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基于社会支持与多中心治理理论的失独家庭父母医养结合型养老模式构建研究 预览

Development of an Integrated Medical and Nursing Care Model for Chinese People Bereaved of Their Only Child Based on Social Support and Polycentric Governance Theories
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摘要 目的构建个性化、系统性、适宜的基于社会支持与多中心治理理论的失独家庭父母医养结合型养老模式.方法于2017年7-8月采用目的抽样法,在东部某省辖市选取失独家庭父母10名、相关卫生行政部门和社会组织人员8名作为关键知情人进行深入访谈.主要访谈内容包括:失独家庭父母的身体健康状况、精神状况、服务需求、帮扶现状、养老意愿等.采用MAXQDA12软件对访谈资料进行整理与分析.结合前期调研结果,构建出基于社会支持与多中心治理理论的失独家庭父母医养结合型养老模式.结果访谈结果显示:失独家庭父母很少主动寻求帮助,区政府部门和社区相关机构人员依政策为其提供了一定帮扶;失独家庭父母的心理状态较差,固定、熟悉慰问者(如社区相关机构人员)的慰问效果较好;随着年龄增长,失独家庭父母的身体健康不容忽视;失独家庭父母的健康状况、自理能力及偏好不同,养老意愿存在差异;需要抚养第三代、疾病负担重的失独家庭父母,经济压力较大.在构建出的失独家庭父母医养结合型养老模式中,服务主体包括政府相关部门、社区相关机构、非政府机构、亲朋邻里等;服务内容包括健康照料、养生养老、经济支持、心理慰藉、参与社会等多个方面.结论对于失独家庭父母的养老帮扶,应以政府为主导,构建多元化的社会支持体系,满足其个性化养老服务需求,为其提供全方位、全周期的医养结合服务,从而实现从健康老龄化向积极老龄化、从生存性养老到发展性养老的转变. Objective To develop a personalized and systematic integrated medical and nursing care model for Chinese people bereaved of their only child based on social support and polycentric governance theories.MethodsWe conducted in-depth interviews with a purposive sample of key informants(10 people bereaved of their only child,8 workers from relevant health administrative departments and social organizations) from a city under provincial jurisdiction in eastern China for July to August 2017 for collecting the data about physical health,mental status,healthcare needs,support status and desired elderly care support of the bereaved people.Based on the interview results organized and analyzed with MAXQDA 12 as well as the theories of social support and polycentric governance,we developed an integrated medical and nursing care model for the bereaved people. Results The bereaved people rarely actively sought help,but they could receive some policy-based support from the relevant departments of the district government and community departments.Their mental status were poor,but it could be improved significantly by consoling from the fixed and familiar people(such as the workers from relevant community departments).Their physical health needed increasing care with aging.Health status,self-care ability and preferences(including preferred elderly care) differed significantly.Those with severe disease burdens or needing to raise the third generation of family members were found with great economic pressures.In our integrated medical and nursing care model,the involved subjects delivering support for bereaved people include relevant governmental departments,relevant community departments,non-governmental institutions,relatives,friends,neighbors and so on;the support includes healthcare,health cultivation,elderly care,financial backing,psychological consolation,social participation and so forth.ConclusionIn order to satisfy the individualized elderly care needs and to offer long-term integrated medical and nursing care
作者 荣超 沈淑华 曹维明 许才明 刘天俐 谢蓉蓉 孙笛枫 RONG Chao1,SHEN Shu-hua2,CAO Wei-ming1,XU Cai-ming1,LIU Tian-li3,XIE Rong-rong1,SUN Di-feng4(1.School of Humanities and Management,Zhejiang Chinese Medical University,Hangzhou 310053,China;2.Center for Health and Disease Prevention,First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,China;3.Institute of Population Research,Peking University,Beijing 100871,China;4.Hangzhou Shangcheng Qingbo Street Xingfujia Integrated Home Service Center Hangzhou 330100 China)
出处 《中国全科医学》 北大核心 2018年第16期1954-1958,1964共6页 Chinese General Practice
基金 教育部人文社会科学研究青年项目(15YJC840024) 国家社会科学基金项目(16CSH071)
关键词 失独家庭 医养结合 社会支持 多中心治理 Families bereowed of their only child Integrated medical and nursing care Social support Polycentric governance
作者简介 通信作者:许才明,教授;E-mail:xucmy0709@qq.com
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