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Article(id=1240375115616153829, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202309329, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1694880000000, receivedDateStr=2023-09-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773658072617, onlineDateStr=2026-03-16, pubDate=1711296000000, pubDateStr=2024-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773658072617, onlineIssueDateStr=2026-03-16, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773658072617, creator=13701087609, updateTime=1773658072617, updator=13701087609, issue=Issue{id=1240375105386238038, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773658070179, creator=13701087609, updateTime=1773658539618, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240377074414833974, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240377074414833975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240375105386238038, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1044, endPage=1049, ext={EN=ArticleExt(id=1240375116299825437, articleId=1240375115616153829, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Vulnerability assesements and obstacle factor analyses of elderly farmers and herdsmen’s families in Nanshan Pastoral Area, Xinjiang, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To comprehensively evaluate the vulnerability level of elderly farmers and herdsmen’s family old-age pension and analyze the obstacle factors.

Methods

Based on the vulnerability framework, we constructed a family old-age pension vulnerability assessment index system, and selected 2 594 research subjects for questionnaire survey by multi-stage random cluster sampling. We applied entropy-weight-TOPSIS method to comprehensively evaluate the level of elderly farmers and herdsmen’s family old-age pension vulnerability, and explored the obstacle factors.

Results

60.14% of the elderly farmers and herders in the southern mountainous pastoral areas of Xinjiang had medium or high levels of vulnerability to old age; the three dimensions of vulnerability to old age and their degree of obstacles were sensitivity (47.59%), adaptive capacity (27.73%), and exposure (25.58%); the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%), physical fitness index (10.86%), and physical health index (11.86%); and the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%). The top five barriers and their degree of obstacles were hospitalization due to illness (11.86%), body mass index (10.17%), debt (10.06%), caring for grandchildren (9.16%), and self-care ability (5.70%); and the degree of obstacles to care for the elderly was the fourth highest among elderly farmers (8.62%) and the fourteenth highest among elderly pastoralists (2.69%).

Conclusion

There are differences in vulnerability levels and obstacles between elderly farmers and herders. It is recommended to pay attention to the differences in the characteristics of elderly farmers and herders themselves and their pension resources, so as to formulate more accurate pension strategies.

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目的

综合评价新疆南山牧区老年农牧民家庭养老脆弱性,分析其障碍因素。

方法

基于脆弱性框架构建评估指标体系，采用多阶段随机整群抽样法,选取2 594例研究对象开展问卷调查。运用熵权-TOPSIS法综合评价老年农牧民家庭养老脆弱性水平,并探讨其障碍因素。

结果

新疆南山牧区老年农牧民家庭养老脆弱性处于中、高水平的占比为60.14%,家庭养老脆弱性的三个层面及其障碍度,分别是敏感性(47.59%)、适应能力(27.73%)、暴露度(25.58%)；前五位障碍因素及其障碍度,分别是因病入院(11.86%)、体质指数(10.17%)、债务(10.06%)、照顾孙辈(9.16%)、生活自理能力(5.70%)、生活照料的障碍度在老年农民中居于第4位(8.62%),老年牧民中居于第14位(2.69%)。

结论

新疆南山牧区老年农牧民家庭养老脆弱性处于中高水平,老年农民与老年牧民的脆弱性水平及障碍因素存在差异,建议关注老年农牧民自身特点及养老资源的差异性,制定更精准的养老策略。

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由淑萍，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=VUAWtia/1GEs5OloWssbuw==, magXml=1+V9EZbtfmk0ItsJ5Q9vIQ==, pdfUrl=null, pdf=YKPjsElfBrIHXUQPa36z4w==, pdfFileSize=743910, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=670ih/xE1JHgiuW/DBnguA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=SIcEnsw3J12huUAU0cd8ww==, mapNumber=null, authorCompany=null, fund=null, authors=

