ABSTRACT
Background: The rapid population aging in China, characterized by a higher prevalence of illnesses, earlier onset of diseases, and longer durations of living with ailments, substantially engenders challenges within the domain of older adults' healthcare. Community home-based elderly care services (CHECS) are a feasible solution to solve the problem of older adults' care and protect older adults' health. The aim of this study is to investigate the relationship, heterogeneity effects and influential mechanisms between older adults' use of CHECS and their self- reported health. Methods: The study employs the Instrumental Variable technique and empirically investigates the relationship, heterogeneity effects and influential mechanisms between older adults using CHECS and their self-reported health using data from the China Longitudinal Aging Social Survey from 2018. Results: The findings indicate, firstly, that using CHECS considerably improves older adults' self-reported health. Secondly, the heterogeneity test reveals that the effect is more pronounced for older adults who are under the age of 80, have functional disabilities, are free of chronic diseases, have never attended school, reside in lower-income households, are single, rarely interact with their children, and live in central urban or city/county regions. Thirdly, the mechanism test reveals that the "social network effect" and "family care effect" are the key influence channels of using CHECS. Conclusion: An empirical foundation for the policy reform of community home-based care for seniors is provided by this study with the limitations to discuss the other socioeconomic aspects such as government health expenditure and discuss the specific services aspects such as health care. The findings carry substantial implications for improving the health of older individuals and provide suggestions for establishing a socialized aged care system in China.
Subject(s)
Home Care Services , Child , Humans , Aged , Self Report , Aging , Delivery of Health Care , ChinaABSTRACT
At present, China’s response to the aging population situation is unprecedentedly urgent, and the construction and planning of the pension system face great challenges. Home-based elderly care services stand out in institutional-based elderly care and family-based elderly care due to their unique advantages in meeting the individual needs of the elderly. By sorting out the main types, policy lines, and supply and demand status of home-based elderly care service, this paper indicated that there are five aspects of problems in home-based elderly care service, including weak professional talent team construction, relatively insufficient capital investment, weak supply-demand matching, imperfect operating mechanism, and imperfect supporting facilities. It was proposed that in the future home-based elderly care services should strive to strengthen the construction of professional talent teams, widen financing channels, fully play the leading role of the government, perfect the operational mechanism and the construction of supporting facilities of home-based elderly care services, so as to provide reference for the optimization of the home-based elderly care service system in China.
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With aging population becoming increasingly prominent, more intelligent, integrated, and anthropomorphic nursing robots are becoming an important option for future home-based elderly care. However, a series of ethical dilemmas may arise when nursing robots that provide long-term services participate in the social life of the elderly as social entities. For example, the encroachment of low-level interaction between humans and nursing robots on the high-level interaction between humans, as well as the dispute over the definition of responsibility caused by unclear moral subjects. The value sensitive design theory advocates incorporating value into technical design, and based on its conceptual research, empirical research, and iterative approach, it can be found that the fundamental reason for the above-mentioned ethical dilemma lies in the confusion and dislocation of the ternary nursing relationship among human caregivers, the elderly, and nursing robots. Accordingly, this paper proposed to clarify the user status of the elderly and human caregivers, while nursing robots serve as auxiliary tools to meet the nursing needs of the elderly, protect and enhance the well-being of the elderly.
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Objective:To explore the factors that affect the participation of elderly care nurses in home-based elderly care services, in order to provide reference for the targeted improvement of human problems in home-based elderly care services.Methods:The phenomenological research method of qualitative research was used to conduct semi-structured in-depth interviews, on-site recordings and transcripts with 14 nurses in the geriatrics department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical College from September to October, 2021. The collected data were analyzed and the theme was refined by using the 7-step analysis method of Colaizzi phenomenology.Results:Through sorting and analysis, four themes and six sub themes were extracted as follows: language behavior factors including environmental discomfort and differences in living habits, freedom was limited; psychological and emotional factors including high psychological pressure and loneliness, not respected; career development factors; social security factors including the definition of work scope is unclear, the division of responsibility for the accident was unclear and the protection of relevant rights and interests was insufficient.Conclusions:The intention of elderly care nurses to participate in home-based elderly care services is affected by many factors. These factors need to be accurately identified and targeted support measures should be taken to improve their enthusiasm to participate in home-based elderly care services and improve the human problems in home-based elderly care services.
