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THUC HANH CHAM SOC SUfC KHOE CUA NGUdi CAO TUOI TAI MOT SO XA VUNG NONG THON, TJNH THAI BINH NAM 2015
TOM TAT
Nhim muc dich nlng cao kha nang quan ly cham sdc sire khde cua ngudi cao tiidi d tgi m^t s6 xa vimg ndng thdn, tinh Thai Binh. Thilt kl nghiSn ciiu md ta cat ngang cd kit hgp phdn tich, dugc tiln hanh ttIn 365 ngudi cao tiidi tai 5 xa viing ndng thdn, tinh Thai Binh thdng qua phdng vin trye tilp dii tirgng.
Ket qua cho thiy, ty lg ngudi cao tudi cd thuc hanh cham sdc sice khde chua tdt Id 65,8%. Trong do, ty le ngudi cao tudi cd hut thudc la 30,2%, cd udng rugu bia 63,3%, khdng tap the dye 68,4%., thudng xuyen an man 75,0% va khdng an hoa qua hdng ngay la 65,0%
Ngudi cao tiidi gda vg hogc chdng, gid yiu, cd bgnh tat cd xu hudng thgc hanh cham sdc siic khde chua tdt (0R>1 vd CI g;,^tii 1,13-4,54, p<0,05).
Tir khda: Thuc hanh, cham sdc siic khde, ngudi cao ludi.
SUMMARY;
PRACTICE OF THE ELDERLY ABOUT HEALTH CARE AT SOME RURAL COMMUNITIES IN THAI BINH PROVINCE, 2015
A cross-sectional study was performed to improve the ability of management and taking care of the elderly's health in in some rural communities m Thai Binh province.
This study was carried out on 365 old people who lived at 5 communities in Thai Binh province
The resuhs showed that 65.8%. of the total people did not have good practice about health care, mcludmg the percentage of people smokmg was 30.2%; people drinkmg alcohol was 63.3%, people who did not exercise was 68.4%, Salt eating habit was 75.0%. and did not eat fruit was 65.4%),
The elderly was divorced/ separated, retirement and having diseases were more likely not to have good practice about health care, p<0.05.
Dqng Bich Thijy', Dqng Thanh Nhan', Ha Ttii Hai' Keywords: Practice, health care, the elderly.
L B^T VAN DE
Qua trinh lao hda la mgt qua trinh sinh hgc ty nhien mang ti'nh tat ySu ngoai tdm kiim soat ciia con ngudi. Dan sd NCT d nhilu nude tten thS gidi dang tang nhanh va sg tilp tuc tang ttong nhiing nam ldi ca vS sd lugng ciing nhu ty 11 tiong ting dan si [3],[5].
O dai da sd cac qudc gia, ty le ngudi tir 60 tudi ttd lln sing d khu vuc ndng thdn cao han thanh thi, Iy do cua hign tugng nay 11 do cd nhiiu ngudi tte tudi ttong dd tudi lao ddng di cu ra thanh thi de tim kiim vigc Idm.
Theo ket qua cac nghiin ciiu d Viet Nam ttong 10 nam ttd lai day, khoang 80% ngudi cao tudi (NCT) cd benh man tinh.
Viec kiSm soat tdt cac bgnh va cham sdc sice khde tot da lam giam ty 11 tii vong ddng thdi lam thay ddi md hmh benh tat vd tii vong. DS tim hieu vin dl nay va cd ca sd cho vi|c xdy dyng md hinh can thiep ndng cao siic khde cho NCT tai viing ndng thdn Thai Binh, chiing tdi tiln hdnh nghiin ciiu nay vdi muc tieu nghien cim nhu sau:
Muc lieu: MS td thuc hdnh cham sdc sue khoe cua ngu&t cao tuoi tgi mgt so xd vimg nong thon, tinh Thdi Binh ndm 2015
H. PHU'ONG PHAP NGHIEN CUtJ 2.1. Dia diem, doi tuang nghien cuu Nghiin Clhi dugc thuc hiln ttIn ngudi cao tudi (tii 60 tudi ttd lln), sinh sdng tai 5 xa viing ndng thdn Thai Binh, bao gdm xa Binh NguySn thugc huygn KiSn Xuong;
xa Trgng Quan, Phong Chau thudc huyen Ddng Hung; xa Nguyln Xa, Minh Lang thugc huyen Vii Thu. Day Id cac xa nam ttong diSn triSn khai chuong trinh y te Qudc gia phdng chdng bgnh tang huyet dp.