孟娜（1989—），女，硕士在读，研究方向：社区护理

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孟娜（1989—），女，硕士在读，研究方向：社区护理

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孟娜（1989—），女，硕士在读，研究方向：社区护理

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Medical Journal of Wuhan University, 2022, 43(2): 302-306., articleTitle=Influence of multiple chronic conditions on the health status of the elderly in China, refAbstract=null)], funds=[Fund(id=1240746310563844409, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, awardId=2023BSH066, language=CN, fundingSource=新疆维吾尔自治区社科基金(2023BSH066), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240746305585206209, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, xref=1., ext=[AuthorCompanyExt(id=1240746305614566339, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, companyId=1240746305585206209, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang 830000, China), AuthorCompanyExt(id=1240746305627149255, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, companyId=1240746305585206209, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.新疆医科大学护理学院,新疆 乌鲁木齐 830000)]), AuthorCompany(id=1240746305740395472, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, xref=2., ext=[AuthorCompanyExt(id=1240746305744589778, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, companyId=1240746305740395472, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.新疆医科大学公共卫生学院)]), AuthorCompany(id=1240746305832670168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, xref=3., ext=[AuthorCompanyExt(id=1240746305841058776, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, companyId=1240746305832670168, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.新疆医科大学第三附属医院)]), AuthorCompany(id=1240746305958499294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, xref=4., ext=[AuthorCompanyExt(id=1240746305962693599, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, companyId=1240746305958499294, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.乌鲁木齐县板房沟镇卫生院公卫科)])], figs=[ArticleFig(id=1240746309083255013, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Fig.1, caption=Distribution of vulnerability index for elderly farmers and herdsmen in Xinjiang Pastoral Areas, figureFileSmall=j/l/occhRoXg1NtnhG1trg==, figureFileBig=wML8cwwrhsQ1R5QcFQqXLQ==, tableContent=null), ArticleFig(id=1240746309171335403, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=图1, caption=新疆南山牧区老年农牧民家庭养老脆弱性指数分布图, figureFileSmall=j/l/occhRoXg1NtnhG1trg==, figureFileBig=wML8cwwrhsQ1R5QcFQqXLQ==, tableContent=null), ArticleFig(id=1240746309284581614, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Fig.2, caption=Radar chart of the obstacle ratio of various indicators of the vulnerability of elderly farmers and herdsmen’s families in Xinjiang Nanshan Pastoral Areas for elderly care, figureFileSmall=MP5JVGkr1RBOfQR5tIZb3Q==, figureFileBig=CY706CS/a5mqgv4b4VXG4A==, tableContent=null), ArticleFig(id=1240746309490102522, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=图2, caption=新疆南山牧区老年农牧民家庭养老脆弱性各指标障碍度占比雷达图, figureFileSmall=MP5JVGkr1RBOfQR5tIZb3Q==, figureFileBig=CY706CS/a5mqgv4b4VXG4A==, tableContent=null), ArticleFig(id=1240746309594960127, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Table 1, caption=

Evaluation index system for the vulnerability of elderly farmers and pastoral families in Nanshan Pastoral Area, Xinjiang

, figureFileSmall=null, figureFileBig=null, tableContent=
目标层准则层指标层指标描述与赋值说明指标类型权重
暴露水平社会风险E1:医疗支出过去一年,家庭医疗支出金额(元)(+)0.013
E2:债务家庭负债金额(元)(+)0.077
自然风险E3:自然灾害过去一年,家庭发生自然灾害,1=是;0=否(+)0.093
家庭风险E4:丧偶过去一年,老年人丧偶,1=是;0=否(+)0.108
E5:不再工作过去一年,老年人不再工作,1=是;0=否(+)0.005
E6:照顾孙辈过去一年,老年人照料孙辈情况,1=几乎不照顾;2=几个月1次;3=2~4周1次;4=每周至少1次;5=几乎每天;(+)0.058
敏感性生理敏感性S1:生活自理能力使用ADL评分,1=完全自理(1~11分);2=基本自理(12~22分);3=轻度依赖(23~33分);4=重度依赖(34~44分)(+)0.058
S2:体质指数正常值区间[18.5~25],1=异常;0=正常(+)0.025
S3:大病老年人患大病,1=是;0=否0.101
S4:慢性病老年人患慢性病个数(+)0.016
S5:因病入院过去一年,老年人因病住院,1=是;0=否(+)0.058
S6:视力1=非常好,2=较好,3=一般,4=较差,5=很差(+)0.016
S7:听力1=非常好,2=较好,3=一般,4=较差,5=很差(+)0.008
心理敏感性S8:抑郁程度使用CES-D 10抑郁自评量表评分,总分0~30分,10分及以上为抑郁,1=是;0=否(+)0.097
S9:睡眠质量近一周睡眠质量不佳,1=少于1天;2=1~2天;3=3~4天;4=5~7天(+)0.031
S10:自评健康状况1=非常好;2=较好;3=一般;4=较差;5=很差(+)0.008
S11:生活满意度1=非常好;2=较好;3=一般;4=较差;5=很差(+)0.009
适应能力自然资本A1:耕地面积家庭耕地面积(亩)(-)0.001
A2:草地面积家庭草地面积(亩)(-)0.001
金融资本A3:家庭资产家庭各项资产总金额(元)(-)0.002
A4:经济收入过去一年家庭年收入(元)(-)0.001
物质资本A5:住房面积家庭住房面积(m2)(-)0.001
人力资本A6:教育程度1=文盲/半文盲;2=小学;3=初中;4=中专/高中;5=大专及以上(-)0.002
A7:劳动力占比过去一年,家中劳动力人数/家庭总人数(-)0.003
社会资本A8:子女个数老人健在的子女个数(-)0.002
A9:居住状态1=独居;0=非独居(-)0.115
A10:生活照料过去一年他人帮忙料理家务或照顾饮食起居情况,1=几乎没有;2=几个月1次;3=2~4周1次;4=每周至少1次;5=几乎每天(-)0.041
A11:子女关爱1=基本没有;2=比较缺乏;3=一般;4=比较充足;5充足(-)0.026
A12:社交活动使用CHARLS中11项社交活动得分总和,0=不参加;1=不经常;2=差不多每周;3=差不多每天(-)0.004
A13:娱乐活动0=不参加;1=不经常;2=差不多每周;3=差不多每天0.006
A14:亲戚社会支持日常往来/帮忙的亲戚个数(-)0.001
A15:朋友社会支持日常往来/帮忙的朋友个数(-)0.002
A16:到最近医疗机构所需时间到医疗机构所需时间(min),1=121及以上;2=61~120;3=31~60;4=16~30 min;5=15 min及以内(-)0.006
A17:医疗服务满意度对现有医疗保健服务的感受,1=很不满意;2=不满意;3=一般;4=满意;5=很满意(-)0.006
), ArticleFig(id=1240746309704012038, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=表1, caption=