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Population aging has become a major challenge for the Chinese government. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018, this study adopts the propensity score matching (PSM) method to assess the effect of community home-based elderly care services (CHECS) on the life satisfaction of the elderly in China. The results demonstrate that CHECS can improve their life satisfaction. Compared with life care services (LCS) and medical care services (MCS), the positive effect of spiritual and cultural services (SCS) and reconciliation and legal services (RLS) is more obvious. Moreover, the heterogeneity test demonstrates that the effect is more significant for the elderly who live with their families, whose activities of daily living are unrestricted, and whose depression levels are lower. The results obtained indicate that CHECS need precise policies for different elderly groups, attention to the positive impact of SCS and RLS on the life satisfaction of the elderly, and the substantive effectiveness of LCS and MCS.
Subject(s)
Activities of Daily Living , Home Care Services , Humans , Aged , East Asian People , Health Status , ChinaABSTRACT
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.
Subject(s)
Burnout, Professional , Home Care Services , Aged , Caregivers , China , Humans , Job Satisfaction , Surveys and QuestionnairesABSTRACT
Objective:To analyze the utilization of traditional Chinese medicine (TCM) services and its influencing factors among home-based elderly care population in Zhejiang Province.Methods:A multi-stage stratified cluster random sampling method was used to enroll 2 300 home-based elderly care population aged 65 years and over and lived in the local area for 6 months and above in Zhejiang Province. The basic characteristics, health status and behavior, TCM cultural literacy, TCM cognitive beliefs and TCM service usage of the subjects were collected by face-to-face questionnaires from July 15 to August 15, 2021, and 2 123 valid questionnaires were recovered. Unconditional logistic regression was applied to analyze the influencing factors of TCM service usage among home-based elderly care population.Results:The overall utilization rate of TCM services among home-based elderly care population in Zhejiang Province was 36.46% (774/2 123). The utilization rates of the 6 types of TCM from high to low was oral administration of traditional Chinese medicine (22.00%), external treatment with traditional Chinese medicine (15.12%), acupuncture treatment (11.96%), medicated diet conditioning (7.44%), constitution identification (7.40%) and exercise conditioning (4.57%). Home-based elderly care population lived in urban areas, had never been to school, with education of primary school or high school and above, suffered from chronic diseases, moderate activities or physical exercise, believed in TCM and had attended lectures on TCM knowledge were more inclined to use TCM services (all P<0.05); agricultural laborers, production and transportation workers and family laborers before retirement were less inclined to use TCM services (all P<0.05); women, those with medical insurance, those drinking alcohol and those with better TCM cultural literacy were more inclined to use 2 and more kinds of TCM services (all P<0.05). Conclusions:The utilization rate of TCM services among home-based elderly care population in Zhejiang Province is relatively high; gender, place of residence, education level, occupation before retirement, medical insurance, belief in TCM, and participation in TCM knowledge lectures are the main influencing factors of the use of TCM services among home-based elderly care population.
ABSTRACT
The aging trend of China's population is increasing, and the pension problem is becoming increasingly prominent. The pension mode provided by the government alone can no longer meet the social demand, and the government's purchase of home-based care services from social organizations has become a new trend. In order to improve the efficiency and quality of pension services, a reasonable performance evaluation model needs to be established. Performance evaluations of home-based elderly-care services purchased by the government are problematic as a result of multiple-attribute group decision-making (MAGDM), as the problems are not single-attribute or single-expert issues. The extended TODIM not only integrates the advantages of cumulative prospect theory (CPT) into a consideration of the psychological factors of DMs, but also retains the superiority of the classical TODIM in relative dominance. The Pythagorean 2-tuple linguistic sets (P2TLSs) could easily depict qualitative assessment information related to the government's purchase of home-based care services. Thus, in this paper, we extend the TODIM method based on the cumulative prospect theory (CPT) to the Pythagorean 2-tuple linguistic sets (P2TLSs) and propose a Pythagorean 2-tuple linguistic CPT-TODIM (P2TL-CPT-TODIM) method for MAGDM. The P2TL-CPT-TODIM method was proven superior to the classical one through a case study that included a performance evaluation of a home-based elderly-care service purchased by the government. Meanwhile, a comparison with the P2TL-CPT-TODIM method was performed to demonstrate the stability and effectiveness of the designed method.