- Th&i gian nghien cuu: Td thdng 9/2015 din thing 12/2015
1. Trirdng Dai hgc Y Dirge Thai Binh
» Ngay nhin bii: 02/04/2018 | » Ngdyphdn bien; 09/04/2018 | » Ngay duylt dang: 14/04/2018
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2.2. Thiit ki nghiin cmi: Ap dyng thiet kl nghiSn ciiu mo td cdt ngang cd phdn tich, sit dung phuong phdp nghiSn ciiu dinh lugng.
2.3.Cd mau; Dugc linh toan bdng cdng thiic;
Trong dd: n 11 c5 mdu tdi thieu; a/2: Do tin ciy lay d ngudng a = 0,05; p; ty IS ngudi cao tudi cd thyc hanh cham sdc siic khde tdt, dugc lay bang 35,0%i; d; Sai sd mong muon, cd gid trj bang 0,05. Ket qua tinh dugc n = 365 ngudi.
Cdch chgn ddi tugng: Tii cac huyen Kien Xuong, Vii Thu, Ddng Hung, tiin hdnh chgn chii dich 5 xa: xa Binh Nguyln thugc huyin Kiin Xuong; xa Trgng Quan, Phong Chiu thudc huygn Ddng Hung; xa Nguyln Xa, Minh Lang thudc huygn Vii Thu
Tai moi xa dugc chon, tien hanh chgn ngiu nhiin moi xa tii 70-75 ngudi cao tuli dl dilu tta. Mdi ddi tugng dugc chgn se dugc cdng tac vien y te thdn gui
giiy mdi din Trgm y ti xa dl khdm bgnh va phdng vin theo kl hoach.
2.4. Ky thugt dp dyng trong nghien ciru - Phdng van trgc tiip NCT vl mdt si thdng tin theo mau phieu cdu tnic da dugc chuan bj trudc. Can bg tham gia ngiiien cim dugc tgp hudn thdng nhat ve each hdi, giai thich va ghi chip thdng tm.
2.5 Xie ly sd lieu: Six dyng phin mim SPSS 21.0.
Tinh cdc ty II %.; tinh OR,CI ^j^^, sy khdc biet dugc coi la cd y nghia thdng ke khi p<0,05.
2.6. Dgo dire trong nghiin cuu: NghiSn ciiu khong giy bit ky mOt dnh hudng gi den siic khde cua ngudi cao tuli. Cac doi tirgng tham gia nghiSn ciiu deu dugc giai thich ly do, ddi tugng loan quyln tur chdi khi khdng myi^
tham gia. Cac thdng lin ciia ddi lugng dugc hodn toan gift bi mgt vl kit qua nghien ciiu chi phgc vy cho myc dich khoa hgc.
IIL KET QUA NGHIEN CtTU ^
Bdng 1. Mdt so ddc diem chung cua ddi tuffng nghien cieu.
f)ac diem Glftl tinh:
Nam NO
Nh6m tudi: . ',. , 60-69
70-79
>80 Tinh tr^Dg lidn nliSn:
Dang CO vo/chong Goa
Khac 1, Hien tai s6ng cdng vol:
Con chau Va/ch6ng Mot minh Cong vi^c hifn t?i:
Nghi ngoi Lam viec kiem tien Co bao hiem y te
SL (n-365) 160 205
\l 174 143 48
273 62 30
115 155 95
260 105 247
%
43,8 56,2 47,7 39,2 13,1 74,8 17,0 8,2 31,5 42,5 26,0 71,2 28,8 67,8
; ^ 32
SO 3 (44) - Thing 05-06/2018VjieHrltii CUfU KHOA HOC
iVTmUMMDO "10 JAVinUOlQua ket qua b a n g i i l i c k i ^y,iiTrong't8ng.,sft»S65i;\ :ii'^vQMkitigiiaiiia^gratfcita-spui^ cho thiy, cd 26,0%
Mudi-cao-tuSi-tfi«)'c-A"g«_tosi^d-43,8-% Id nam-gidi-vo—-ngudi-cao-t«d^sdHg4gG-tilan-va-GG^58J8%-Rg«d^-Gae4udi-1 56,2% l a n ^ gidi. M l ^ ^ t t i d i tii;60-6S^?fi§i%rem 471?%; ' ^ S : d A ' ^ ^ giajlao d ^ ^ M l m t i i . Ty IS tham tir 709/01
^dng 2. Tyle ngii di caotu&l tu ddnh gid ve thudihdnKchdm sdciJd^ thd^cua bdn fMsbfil aduriJ l u H
jmm,
a n y J l xhiim^i^Wa ddng n9up iodT
- d a
