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中国老年人日常生活活动能力对其无用感影响

Influence of activities of daily living on feelings of uselessness among older adults in China

  • 摘要:
    目的 了解中国老年人日常生活活动能力对其无用感的影响及老化态度和年龄在其中发挥的作用,为制定老年健康教育与干预策略、有效应对人口老龄化挑战提供参考依据。
    方法 收集2020年中国老年社会追踪调查(CLASS)数据中28个省级行政区10 883名60~98岁老年人的相关数据,采用有调节的中介模型对其日常生活活动能力、老化态度和年龄与无用感之间的关系进行分析,并应用SPSS 26.0及其插件PROCESS 4.1中的Model 5进行统计学分析及有调节的中介效应检验。
    结果 中国10 883名60~98岁老年人中,平均年龄为(71.5±6.6)岁,经常、有时和没有感受到无用感者分别为1 729人(15.89%)、4 582人(42.10%)和4 572人(42.01%);中国老年人无用感、日常生活活动能力和老化态度平均得分分别为(0.739±0.715)、(0.238±1.075)和(14.311±3.638)分。相关分析结果显示,老年人无用感平均得分与日常生活活动能力平均得分(r=0.140)、老化态度平均得分(r=0.148)和平均年龄(r=0.163)均呈正相关(均P<0.001),老年人日常生活活动能力越差、老化态度越消极、年龄越大,其无用感越强烈;在控制了性别、文化程度、婚姻状况、同住人数量、户籍和自评经济状况等混杂因素后,有调节的中介模型分析结果显示,老年人日常生活活动能力对其无用感存在直接影响(β=0.082,P<0.001),老化态度对无用感存在间接影响(β=0.010,P<0.001),年龄在日常生活活动能力对无用感的影响机制中发挥负向调节作用(β= –0.003,P=0.001)。
    结论 中国老年人日常生活活动能力越差,其无用感越强;老化态度会随日常生活活动能力的下降而愈发消极,间接增加老年人的无用感,但随着年龄增长,老年人日常生活活动能力对其无用感的影响会逐渐减小。

     

    Abstract:
    Objective To understand the influence of activities of daily living (ADL) on feelings of uselessness among older adults in China, and the role of attitudes toward aging and age on this relationship, to provide a reference for developing health education and intervention strategies for older adults, and to effectively address the challenges of population aging.
    Methods Study data on 10 883 residents aged 60–98 years were collected from a wave of the China Longitudinal Aging Social Survey (CLASS) conducted in 2020 in 28 provincial-level administrative divisions across China in 2020. A moderated mediation model was used to analyze the relationships among ADL, attitudes toward aging , age, and feelings of uselessness. Statistical analysis and moderated mediation effect tests were conducted using SPSS 26.0 and its PROCESS 4.1 plug-in (Model 5).
    Results For all the participants with a mean age of 71.5±6.6 years, the number (percentage) of individuals who reported feeling useless often, sometimes, and never were 1 729 (15.89%), 4 582 (42.10%), and 4 572 (42.0%), and the mean scores for feelings of uselessness, ADL, and attitudes toward aging were 0.739±0.715, 0.238±1.075, and 14.311±3.638, respectively. Correlation analysis showed that the mean score of feelings of uselessness was positively correlated with the mean scores of ADL (r=0.140), attitudes toward aging (r=0.148), and mean age (r=0.163) (all P<0.001). Poorer ADL, more negative attitudes toward aging, and older age were associated with a greater feelings of uselessness. After controlling for gender, education, marital status, number of cohabitants, household registration, and self-rated economic status, the moderated mediation model analysis showed that ADL had a direct effect on feelings of uselessness (β=0.082, P<0.001); attitudes toward aging had an indirect effect on feelings of uselessness (β=0.010, P<0.001); and age played a negative moderating role on the influence of ADL on feelings of uselessness (β= –0.003, P=0.001).
    Conclusions Poorer ADL was associated with greater feelings of uselessness among older adults in China. Attitudes toward aging became more negative as ADL declined, indirectly increasing feelings of uselessness. However, the influence of ADL on feelings of uselessness gradually decreased with increasing age.

     

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