ObjectiveTo explore the factors that influence institutional care for the disabled elderly in China and the key factors that influence individuals based on the Andersen model.DesignCross-sectional survey.SettingThe research was conducted in 18 cities in Henan Province, China.Main outcome measuresA multistage, stratified sampling design was employed. The χ2test was used to compare the differences in basic information of the disabled elderly. A binary Logit model was used to examine the factors influencing the willingness to institutionalise elderly people with disabilities. The determinants of willingness to care in an institution were also explored in a stratified study by gender, age and region to identify the key differences affecting institutionalisation. The Andersen model was used as the theoretical framework to infer the impact strength of each model.ResultsOf the 2810 disabled elderly people in Henan, China, 7.4% of the elderly had a willingness for institutional care. In the binary logistic regression analysis, whether living alone (OR (95% CI)=0.596 (0.388 to 0.916)), medical payment method (basic medical insurance for urban employees: OR (95% CI)=2.185 (1.091 to 4.377)), having mental illness (OR (95% CI)=2.078 (1.044 to 4.137)) had a statistically significant difference (p<0.05) on the impact on the willingness of the disabled elderly to receive institutional care. Validation of the fitted coefficients of the model revealed that the needs factor had the most significant effect on the enabling variable, while the predisposing factor had more minerally effect.ConclusionsSeveral factors influence the willingness of the disabled elderly to institutionalise. Therefore, it is recommended that relevant authorities take targeted measures to focus on the disabled elderly to identify more precise elderly care services to deal with the ageing crisis.

Purpose This study aimed to evaluate the relationship between hypertension (HTN) and type 2 diabetes mellitus (T2DM) on health-related quality of life (HRQoL) in elderly patients in the eastern coastal regions of China, which correspond to socio-demographic conditions, comorbidities and health outcomes. Methods From September 2021 to December 2021, 750 participants with HTN and T2DM over the age of 60 were recruited through multi-stage stratified sampling to conduct a cross-sectional study in the eastern coastal region of China. HRQoL was assessed using the EQ-5D-3L questionnaire. The multi-level model was developed to analyze the effects of patients' own factors and regional factors on HRQoL in patients with HTN and T2DM, using patients as level 1 and regions as level. Results The percentage of co-morbidity of HTN and T2DM in community-dwelling older adults was 14.3%, with a health utility index (0.778 ± 0.270). The multi-level model showed that the ICC was 0.797 and 0.815, respectively, which means that about 79.7% of the variance in EQ-5D health utility index was due to older adults' own factors and 20.3% of the variance was from urban level aggregation; about 81.5% of the variance in EQ-VAS scores was due to own factors and 18.5% of the variance was from urban level aggregation. Multi-level model results show that age, marital status, monthly income, number of chronic diseases, and alcohol consumption (P < 0.05) were significantly related to HrQoL in elderly patients with HTN and T2DM. Conclusion The HRQoL of older adults with HTN and T2DM is significantly lower than that of the general population, and emphasis should be placed on the prevention and management of older adults with the disease. Meanwhile, a central aspect to the management of HTN and T2DM is promoting a healthy lifestyle, and health-related knowledge should be promoted more, with emphasis on patients' mental health, to improve the HTN and T2DM of older adults.

ObjectiveTo investigate whether there is a curvilinear relationship between burnout and work engagement among staff in Chinese community services for the elderly.MethodsA stratified whole-group random sampling method was used to survey 244 staff members from eight communities in two cities. Data were collected using the Maslach Burnout Inventory scale (MBI) and the Utrecht Work Engagement Scale- 9 (UWES- 9). The curve estimation method explored the functional model of burnout and work engagement scales.ResultsTwo hundred forty-four staff members completed the survey. Burnout, depersonalization (DP), and personal accomplishment (PA) were found to be related to work engagement in a cubic function (R2 = 0.166, P &lt; 0.05), (R2 = 0.061, P &lt; 0.05), and (R2 = 0.2230, P &lt; 0.05), respectively. There was no statistically significant relationship between emotional exhaustion (EE) and work engagement (P &gt; 0.05). “Personal Accomplishment” is related to work engagement in a U-shaped curve.ConclusionsThere was a cubic function relationship between burnout and work engagement, where “personal accomplishment” was related to work engagement in a U-shaped curve. Therefore, the government and related service organizations should understand the impact of different levels of burnout on work engagement and take targeted measures to alleviate burnout and improve work engagement by targeting emotions and stroke.