新疆南山牧区老年农牧民家庭养老脆弱性评估指标体系

, figureFileSmall=null, figureFileBig=null, tableContent=
目标层准则层指标层指标描述与赋值说明指标类型权重
暴露水平社会风险E1:医疗支出过去一年,家庭医疗支出金额(元)(+)0.013
E2:债务家庭负债金额(元)(+)0.077
自然风险E3:自然灾害过去一年,家庭发生自然灾害,1=是;0=否(+)0.093
家庭风险E4:丧偶过去一年,老年人丧偶,1=是;0=否(+)0.108
E5:不再工作过去一年,老年人不再工作,1=是;0=否(+)0.005
E6:照顾孙辈过去一年,老年人照料孙辈情况,1=几乎不照顾;2=几个月1次;3=2~4周1次;4=每周至少1次;5=几乎每天;(+)0.058
敏感性生理敏感性S1:生活自理能力使用ADL评分,1=完全自理(1~11分);2=基本自理(12~22分);3=轻度依赖(23~33分);4=重度依赖(34~44分)(+)0.058
S2:体质指数正常值区间[18.5~25],1=异常;0=正常(+)0.025
S3:大病老年人患大病,1=是;0=否0.101
S4:慢性病老年人患慢性病个数(+)0.016
S5:因病入院过去一年,老年人因病住院,1=是;0=否(+)0.058
S6:视力1=非常好,2=较好,3=一般,4=较差,5=很差(+)0.016
S7:听力1=非常好,2=较好,3=一般,4=较差,5=很差(+)0.008
心理敏感性S8:抑郁程度使用CES-D 10抑郁自评量表评分,总分0~30分,10分及以上为抑郁,1=是;0=否(+)0.097
S9:睡眠质量近一周睡眠质量不佳,1=少于1天;2=1~2天;3=3~4天;4=5~7天(+)0.031
S10:自评健康状况1=非常好;2=较好;3=一般;4=较差;5=很差(+)0.008
S11:生活满意度1=非常好;2=较好;3=一般;4=较差;5=很差(+)0.009
适应能力自然资本A1:耕地面积家庭耕地面积(亩)(-)0.001
A2:草地面积家庭草地面积(亩)(-)0.001
金融资本A3:家庭资产家庭各项资产总金额(元)(-)0.002
A4:经济收入过去一年家庭年收入(元)(-)0.001
物质资本A5:住房面积家庭住房面积(m2)(-)0.001
人力资本A6:教育程度1=文盲/半文盲;2=小学;3=初中;4=中专/高中;5=大专及以上(-)0.002
A7:劳动力占比过去一年,家中劳动力人数/家庭总人数(-)0.003
社会资本A8:子女个数老人健在的子女个数(-)0.002
A9:居住状态1=独居;0=非独居(-)0.115
A10:生活照料过去一年他人帮忙料理家务或照顾饮食起居情况,1=几乎没有;2=几个月1次;3=2~4周1次;4=每周至少1次;5=几乎每天(-)0.041
A11:子女关爱1=基本没有;2=比较缺乏;3=一般;4=比较充足;5充足(-)0.026
A12:社交活动使用CHARLS中11项社交活动得分总和,0=不参加;1=不经常;2=差不多每周;3=差不多每天(-)0.004
A13:娱乐活动0=不参加;1=不经常;2=差不多每周;3=差不多每天0.006
A14:亲戚社会支持日常往来/帮忙的亲戚个数(-)0.001
A15:朋友社会支持日常往来/帮忙的朋友个数(-)0.002
A16:到最近医疗机构所需时间到医疗机构所需时间(min),1=121及以上;2=61~120;3=31~60;4=16~30 min;5=15 min及以内(-)0.006
A17:医疗服务满意度对现有医疗保健服务的感受,1=很不满意;2=不满意;3=一般;4=满意;5=很满意(-)0.006
), ArticleFig(id=1240746309804675343, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Table 2, caption=