•i.Qd Micj; d d ^ d n h gia eo,05 .16
Nam
" ( n - 1 6 0 )
^lk_
(n=a05)
%
Chung snorDl (n-ufiSiiid anolj
% oD - J S
f i - o ^ k i Tn|ng^3Rh
\ ' « i f l l oer ' ^ 5
~ 2 ^
4$,7d,Cl 89: I 6 7 " ' ' 5 ' » l f i j ^ _ f ™ j 73 20,0 "-"
-CM-thich: *-:SukMrc'-b
^"^QM'kft^4ifl°A8Wg'2'cli6''tiiy;'co34,2!'.''ig\iiWcao' 6i,iV^ rigiicii'A&'tdoilii^c'&i MSiA so'csSctSQ i±!, t i S f i 8 " i i m ' l a i = a t l i u e ' h a i i h c i W ' 5 8 c s v K i A ' 6 i ! t 6 t b i i l h a n f t J n f f i t h i i a M ; "''"'' '-"''- ""' " " '" " " P nil cao hon nam gioi (38,0 so vol 29,%) vai p<0,05.'Co' " ' ' ' ^ ' ' " ' " " "^' "'^ oElViil ')QarIJ Jjjrl 63
Bdng 3. l^,§d^,u,td,4igniSlia*^Mn,ch^ spc_ siiK\1iMe^m^oehua tDt,cdM ngledi cao tuoi
§nnfl3 Y l u t 6 ( 2 « - n )
iout 08 < Chain sdnsmHOi^
mmUt ( t M - n ) T3t S I ^ 8 GiiK:
cO.O<
Nil
112 128
'-^6,:^
• 53,3
3S,4 6(,6
" 1,4
'1,2^-2,31 Sn6i01
Nhom tuoi:
>=70 - 1 ?.0,0> 60-69
123 1'17'
k ? 8
57' 4^ , (.a
54,4 45-6 Lit
13
"^1,1^-2,14 60
g n o O Goa vtf/chong, doc t h a n :
Co 75
165
31,3 68,7
I20 105
16,0 :_?(*,o
2 38 ,2,31-4,54
T—I—ror
. r,<o-_o5!iA :^G3n gosil TS m i c b e n h :
»
Co Khong
40,8 59,2
33,6 1)36
T,065r6T"
'' 'Qua kef q u i bang 3 cho thay, c6 nipt s6 yeu to' lien doc than va tien sir bHii thin CO bSnh vai 0 R > l"va CI tjiian den'cliam soc sue kh6e cr miic chua t6ti:uangtrcfi tir 1,13-4,54, p<0,05. ^°i^^ ^^ 1^
cao tufli do la nam gi6i, tuoi gii ygu (tir 70 tija len), song oojv Olio m DO mfil T0S4 ^l?<i nau uBh nad iiig rin£h rinfid TOVi oris sorljl siiy OGO ^ncn qsitij nfo riniri flrn §mjb yiij;
rinia iarlT .isH noiT iijl a i p HaiJ liiji miiril ij^ K[j[j gnoiiJ 'j6ri>l oil!, g n i i oda TM i-"\.K il mip IO;i odo OIOH m i n 'jiK oo rinim griisi odD T'J14 ')l vl ""^- <' Bl mad Iiil .msji
niup iodt os'J .^Bgn gned cup Bod nB §n6ri;f lougn OB o\''0,?f) .£0,0>q i w ioLTl m6dn -jfia fiiiig Joid oerii! m 60 §niJo yen
KAUJl AAS ,V1 ioiy 3flT 31Y oijda 6T suo yiit) iiiig uaii ict uii3 03dT itit ntii JAI gnonri rini gno^ iol .iv dnBd 01 uSy .(OHW)
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JOURNAL OF COIHMUNITY MEDICINE
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Bdng 4. Mot so thdi quen khdng
Thoi quen Hut thuoc la/lao:
Co Khong U6ng bia riroii:
Co Khong Luyen tap the dye:
C6 Khong
60-69 tudi (n=174) SL 67 107 107 67 81 93
%
38,5 61,5 61,5 38,5 46,6 53,4
cd Ifi cho siec khde 70-79 tuoi
(n=I43) SL 35 108 109 34 28 115
%
24,5 75,5 76,2 23,8 19,6 80,4
cda ngudi cao tuoi
> 80 tuoi (n-48) SL
8 40 15 33 6 42
%
16,6 83,4 31,2 68,8 12,5 87,5
Chung (n=36S) SL 110 255 231 134 115 250
%
30,2 69,8 63,3 36,7 31,6 68,4
P
<0,05
<0,05
<0,05
Qua kit qua bang 4 cho biet vl ty le mgt sd thdi 68,4% ngudi cao tudi khdng luyen tap the dye. Cac quen cd hai cho sdc khde: 30,2% ngudi cao tudi thdi quen oay cd sg khac bi|t giua cdc nhdm tu6i vci cd hiit thudc Id/lao; 63,3% cd udng bia rugu va cd p<0,05.
