马鞍山市社区空巢老年人生活质量动态变化及影响因素分析

李杰; 秦其荣; 卞正平; 王春; 蔡华英; 王丹妮; 孙业桓

doi:10.11847/zgggws1134808

马鞍山市社区空巢老年人生活质量动态变化及影响因素分析

doi: 10.11847/zgggws1134808

1.
安徽医科大学公共卫生学院预防医学教学中心，安徽合肥 230032
2.
安徽省马鞍山市疾病预防控制中心社区服务与慢性病防治科
3.
安徽医科大学公共卫生学院流行病与卫生统计学系

基金项目: 安徽省高校人文社科类研究项目（SK2018ZD013；SK2019A0170）；马鞍山市科技计划项目（YL – 2017 – 02）；安徽医科大学博士科研资助项目（XJ201822）

详细信息

作者简介:
李杰（1985 – ），女，安徽界首人，副教授，讲师，博士，研究方向：老年行为与健康

通讯作者:
孙业桓，E-mail：yhsun_ahmu_edu@yeah.net

中图分类号: R 161.7
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- 文章访问数: 440
- HTML全文浏览量: 140
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- 被引次数: 0
出版历程
- 接收日期: 2021-03-24
- 网络出版日期: 2021-12-13
- 刊出日期: 2022-07-01

Dynamics and influencing factors of quality of life among community elderly empty-nesters in Ma′anshan city

1.
Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui Province 230032, China

摘要

摘要: 目的了解安徽省马鞍山市社区空巢老年人生活质量的2年动态变化情况及影响因素，为制定老年人卫生保健对策、开展老年卫生保健服务和健康教育提供科学依据。方法于2016年12月 — 2017年3月采用分层整群随机抽样方法在马鞍山市抽取3476名 ≥ 60岁社区老年人进行生活质量基线调查，并于2018年12月 — 2019年3月进行随访，以2次调查均为空巢状态的2344名老年人组成纵向队列，分析社区空巢老年人生活质量的2年动态变化情况及影响因素。结果马鞍山市社区空巢老年人随访调查时心理领域和社会关系领域生活质量得分分别为（55.40 ± 10.76）和（65.70 ± 12.56）分，均低于基线调查时的（65.71 ± 13.52）和（67.43 ± 12.42）分（均P < 0.05）；生理领域和环境领域生活质量得分分别为（64.62 ± 13.92）和（63.53 ± 11.90）分，与基线调查时的（65.22 ± 14.55）和（63.97 ± 12.67）分比较，差异均无统计学意义（均P > 0.05）。广义估计方程分析结果显示，年龄 ≥ 70岁、日常生活能力障碍、抑郁是马鞍山市社区空巢老年人心理领域生活质量的危险因素，自评经济水平中等和好、吸烟、饮酒、参加体育锻炼、心理弹性中等和高是马鞍山市社区空巢老年人心理领域生活质量的保护因素；年龄 ≥ 70岁、文化程度小学及以上、独居、患慢性病、日常生活能力下降和障碍、抑郁是马鞍山市社区空巢老年人生理领域生活质量的危险因素，自评经济水平中等和好、吸烟、饮酒、参加体育锻炼、心理弹性中等和高是马鞍山市社区空巢老年人生理领域生活质量的保护因素；年龄70～79岁、独居、日常生活能力障碍、抑郁是马鞍山市社区空巢老年人社会关系领域生活质量的危险因素，女性、自评经济水平中等和好、饮酒、心理弹性中等和高是马鞍山市社区空巢老年人社会关系领域生活质量的保护因素；日常生活能力障碍和抑郁是马鞍山市社区空巢老年人环境领域生活质量的危险因素，自评经济水平中等和好、吸烟、饮酒、参加体育锻炼、心理弹性中等和高是马鞍山市社区空巢老年人环境领域生活质量的保护因素。结论马鞍山市社区空巢老年人生活质量主要问题在于心理领域和社会关系领域质量的下降，年龄、自评经济水平、是否饮酒、日常生活能力、是否抑郁和心理弹性状况为该地区社区空巢老年人心理领域和社会关系领域生活质量的共同影响因素。
- 生活质量 /
- 动态变化 /
- 影响因素 /
- 空巢老年人 /
- 社区
Abstract: Objective To examine the 2-year dynamics of quality of life (QoL) and its influencing factors among community elderly empty-nesters in Ma'anshan city and to provide evidence for developing health care strategies and conducting health care services and health education in the elderly. Methods With stratified cluster random sampling, we conducted a baseline survey among 3 476 permanent residents aged 60 years and above in Ma′anshan city from December 2016 to March 2017 and a follow-up interview was conducted from December 2018 to March 2019. Finally, the information on 2 344 elderly being empty-nesters during the period of baseline and follow-up survey were extracted to analyze dynamics and influencing factors of QoL for the elderly empty-nesters. World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), Activity of Daily Living Scale (ADL), Geriatric Depression Scale-15 (GDS-15), Stress Resilience Quotient Scale (SRQS), and a self-designed questionnaire were used in the study. Results Compared to those in the baseline survey in all the elderly empty-nesters, significantly lower scores of WHOQOL-BREF′s psychological domain (55.40 ± 10.76 vs. 65.71 ± 13.52) and social relationship domain (65.70 ± 12.56 vs. 67.43 ± 12.42) were measured in the follow-up survey (both P < 0.05); while there were no significant differences in the scores of physiological domain (64.62 ± 13.92 vs. 65.22 ± 14.55) and environmental domain (63.53 ± 11.90 vs. 63.97 ± 12.67) (both P > 0.05). The results of generalized estimating equation analysis revealed following influencing factors of elderly empty-nesters′ QoL: (1) for psychological domain, aged ≥ 70 years, impaired ADL, and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol-drinking, taking part in physical exercise, moderate or high resilience were protective factors; (2) for physiological domain, aged ≥ 70 years, with the education of primary school or above, living alone, suffering from a chronic disease, declined or impaired ADL, and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol-drinking, taking part in physical exercise, moderate or high resilience were protective factors; (3) for social relationship domain, aged 70 – 79 years, living alone, impaired ADL, and depression were risk factors and being female, moderate or good self-rated economic condition, alcohol-drinking, moderate or high resilience were protective factors; and (4) for environmental domain, impaired ADL and depression were risk factors and moderate or good self-rated economic condition, smoking, alcohol- drinking, taking part in physical exercise, moderate or high resilience were protective factors. Conclusion For community elderly empty-nesters in Ma′anshan city, the main problem in quality of life is the declined quality of psychology and social relationship domains and the quality of the two domains are influenced in common by age, self-rated economic condition, alcohol-drinking, activity of daily living, depression, and resilience.
- quality of life /
- dynamic variation /
- influencing factor /
- empty-nest elderly /
- community

