Long‐Term Care Needs and Associated Factors Among Older Adults With Disabilities in Guilin, China: A Cross‐Sectional Study
Yangguang Chen, Zili ZhouBackground
Long‐term care (LTC) needs of older adults with disabilities have been studied in several Chinese provinces, but no evidence exists for Guilin, whose aging rate (20.33%) is well above the national average (18.70%).
Aim
To measure the level and profile of LTC needs among older adults with disabilities in Guilin and identify the factors associated with these needs.
Design
A cross‐sectional survey with face‐to‐face interviews.
Methods
A multistage sampling method was used to survey 215 older adults with disabilities in Guilin, China; their independent daily living ability and LTC needs were assessed utilizing the Barthel Index (BI) and the Long‐term Care Needs Scale. The data were analyzed by descriptive analysis, one‐way ANOVA, two independent samples t ‐test, and multiple regression analysis using SPSS 22.0.
Results
Participants had a mean age of 76.90 years (SD = 6.70), and 90.7% preferred aging at home with community services. The item mean of LTC needs was 3.61 (SD = 0.73) on a five‐point scale, exceeding the midpoint of 3; medical care (4.10 ± 0.99) and spiritual comfort (3.67 ± 0.85) scored the highest. In the full model, age ( B = 5.993, 95% CI: 3.951–8.036), education ( B = 4.509, 95% CI: 1.813–7.205), marital status ( B = 6.957, 95% CI: 3.428–10.486), number of diseases ( B = 2.643, 95% CI: 0.921–4.364), and BI disability level ( B = 2.772, 95% CI: 0.309–5.234) were significantly associated with greater LTC needs. Stratified analyses revealed both commonalities and individualities: age remained a consistent factor across all groups, whereas education and marital status were significant only in the mild disability group, and the number of chronic diseases was significant only in the moderate group. In the severe disability group, only age and place of domicile (marginally significant, B = −9.361, 95% CI: −18.703 to −0.019) were associated with LTC needs.
Conclusions
LTC needs among older adults with disabilities in Guilin were moderate to high, primarily involving medical care and spiritual comfort. A stratified, need‐based service model is recommended. Resources should prioritize the oldest‐old and those with multiple chronic conditions; for mild to moderate disability, family caregiving capacity, and psychological support should be strengthened; for severe disability, particularly in rural and mountainous areas, telemedicine, mobile care units, and community‐based respite care should be expanded to reduce geographic inequities.
Patient or Public Contribution
Older adults with disabilities shared their care needs and service preferences through face‐to‐face interviews, which shaped the recommendations for community‐based services.