目的 探讨失能老人子女照护者孝老伦理、照护技能在照护负担对老人照护质量影响机制中的多重中介作用。方法 便利选取唐山市5家三级综合医院住院治疗的失能老人及其子女照护者共786对为调查对象。采用一般资料调查表、Zarit照顾负担量表、老年人照护进程中子代孝老伦理知信行问卷、失能老人家庭照护者照护技能缺陷评测量表以及世界卫生组织生存质量测定简表进行问卷调查,构建链式中介模型。结果 本组786对研究对象中,失能老人照护质量总分为（54.28±14.48）分,子女照护者的照护负担总分为（35.25±11.20）分,孝老伦理总分为（98.33±12.61）分,照护技能总分为（48.22±17.20）分。子女照护负担对老人照护质量的间接效应成立,总间接效应值为-0.210;其中子女孝老伦理和照护技能的特定中介效应分别占5.74%和24.94%,两者的链式中介效应成立,占总间接效应的比例为21.69%。结论 失能老人子女照护者孝老伦理、照护技能在照护负担与老人照护质量间的链式中介效应成立。建议相关部门通过支持政策减轻子女照护负担,宣传孝老伦理观念、组织进行专业照护技能的培训和指导,进而提高失能老人照护质量。
Abstract
Objective To explore the multiple mediating roles of filial piety and nursing skills in the impact mechanism of care burden on the quality of care in adult children as caregivers of disabled elderly people. Methods A total of 786 pairs of disabled elderly people who were hospitalized in 5 tertiary general hospitals in Tangshan and their adult children as caregivers were selected as the survey objects. General Information Questionnaire, Zarit Care Burden Scale, Questionnaire on Knowledge, Attitude and Practice about Filial Piety for Offspring during Caring the Elderly, Care Skill Deficit Assessment Scale of Family Caregivers of Disabled Elderly and the World Health Organization Quality of Life (WHOQOL) were used to conduct questionnaire investigation, and a chain mediation model was constructed. Results Among the 786 pairs of subjects, the total score of care quality for disabled elderly people, care burden for children as caregivers, filial ethics and care skills was 54.28±14.48, 35.25±11.20, 98.33±12.61, 48.22±17.20, respectively. The indirect effect of care burden of adult children as caregivers on the quality of care was established, and the total indirect effect value was -0.210. Among them, the specific mediating effect of filial piety and nursing skills accounted for 5.74% and 24.94% respectively, and the chain mediating effect of the two was established, accounting for 21.69% of the total indirect effect. Conclusion The chain mediating effect of filial piety and nursing skills between care burden and care quality of adult children as caregivers of disabled elderly people is established. The quality of care for disabled elderly people could be improved by supporting policies for reducing the burden of care, promotion of ethical concept of filial piety and professional care skills training and guidance.
关键词
失能老人 /
照护者 /
照护负担 /
照护质量 /
孝老伦理 /
照护技能 /
链式中介
Key words
disabled elderly people /
caregiver /
care burden /
care quality /
filial piety /
caregiving skill /
chain mediation
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基金
河北省社会科学基金项目（HB23SH012）
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