Baseline data of survey subjects n (%)

, figureFileSmall=null, figureFileBig=null, tableContent=
指标全样本(n=2 594)农民(n=978)牧民(n=1 616)
个人特征
性别
男1 208(46.57)446(45.60)762(47.15)
女1 386(53.43)532(54.40)854(52.85)
年龄(岁)
60～64726(27.99)202(20.65)524(32.43)
65～69704(27.14)286(29.24)418(25.87)
70～74544(20.97)160(16.36)384(23.76)
75～79324(12.49)122(12.47)202(12.50)
≥80296(11.41)208(21.27)88(5.45)
教育程度
文盲/半文盲482(18.58)304(31.08)178(11.01)
小学1 630(62.84)492(50.31)1 138(70.42)
初中371(14.30)164(16.77)207(12.81)
高中及以上111(4.28)18(1.84)93(5.76)
家庭特征
家庭结构
独居户86(3.32)32(3.27)54(3.34)
夫妻户942(36.31)610(62.37)332(20.54)
与子女同住1 530(58.98)334(34.15)1 196(74.01)
其他36(1.39)2(0.20)34(2.10)
家庭人口数3.64±1.792.79±1.304.15±1.85
子女个数3.22±1.323.00±1.393.36±1.27
保障体系
养老经济来源
养老金532(20.51)370(37.83)162(10.02)
子女/亲友补贴1 702(65.61)384(39.26)1 318(81.56)
政府/集体救助52(2.00)18(1.84)34(2.10)
劳动收入174(6.71)128(13.09)46(2.85)
个人储蓄36(1.39)18(1.84)18(1.11)
房屋/土地租金98(3.78)60(6.13)38(2.35)
健康状况
慢性病个数
0519(20.01)238(24.34)281(17.39)
11 099(42.37)429(43.87)670(41.46)
≥2976(37.62)311(31.80)665(41.15)
体质指数(kg/m2)
偏瘦50(1.93)22(2.25)28(1.73)
正常871(33.58)378(38.65)493(30.51)
超重1 013(39.05)390(39.88)623(38.55)
肥胖660(25.44)188(19.22)472(29.21)
因病入院
是794(30.61)298(30.47)496(30.69)
否1 800(69.39)680(69.53)1 120(69.31)
), ArticleFig(id=1240746309909532951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=表2, caption=

调查对象一般资料 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标全样本(n=2 594)农民(n=978)牧民(n=1 616)
个人特征
性别
男1 208(46.57)446(45.60)762(47.15)
女1 386(53.43)532(54.40)854(52.85)
年龄(岁)
60～64726(27.99)202(20.65)524(32.43)
65～69704(27.14)286(29.24)418(25.87)
70～74544(20.97)160(16.36)384(23.76)
75～79324(12.49)122(12.47)202(12.50)
≥80296(11.41)208(21.27)88(5.45)
教育程度
文盲/半文盲482(18.58)304(31.08)178(11.01)
小学1 630(62.84)492(50.31)1 138(70.42)
初中371(14.30)164(16.77)207(12.81)
高中及以上111(4.28)18(1.84)93(5.76)
家庭特征
家庭结构
独居户86(3.32)32(3.27)54(3.34)
夫妻户942(36.31)610(62.37)332(20.54)
与子女同住1 530(58.98)334(34.15)1 196(74.01)
其他36(1.39)2(0.20)34(2.10)
家庭人口数3.64±1.792.79±1.304.15±1.85
子女个数3.22±1.323.00±1.393.36±1.27
保障体系
养老经济来源
养老金532(20.51)370(37.83)162(10.02)
子女/亲友补贴1 702(65.61)384(39.26)1 318(81.56)
政府/集体救助52(2.00)18(1.84)34(2.10)
劳动收入174(6.71)128(13.09)46(2.85)
个人储蓄36(1.39)18(1.84)18(1.11)
房屋/土地租金98(3.78)60(6.13)38(2.35)
健康状况
慢性病个数
0519(20.01)238(24.34)281(17.39)
11 099(42.37)429(43.87)670(41.46)
≥2976(37.62)311(31.80)665(41.15)
体质指数(kg/m2)
偏瘦50(1.93)22(2.25)28(1.73)
正常871(33.58)378(38.65)493(30.51)
超重1 013(39.05)390(39.88)623(38.55)
肥胖660(25.44)188(19.22)472(29.21)
因病入院
是794(30.61)298(30.47)496(30.69)
否1 800(69.39)680(69.53)1 120(69.31)
), ArticleFig(id=1240746310010196248, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Table 3, caption=

