for four months. The control group received the disease related knowledge health education. The cognitive function of the two groups were assessed using the Montreal Cognitive Scale (MoCA) before and after the intervention. Results Before the intervention, two groups had no statistical significance in each dimension score and total score of MoCA. After the intervention, four dimensions scores including ability of visual spatial and execute , attention , delayed recall , directional force and the total score of the intervention group respectively were (2.67±1.09) points, (4.07±1.08) points, (1.97±0.81) points, (4.83±0.99) points, (18.80±1.74) points while the control group were (2.15 ± 0.71) points, (3.30 ± 0.63) points, (1.39 ± 0.97) points, (4.24 ± 1.41) points, (15.06 ± 2.98) points, and the difference was statistically significant (t=1.91-6.06, P < 0.05 or 0.01) ;Before intervention the language score, delayed recall score and the total score of the intervention group were (1.43±0.77) points, (1.57±1.10) points, (17.27±1.99) points, respectively while after the intervention were (1.80 ± 0.66) points, (1.97 ± 0.81) points, (18.80 ± 1.74) points, there was statistically significant difference (t =-2.16,-2.11,- 4.34, P < 0.05 or 0.01). Conclusions Nursing of Traditional Chinese Medicine can delay the process of cognitive decline of mild cognitive impairment in the elderly, and have a certain effect on prevention and treatment of patients with mild cognitive impairment.