641名上海市老年人机构养老意愿及其影响因素
Investigating predictors of the 641 elders’ willingness to enroll in nursing homes in Shanghai

目的 ·了解上海市老年人的机构养老意愿情况，探讨影响其意愿的因素。方法 .采用方便抽样法抽取641名在上海市6个社区卫生服务中心就诊的60周岁及以上的老年人，对其社会人口学因素、机构养老意愿、感知障碍和感知利益进行问卷调查。结果 ·调查问卷的结构效度（KMO统计量为0.862，Bartlett’s球性检验 P=0.000）和内在信度（Cronbach’s α系数取值范围为0.739～0.824）良好。46%的受访者表示将来愿意入住养老机构；在人口学因素中，仅不同年龄层次之间入住意愿差异有统计学意义（P=0.045）。校正年龄后的多因素Logistic回归分析结果表明羞耻感（OR=0.76，95% CI=0.62～0.94）、适应性（OR=0.61， 95% CI=0.50～0.74）以及感知利益（OR=1.63，95% CI=1.32～2.03）与老年人机构养老意愿显著相关（均P<0.05）。结论 ·上海老年人整体对机构养老的接受度已有所提高，其中60～69岁老年人接受度最高；羞耻感、适应性，以及养老机构所能提供的服务质量和种类是影响老年人机构养老意愿的主要影响因素。
： Objective · To survey the willingness to enroll in nursing homes among the elders in Shanghai and explore its predictors. Methods · A field survey was performed to collect data from 641 elders aged 60 years old and above in six community health centers in Shanghai. Sociodemographic variables, willingness to use nursing home, perceived barriers and perceived benefits were measured. Results · The questionnaire is with good structural validity and good intrinsic reliability. KMO index, P value of Bartlett’s test of sphericity, and the range of Cronbach’s α coefficients were 0.862, 0.000, and 0.739-0.824, respectively. Among the respondents, 46% were willing to enroll in a nursing home in this survey. Age had significant influence on their willingness (P=0.045). After adjusting for age, the multivariate Logistic regression analysis showed that shame (OR=0.76, 95% CI=0.620.94), adaptability (OR=0.61, 95% CI=0.50-0.74) and perceived benefits (OR=1.63, 95% CI=1.32-2.03) were related to willingness (P<0.05). Conclusion · Elders in Shanghai have a relatively high level of willingness to enroll in nursing homes, especially the elders aged from 60 to 69. Shame and adaptability of elders, and the services provided by nursing homes were the predictors of the elders’ willingness