K-means clustering results

, figureFileSmall=null, figureFileBig=null, tableContent=
脆弱性级别脆弱指数范围均值个案数百分比
低脆弱性0.033≤V≤0.1530.0951 03439.86%
中脆弱性0.153<V≤0.2740.2101 14444.10%
高脆弱性0.274<V≤0.6040.33841616.04%
), ArticleFig(id=1240746310140219680, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=表3, caption=

K均值聚类结果

, figureFileSmall=null, figureFileBig=null, tableContent=
脆弱性级别脆弱指数范围均值个案数百分比
低脆弱性0.033≤V≤0.1530.0951 03439.86%
中脆弱性0.153<V≤0.2740.2101 14444.10%
高脆弱性0.274<V≤0.6040.33841616.04%
), ArticleFig(id=1240746310249271594, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=EN, label=Table 4, caption=

The obstacle levels of various dimensions and the top five obstacle factors in the vulnerability of elderly farmers and pastoral families in the Nanshan Pastoral Area of Xinjiang (%)

, figureFileSmall=null, figureFileBig=null, tableContent=
全样本农民牧民
暴露度24.6822.0626.24
债务10.066.2512.32
照顾孙辈9.169.568.92
敏感性47.5946.6048.18
因病入院11.8611.9511.81
体质指数10.179.7310.43
生活自理能力5.70-5.89
适应能力27.7331.3425.58
生活照料-8.62-
), ArticleFig(id=1240746310375100724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240375115616153829, language=CN, label=表4, caption=

新疆南山牧区老年农牧民家庭养老脆弱性各维度及前五位障碍因素的障碍度(%)

, figureFileSmall=null, figureFileBig=null, tableContent=
全样本农民牧民
暴露度24.6822.0626.24
债务10.066.2512.32
照顾孙辈9.169.568.92
敏感性47.5946.6048.18
因病入院11.8611.9511.81
体质指数10.179.7310.43
生活自理能力5.70-5.89
适应能力27.7331.3425.58
生活照料-8.62-
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新疆南山牧区老年农牧民家庭养老脆弱性评估及障碍因素分析
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孟娜 1 , 由淑萍 1 , 刘涛 2 , 吴培 1 , 周永 3 , 詹怀峰 4
现代预防医学 | 卫生政策与管理 2024,51(6): 1044-1049
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现代预防医学 | 卫生政策与管理 2024, 51(6): 1044-1049
新疆南山牧区老年农牧民家庭养老脆弱性评估及障碍因素分析
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孟娜1, 由淑萍1 , 刘涛2, 吴培1, 周永3, 詹怀峰4
作者信息
  • 1.新疆医科大学护理学院,新疆 乌鲁木齐 830000
  • 2.新疆医科大学公共卫生学院
  • 3.新疆医科大学第三附属医院
  • 4.乌鲁木齐县板房沟镇卫生院公卫科

    • 孟娜（1989—），女，硕士在读，研究方向：社区护理

通讯作者:

由淑萍，E-mail：
Vulnerability assesements and obstacle factor analyses of elderly farmers and herdsmen’s families in Nanshan Pastoral Area, Xinjiang
Na MENG1, Shu-ping YOU1 , Tao LIU2, Pei WU1, Yong ZHOU3, Huai-feng ZHAN4
Affiliations
  • School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang 830000, China
出版时间: 2024-03-25 doi: 10.20043/j.cnki.MPM.202309329
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摘要
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目的

综合评价新疆南山牧区老年农牧民家庭养老脆弱性,分析其障碍因素。

方法

基于脆弱性框架构建评估指标体系，采用多阶段随机整群抽样法,选取2 594例研究对象开展问卷调查。运用熵权-TOPSIS法综合评价老年农牧民家庭养老脆弱性水平,并探讨其障碍因素。

结果

新疆南山牧区老年农牧民家庭养老脆弱性处于中、高水平的占比为60.14%,家庭养老脆弱性的三个层面及其障碍度,分别是敏感性(47.59%)、适应能力(27.73%)、暴露度(25.58%)；前五位障碍因素及其障碍度,分别是因病入院(11.86%)、体质指数(10.17%)、债务(10.06%)、照顾孙辈(9.16%)、生活自理能力(5.70%)、生活照料的障碍度在老年农民中居于第4位(8.62%),老年牧民中居于第14位(2.69%)。

结论

新疆南山牧区老年农牧民家庭养老脆弱性处于中高水平,老年农民与老年牧民的脆弱性水平及障碍因素存在差异,建议关注老年农牧民自身特点及养老资源的差异性,制定更精准的养老策略。

家庭养老脆弱性  /  老年农牧民  /  脆弱性评估  /  障碍因素
Objective

To comprehensively evaluate the vulnerability level of elderly farmers and herdsmen’s family old-age pension and analyze the obstacle factors.

