季永娟 许婷婷 陈雪飞 叶涛

摘 要 目的：探讨长期护理保险（长护险）居家护理对居家养老失能老人生活状态的影响。方法：对上海市静安区南京西路街道老年照护统一需求评估为2～6级，并选择长护险居家养老的失能老人150例提供居家护理。失能老人的年龄为60～92岁，其中男性66例，女性84例。采用总体幸福感量表、老年抑郁量表、Barthel指数量表及满意度调查表评估居家养老失能老人享受长护险后6个月后的生活状态和满意度情况。结果：采用长护险居家护理6个月后，失能老人满意度评分较护理前显著提高（90.5±8.84比94.95±4.50，P<0.001），总体幸福感评分也有显著提高（90.15±2.65比93.05±2.92，P<0.001），抑郁评分显著降低（12.46±3.77比9.48±4.42，P<0.001），生活自理能力评分显著提高（50.66±14.66比55.73±16.47，P<0.05）。结论：长护险居家护理可改善失能老人的总体幸福感、抑郁情况和生活自理能力，提高失能老人的满意度。

关键词 失能老人；长护险；居家养老；生活状态

中图分类号：R473 文献标志码：A 文章编号：1006-1533（2021）24-0051-04

Effect of home care of long-term care insurance on the life status of the disabled elderly at home

JI Yongjuan， XU Tingting， CHEN Feixue， YE Tao（Science and Education Section of Nangjingxilu Community Health Service Center of Jinan District， Shanghai 200041， China）

ABSTRACT Objective： To explore the effect of home care of long-term care insurance on the life status of the disabled elderly at home. Methods： One hundred and fifty disabled elderly who were assessed as grade 2～6 by the unified needs of elderly care in Nanjingxilu Community of Jingan District， Shanghai， and who selected home-based care of long-term care insurance were provided home-based care. The age of the disabled elderly was 60～92 years old， including 66 males and 84 females. The overall well-being scale， the elderly depression scale， the Barthel index scale and the satisfaction questionnaire were used to evaluate the life status and satisfaction of the disabled elderly at home 6 months after enjoying the long-term care insurance. Results： After 6 months of home care of long-term care insurance， the satisfaction score of the disabled elderly was significantly higher than that before care （90.5±8.84 vs 94.95±4.50， P<0.001）， the overall well-being score was also significantly improved （90.15±2.65 vs 93.05±2.92， P<0.001）， the depression score decreased significantly （12.46±3.77 vs 9.48±4.42， P<0.001）， and the score of self-care ability was significantly improved （50.66±14.66 vs 55.73±16.47， P<0.05）. Conclusion： Home care of long-term care insurance can improve the general well-being， depression and self-care ability of the disabled elderly， and increase the satisfaction of the disabled elderly.

KEY WORDS disabled elderly； long-term care insurance； home-based elderly care； life state

我國老年人的失能问题已成为重大社会风险之一。据预测，到2050年我国失能老人数量将增至9 750万[1]。长期护理保险（以下简称长护险）制度是指以社会互助共济方式筹集资金，对评估达到一定护理需求等级的长期失能人员，为其基本生活照料和基本生活密切相关的医疗护理提供服务或资金保障的社会保险制度[2]。年满60岁的职工医疗保险或居民医疗保险参保人员可自愿申请老年照护。经统一需求评估等级为2～6级的失能老人由定点护理服务机构为其提供相应的护理服务，并按规定结算护理费用。……