杨海妹　叶静

[摘要] 目的 探讨社区护理在居家养老保健服务中的应用效果。 方法 2014年3月～2014年8月，从深圳市宝安区中心医院所属36家社区健康服务中心中随机选取2家社区的200名居家养老老人，将其随机分为A、B社区，每个社区100名。A社区老人采取常规健康教育宣传管理，B社区老人给予针对性、个性化的社区护理管理，两个社区均进行6个月的护理管理。观察两个社区老人管理后的健康相关危险行为和满意度变化，并对B社区老人护理管理前后的生命质量进行评估。 结果 经过6个月管理后，B社区老人的危险行为改变人数显著多于A社区，差异有统计学意义（P<0.01）。B社区老人对社区健康服务中心的满意度为98.0%，显著高于A社区的60.0%（P<0.01）。B社区老人实施社区管理后的生命质量评分显著高于实施前，前后差异有统计学意义（P<0.05）。 结论 社区护士结合社区老人的生理、心理和社会活动等特点进行针对性、个体化的社区护理管理，可提高社区老人对社区健康服务中心的满意度，改善社区老人的健康相关危险行为，进而提升社区居家老人的生活质量。

[关键词] 社区护理；居家养老保健服务；生活质量

[中图分类号] R473.2 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0183-04

[Abstract] Objective To explore the application effect of community nursing in health services in home care. Methods From March 2014 to August 2014，200 elderly at home pension from 36 community health service centers affiliated to central hospital of Baoan District in Shenzhen City were selected.They were randomly divided into A and B community， with 100 cases in each community.A community was taken routine health education propaganda management，B community was provided targeted and personalized community care management.The elderlies in the B community were given nursing management for 6 months.Health related risk behaviors and changes of satisfaction was observed between two groups，and life of quality before and after nursing management in the B community was evaluated. Results After 6 months of management，the number of dangerous acts of change in B community was significantly more than that of A community，the difference was significant（P<0.01）.The satisfaction degree with the community health service in B community was 98.0%，which was significantly higher than 60.0% of A community（P<0.01）.After the community management，the index of life quality score in B community was significantly higher than before management，and the difference was significant（P<0.05）. Conclusion Community nurses combined with the physical，psychological and social activities of elderly in the community to carry out targeted and personalized community care management，which can enhance the satisfaction that community members to community health service center and improve health related risk behaviors，and to improve the quality of life of elderly in the community.

[Key words] Community nursing；Health services in home care；Quality of life

随着中国经济社会的快速发展，人民生活水平和医疗卫生保健事业逐渐改善，加之生育率持续保持较低水平，使我国老龄化进程逐步加快。第6次全国人口普查初步汇总的情况显示，我国>60岁的人口占13.26%，按照联合国的传统标准，中国已进入老龄化社会。目前，探讨居家养老服务中社区护理的作用流程、模式以及效果仍然是医学护理研究的重点之一[1-2]。在建设和谐社会的今天，对于老年人生活质量和居家养老问题的研究调查越来越多，探讨社区老年人养老方式的研究也比较多[3]，本研究通过对深圳市宝安区中心医院所属2家社区健康服务中心的居家养老老人进行不同模式的社区护理管理，并对社区护理的应用效果进行分析，总结报告如下。……