Methods

Based on the vulnerability framework, we constructed a family old-age pension vulnerability assessment index system, and selected 2 594 research subjects for questionnaire survey by multi-stage random cluster sampling. We applied entropy-weight-TOPSIS method to comprehensively evaluate the level of elderly farmers and herdsmen’s family old-age pension vulnerability, and explored the obstacle factors.

Results

60.14% of the elderly farmers and herders in the southern mountainous pastoral areas of Xinjiang had medium or high levels of vulnerability to old age; the three dimensions of vulnerability to old age and their degree of obstacles were sensitivity (47.59%), adaptive capacity (27.73%), and exposure (25.58%); the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%), physical fitness index (10.86%), and physical health index (11.86%); and the top five obstacles and their degree of obstacles were hospitalization due to illness (11.86%). The top five barriers and their degree of obstacles were hospitalization due to illness (11.86%), body mass index (10.17%), debt (10.06%), caring for grandchildren (9.16%), and self-care ability (5.70%); and the degree of obstacles to care for the elderly was the fourth highest among elderly farmers (8.62%) and the fourteenth highest among elderly pastoralists (2.69%).

Conclusion

There are differences in vulnerability levels and obstacles between elderly farmers and herders. It is recommended to pay attention to the differences in the characteristics of elderly farmers and herders themselves and their pension resources, so as to formulate more accurate pension strategies.