Bdng 5, Mpt so thdi quen ve cham soc dinh du&ng cua ngu&i cao tuSi
Thoi quen An m^n:
Co Khong An nhieu mon an ran:
Co Khong An hoa qua hing ngay:
Co Khong
60-69 tuoi (n-174) SL 142 32
78 96
63 111
%
81,6 18,4
44,8 55,2
36,2 63,8
70-79 tuoi (n-143) SL 107 36
80 63
36 107
%
74,8 25,2
55,9 44,1
25,2 74,8
> 80 tool (11-48) SL 25 23
7 41
29 19
%
52,1 47,9
14,6 85,4
60,4 39,6
Chung (n-365) SL 274 91
165.
200
128 237
%
75,0 24,9
45,2 54,8
35,0 65,0
P
>0,05
<0,05
<0,05
Qua kit qua bang 5 cho thay, trong long sd ngudi cao ludi dugc diSu tra, cd 75,0% sd ngudi cd thdi quen an man va cd xu hudng gidm ddn theo nhdm tudi (81,6% so vdi 74,8%.
va 52,1%); 45,2% ngudi cao tudi thich an mdn ran va cd tdi 65,0% sd ngudi khdng an hoa qua hang ngdy. Cdc thdi quen nay ciing cd sg khac bilt giira cdc nhdm tudi vdi p<0,05.
IV. BAN LUAN
Theo cdc lai lieu gan day ciia Td chirc Y tS Thi gidi (WHO), ylu td hanh vi, Idi sdng dnh hudng rat ldn ldi
viec hinh thanh va phat triln cdc benh man tinh nhat 14 d ngudi cao tudi. MOt phdn ba cac binh tat lien quan den hanh vi ldi sdng, cac benh nay chu ylu la cac bluli man tinh [7].
Theo nghiSn cieu cua Ll Via Anh va cgng sg tien hdnh danh gia ban ddu trSn 958 NCT lam co sd cho vife xay dgng md hinh can thi^p nang cao site khde cho NCT' thdng qua su tham gia tich cue tai Tiin Hai, Thdi Binh nam 2010 cho kit qud la 34,7% NCT cho ring siic khoe kem, rdt kem Id 9,5%i, ty 1| NCT cho rdng minh co siic
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khde buih thudng chiSm 47,5%, ty le NCT tg danh gia cd siic khde tdt chiim 8,l%i [1].
Trong nghien ciiu cita chdng tdi, kit qua cho thay cd 34,2%. ngudi cao tudi tu danh gid cd thgc hdnh cham sdc siic khde tdt, nu cao hon nam gidi (38,0 so vdi 29,%) vdi p<0,05. Cd 65,8% ngudi cao tudi thue hanh cham sdc siic khde cua ban than d mite chua tdt. Cd mdt sd ySu td liln quan dSn cham sdc sice khde d miic chua tdt cua ngudi cao ludi dd la nam gidi, tudi gia yeu (ttt 70 trd len), s6ng ddc than va tiln su ban thdn cd benh vdi 0R>1 vd CI tir 1,13-4,54, p<0,05.
