关键词: 老年人, 养老机构, 分级照护, 老年综合评估, 照护需求, 对应分析

Abstract: Background　The inconsistent criteria and basis for grading the level of nursing care in heath institutions in different regions of China，and the financial and other factors of the elderly，have affected the integrity and objectivity of the contents of nursing care of different levels，possibly leading to the failure of services in meeting elderly people's disability and needs in actual practice.Objective　To explore the long-term care needs of elderly people with different ability levels in geriatric nursing facilities，providing a basis for the delivery of targeted care for the elderly.Methods　From April to July，2018，a questionnaire survey was conducted in a convenience sample of 575 elderly people aged ≥60 years old in 2 geriatric nursing facilities in 2 cities of China，Nanjing and Changzhou.The questionnaire used includes two parts：Ability Assessment for Older Adults and interRAI-LTCF，the former was used to assess the ability level of the elderly，and the latter was adopted to evaluate the health problems and needs.Comprehensive assessment results were analyzed and health problems were recorded with the interRAI CAPs.Correspondence analysis was performed to investigate health problems and ability level in the elderly.Results　The survey achieved a response rate of 92.5%.Of the 532 respondents，the prevalence of normal ability，mild，moderate and severe disability was 10.3%（55 cases），49.6%（264 cases），13.4%（71 cases），and 26.7%（142 cases），respectively.By use of CAPs，health problems of the elderly were divided into 4 categories and 21 aspects.The median number of health problems of the elderly was 4（3）．Correspondence analysis results showed that：the major health problem of those with normal ability was bad living habits，and health education was required.Those with mild disability mainly had mental and social problems and insufficient physical activities，showing high demand for spiritual comfort and health promotion services.Those with moderate or severe disability had ADL limitation and clinical health problems.They were a high-demand group for daily care and medical care.Conclusion　The corresponding analysis of health problems and care needs found that care needs differed significantly by ability level in elderly people.This provides a basis for carrying out appropriate health services for improving the quality of life in the elderly in geriatric nursing facilities.

Key words: Aged, Geriatric nursing facilities, Grading care, Comprehensive geriatric assessment, Care needs, Correspondence analysis