Vulnerability of family elderly care  /  Elderly farmers and herdsmen  /  Vulnerability assessment  /  Obstacle factors
孟娜, 由淑萍, 刘涛, 吴培, 周永, 詹怀峰. 新疆南山牧区老年农牧民家庭养老脆弱性评估及障碍因素分析. 现代预防医学, 2024 , 51 (6) : 1044 -1049 . DOI: 10.20043/j.cnki.MPM.202309329
Na MENG, Shu-ping YOU, Tao LIU, Pei WU, Yong ZHOU, Huai-feng ZHAN. Vulnerability assesements and obstacle factor analyses of elderly farmers and herdsmen’s families in Nanshan Pastoral Area, Xinjiang[J]. Modern Preventive Medicine, 2024 , 51 (6) : 1044 -1049 . DOI: 10.20043/j.cnki.MPM.202309329
正文
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第七次全国人口普查数据显示:我国60岁及以上老年人已达2.64亿,占总人口的18.7%,农村人口老龄化态势严峻,远超全国水平[1],养老问题正经历“隐性”到“显性”风险的快速转变[2]。家庭养老是我国农村地区最重要的养老方式,但随着农村家庭结构小型化,人口流动常态化,土地养老保障功能下降等一系列社会、经济、家庭问题出现[3],农村家庭养老功能不断弱化,表现出较高的脆弱性,阻碍了农村家庭、社会可持续发展[4]。家庭养老脆弱性受到老年人身体状况、家庭特征、社会保障等多重因素影响[5],农村脆弱水平显著高于城市,并呈现地域异质性[6]。前期研究发现，牧区老年人与一般农村老年人在生存环境、生计方式、生活习惯、健康状况、社会保障等方面存在差异,分析家庭养老脆弱性问题,是实现牧区家庭养老福祉与可持续的基础。新疆南山牧区幅员辽阔，多民族农牧民世代聚居,较好的代表了新疆牧区的特点。因此，本研究以新疆南山牧区作为研究现场，引入脆弱性框架[7],构建家庭养老脆弱性评估指标体系,分析牧区老年农牧民家庭养老脆弱性及障碍因素,找准牧区家庭养老痛点,为后续细化养老策略提供数据支撑。
1 对象与方法
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1.1 研究对象
新疆南山牧区农牧民在居住环境、生产生活方式、家庭观念等方面存在差异,本研究以农民和牧民作为研究对象,分组比较其家庭养老脆弱性及障碍因素的差异。采用多阶段随机整群抽样法,于2023年1月至2023年6月在新疆乌鲁木齐县南山牧区开展横断面调查。第一阶段:根据新疆牧区地理分布特点,在南疆、北疆、东疆的7个代表性牧区，通过简单随机抽样抽取乌鲁木齐县南山牧区;第二阶段:乌鲁木齐县南山牧区下辖三镇三乡,根据各乡镇人口占比抽取具有代表性的行政村,其中:每个镇抽取7个村,每个乡抽取5个村,共抽取36个村;第三阶段:在抽取的行政村内,按照整群抽样法纳入所有符合条件、自愿参与调查的研究对象。纳入标准:(1)在乌鲁木齐县南山牧区居住时间≥1年的常住农牧民;(2)年龄≥60岁;(3)对本次研究知情同意,愿意配合调查者。排除标准:因精神损害性疾病、认知障碍、身体状况差等不能配合调查者。共发放2 800份问卷,回收有效问卷2 594份，有效率为92.64%。本研究计划经新疆医科大学伦理委员会批准(XJYKDXR20231208001)。
1.2 研究方法
1.2.1 家庭养老脆弱性评估指标体系的构建
本研究充分理解家庭养老脆弱性内涵及表征,查阅相关文献[6,8-10],结合新疆牧区特点选取指标，经过德尔菲法确定指标体系,包括暴露度、敏感性、适应能力3个维度,共34个指标，见表1。
暴露度指老年人暴露在自然、社会和家庭各种风险中的概率[10],包括6个指标,老年人家庭暴露在风险中的概率越高,潜在损失越大,其家庭养老脆弱性程度也越高；敏感性指老年人应对养老风险的变化和易感程度[9],主要体现在身体健康和心理健康两个方面,包括11个指标,敏感性越高,对家庭养老风险的影响越大,家庭养老脆弱性程度也越高;适应能力指老年人应对养老风险时,抵抗风险以及从风险中恢复的能力[8],主要包括老年人家庭的生计资本总和[10],包括自然资本、金融资本、物质资本、人力资本和社会资本,共计17个指标,老年人家庭的适应能力越强,对养老风险的抵抗力与恢复力也越强,家庭养老脆弱性程度则越低。
根据指标对家庭养老脆弱性的促进或抑制作用,可分为正向(+)指标与负向(-)指标,正向指标的数值越大,脆弱性越高;负向指标的数值越大,脆弱性越低。
1.2.2 资料收集
根据家庭养老脆弱性评估指标体系制定调查问卷，包括两个部分:（1）一般情况调查,包括年龄、性别、婚姻状况、职业、家庭结构、养老经济来源、就医机构、家庭成员数、劳动力人数医疗费用支付方式共10项指标。（2）家庭养老脆弱性调查,共34项指标,问题及选项设置参照2018中国健康与养老追踪调查问卷(CHARLS)相关条目,并结合新疆牧区实际情况设定。
1.2.3 熵权-TOPSIS分析
熵权法是一种客观赋权方法，根据各项指标反馈出的信息量大小确定指标权重。熵值越小,信息量越大,在综合评价中的作用就越大,其权重也越大;TOPSIS法是一种逼近于理想值的排序方法，计算评价对象各项指标的加权得分,再提取各项指标的正理想解(最大值)和负理想解(最小值),分别计算评价对象与正理想解、负理想解的欧式距离,最终获得评价对象与正理想解的相对接近程度Ci,将Ci值看作家庭养老脆弱性指数,取值区间为(0,1),Ci数值越大表明脆弱性越高,计算公式详见文献[11]。
1.2.4 障碍度分析
引入障碍度模型[9]探讨老年农民与老年牧民家庭养老脆弱性的障碍因素，并比较差异性，计算公式如下:
式中,Wi为指标的权重值;Mi为指标的标准化值;Ni为指标的障碍度。
1.2.5 统计学方法