Mac du lgi ich cila hoat dgng thi luc thudng xuyIn da cd nhiiug bdng chiing rit rd rdng, song ddi vdi NCT cd nhiSu ySu td can trd nhan thiic va thuc thien diing theo chi d&i. Nam 2001, K. M. Cooper va cgng sg tiln hanh nghiin citu nhiing rao cdn trong viec thuc hien cac boat ddng thS luc d ngudi 60 - 80 tudi cho thdy d NCT dau, met mdi, suy giam ehiic nang cua cdc giac quan la rdt phd biin va Id ylu td ldm can trd NCT tham gia cdc hoat ddng thS luc [4]. Qua kit qua nghien ciiu cua chiing tdi cho biSt c6 68,4%. ngudi cao tudi khdng luyen tdp thS due, cd sg khac bilt giua cdc nhdm tudi vdi p<0,05.
Cac hanh vi nguy ca dnh hudng tdi siic khoe NCT d tat cd cac qudc gia trSn the gidi dugc xdc dinh la: Hiit
thudc la; su dung rugu bia qud mice (lam dung rugu, bia), it hoat ddng thi lue, dinh dudng khdng hgp ly va thira can bdo phi [7]. Kit qua cua chimg tdi cung cho biSt ty le mot sd thdi quen cd hai cho siic khde: 30,2% ngudi cao tudi cd hiit thudc Id/lao; 63,3% cd udng bia rugu; cd 75,0% sd ngudi cd thdi quen an; 45,2% ngudi cao tudi thich an mdn ran va cd tdi 65,0% sd ngudi khdng an hoa qua hdng ngay.
Nhiing bang chting khoa hgc hien nay cho thdy mudn cd cugc sdng khde manh, con ngudi chn phdi biSt sir dung thgc phdm mdt cdch hgp ly ddng thdi phdi tich cue boat ddngthS lgc [6].
IV. KfeT L U ^
Qua dieu tra 365 ngudi cao tudi, kit qua cho thdy:
Ty 11 ngudi cao tudi cd thgc hanh cham sdc siic khde chua tdt la 65,8%. Ty 11 ngudi eao tudi cd hiit thudc la 30,2%, cd u6ng rugu bia 63,3%., khdng tap thi due 68,4%, thudng xuyen an man 75,0% vd khdng an hoa qua hdng ngay la 65,0%; cd su Ididc biet giiia cac nhdm tudi vdi p<0,05.
Ngudi cao tudi gda vg hoac chdng, gia yeu, cd bSnh t§t cd xu hudng thgc hanh cham sdc sdc khde chua tdt (vdi 0R>1 va CI ^^^tir 1,13-4,54, p<0,05).
J T A I LmU THAM K H A O
1. Le Vii Anh va cac c^ng sir (2010), Xdy dung md hinh ndug cao sdc khde ngudi cao tudi thdng qua sg tham gia tich cue trong mgt chuong trinh can thiep y tS edng cgng d TiSn Hai, Thai Binh, Bao cao todn van Hdi nghi Idioa hgc todn qudc Hdi YtS Cdng cdng Viet Nam ldn thii VI, chu bien, Nha Trang, Khdnh Hda, tr. 128-141.
2. Hoi Y t^ Cdng c6ng Vilt Nam (2010), NSog cao siic khoe ngudi cao tudi thdng qua su tham gia chii ddng, tich cue vdo cdc hoat ddng ciia cdng ddng, http://www.vpha.org.vn/index.php/TabIe/Suc-khoe-nguoi-cao-tuoi/.
3. Nguyen Thi Xnyen (2010), "Gia hda dan sd vd chinh sach cham sdc sdc khde cho ngudi cao tudi Viet Nam", Tap chi Y hpc Thuc hdnh. 5(715), tr. 56-58.
4. K. M. Cooper, et al. (2001), "Health barriers to walking for exercise in elderly primary care", Geriatr Nurs.
22(5), pp. 258-62.
5. United Nations - Department of Economic and Social Affairs Office of the High Commissioner for Human Rights (2010), Cuiremt status of the Social situation, Wellbeing, Participation m Deveplopmenl and Rights of Older persons Worldwide, accessed 14/3/2011, fromwww.un.org/esa/socdev/ageing/.../currenl-status-older-persons.pdf. 129 6. WHO (2009), Global Health Risks, Mortality and burden of disease attributable to selected major risks, WHO Press, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
7. WHO (2011), Global status report on noncommunicable diseases 2010, WHO press, 20 Avenue Appia, 1211 Geneva 27, Switzerland. 145
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