采用SPSS 26.0 统计分析，Stata 17.0绘制核密度图。计数资料以频数、百分比〔n(%)〕表示，计量资料以()表示，分类变量组间比较采用χ2检验，熵权-TOPSIS法测算指标权重及脆弱性指数,核密度图反映脆弱性指数分布情况，K-means法对脆弱性指数进行聚类,障碍度模型分析障碍因素。检验水准α＝0.05。
2 结果
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2.1 调查对象一般资料
见表2。
2.2 家庭养老脆弱性指数分布情况
使用熵权法计算指标权重(见表1), TOPSIS法计算家庭养老脆弱性指数后,使用K-means法聚类(见表3)，农牧民家庭养老脆弱性分为低脆弱性、中脆弱性、高脆弱性三类,经单因素方差分析,F=7 252.272，P<0.001,说明3种类型之间差异显著,分类合理。处于低、中、高脆弱性的农民数量及占比分别是394(40.3%)、448(45.8%)136(13.9%);牧民数量及占比分别是640(39.6%)、696(43.1%)280(17.3%);家庭养老脆弱性水平总体呈现中高水平(60.14%),牧民家庭在养老高脆弱性水平的占比高于农民家庭,差异具有统计学意义(χ2=5.295,P=0.021),老年农牧民家庭养老脆弱性指数分布情况,见图1。
2.3 家庭养老脆弱性的障碍因素
老年农牧民家庭养老脆弱性的障碍因素前五位，由高到低分别是:因病入院、体质指数、债务、照顾孙辈、生活自理能力、老年农民中，前五位障碍因素分别是因病入院、体质指数、照顾孙辈、生活照料、债务;老年牧民中，前五位障碍因素分别是债务、因病入院、体质指数、照顾孙辈、生活自理能力。因病入院、体质指数、照顾孙辈、债务是两者共有的主要障碍因素,见表4。图2。
3 讨论
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新疆南山牧区老年农牧民家庭养老脆弱性总体处于中高水平,与徐洁[10]等的研究结果相似。其中,老年牧民在高脆弱性水平的占比高于老年农民,说明牧民家庭面临更严峻的养老困境。
老年农牧民家庭养老脆弱性三个层面的障碍度,由高到低分别是敏感性、适应能力、暴露度、老年农民在适应能力层面的障碍度更高,说明他们抵御养老风险的家庭资本存量偏低,老年牧民在暴露度、敏感性层面的障碍度更高,说明他们的健康问题、外部风险对家庭养老的冲击更显著。
老年农牧民家庭养老脆弱性的主要障碍因素既有共性,也有不同。其中,因病入院、体质指数、债务、照顾孙辈是共性因素。因病入院障碍度最高,可能是老年农牧民慢性病患病率较高，增加了因病入院的概率。本研究中,老年农牧民慢性病的患病率为79.99%,其中:老年农民为75.66%,老年牧民为82.61%,高于全国水平(71.9%)[12]。尽管老年牧民慢性病的患病率更高,但因病入院的发生率却与老年农民基本持平，可能是牧民在游牧期间,因交通不便、无人陪护、经济收入低等现实困难,常拒绝住院治疗[13]。体质指数的障碍度较高,可能是因为农牧民健康素养偏低,饮食结构不合理,尤其是牧民,偏好熏肉、奶茶等高盐高脂饮食,摄入蔬菜和水果较少[14]，再者，农牧民进入冬季后活动量减少,超重与肥胖加剧了脆弱风险。债务成为主要障碍因素,一方面，可能是老年农牧民患病后需要子女照料,增加医疗支出的同时,家庭收入锐减;另一方面,2022年的新冠疫情对当地农业及畜牧业冲击较大,影响了农作物及牲畜的产量与销路,农牧民家庭经济收入下滑。照顾孙辈成为主要的障碍因素,并且在老年农民中的障碍程度高于老年牧民。老年农民在子女外出务工期间,要照顾孙辈、料理家务,增加了日常生活负担;老年牧民多与子女同住,儿子负责放牧,儿媳则负责料理家务,老年牧民协助儿媳照顾孩子，负担相对较轻。
除上述障碍因素外，生活照料是老年农民主要的障碍因素,生活自理能力是老年牧民主要的障碍因素。老年农民生活尚能自理时，习惯独居或夫妻同住,子女多就近居住。但子女白天外出务工,无暇顾及老人,导致其生活照料资源缺位。老年牧民生活自理能力的障碍度较高,有研究表明,患慢性病的老年人生活自理能力较差,并且生活自理能力会随着慢性病数量的增多呈现下降趋势[15]。课题组研究也发现,农牧民骨关节疾病的检出率较高,导致其活动自理能力下降,这与新疆南山牧区特殊的地理环境、气候以及老年人体重负荷、骨骼退行性改变等因素有关。
综上所述,新疆南山牧区老年农牧民家庭养老脆弱性处于中高水平,老年牧民的家庭养老脆弱性水平高于老年农民,因病入院、体质指数、债务、照顾孙辈、生活照料、生活自理能力是老年农牧民家庭养老脆弱性的主要障碍因素。因此,相关部门应制定精准的策略应对养老问题，同时,在全社会积极弘扬孝老爱亲的家庭养老文化,巩固家庭养老在农牧区的主体地位,打造“老有所依,老有所养”的家庭养老新形态。
基金
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  • 新疆维吾尔自治区社科基金(2023BSH066)
文献
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2024年第51卷第6期
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doi: 10.20043/j.cnki.MPM.202309329
  • 接收时间：2023-09-17
  • 首发时间：2026-03-16
  • 出版时间：2024-03-25
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  • 收稿日期：2023-09-17
基金
新疆维吾尔自治区社科基金(2023BSH066)
作者信息
    1.新疆医科大学护理学院,新疆 乌鲁木齐 830000
    2.新疆医科大学公共卫生学院
    3.新疆医科大学第三附属医院
    4.乌鲁木齐县板房沟镇卫生院公卫科

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
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