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表 1 马鞍山市社区空巢老年人基线生活质量得分比较（分，$\bar x \pm s$）

特征		心理领域	生理领域	社会关系领域	环境领域
性别	男性	65.97 ± 13.84	65.79 ± 15.03	67.07 ± 13.21	64.34 ± 12.90
	女性	65.48 ± 13.23	64.71 ± 14.09	67.75 ± 11.66	63.63 ± 12.46
年龄（岁）	60～69	66.71 ± 13.39	67.34 ± 13.72	68.54 ± 12.32	64.51 ± 13.08
	70～79	64.78 ± 13.77	63.46 ± 14.80	66.18 ± 12.57	63.49 ± 12.29
	≥ 80	64.20 ± 12.38 ^b	60.58 ± 16.26 ^c	67.04 ± 11.38 ^c	62.93 ± 11.84
文化程度	文盲/半文盲	64.09 ± 13.76	63.30 ± 14.82	66.82 ± 12.30	62.31 ± 12.69
	小学	65.81 ± 13.31	65.11 ± 13.83	67.34 ± 12.46	63.91 ± 11.96
	初中及以上	66.52 ± 13.44 ^b	66.32 ± 14.71 ^c	67.43 ± 12.42	64.90 ± 12.98 ^c
居住状况	非独居	65.91 ± 13.55	65.54 ± 14.65	67.72 ± 12.32	64.12 ± 12.70
	独居	64.05 ± 13.24 ^a	62.63 ± 13.45 ^b	65.09 ± 12.94 ^b	62.69 ± 12.31
自评经济水平	差	61.57 ± 12.25	60.63 ± 14.47	64.74 ± 12.73	58.65 ± 11.52
	中等	66.70 ± 13.58	66.39 ± 14.11	68.00 ± 12.06	65.25 ± 12.38
	好	70.91 ± 13.52 ^c	70.65 ± 14.03 ^c	71.14 ± 12.19 ^c	70.63 ± 12.14 ^c
吸烟情况	不吸烟	65.48 ± 13.30	64.91 ± 14.41	67.30 ± 12.08	63.73 ± 12.44
	吸烟	67.45 ± 14.95 ^a	67.57 ± 15.37 ^b	68.40 ± 14.64	65.69 ± 14.20 ^a
饮酒情况	不饮酒	65.27 ± 13.36	64.63 ± 14.53	67.17 ± 12.24	63.63 ± 12.50
	饮酒	69.50 ± 14.32 ^c	70.39 ± 13.72 ^c	69.72 ± 13.68 ^b	66.88 ± 13.75 ^c
参与体育锻炼情况	不参与	61.99 ± 13.56	60.09 ± 16.56	64.98 ± 13.59	60.47 ± 12.85
	参与	66.72 ± 13.33 ^c	66.61 ± 13.63 ^c	68.08 ± 12.01 ^c	64.91 ± 12.46 ^c
是否患慢性病	否	67.00 ± 13.31	69.96 ± 13.62	68.02 ± 12.84	64.70 ± 12.87
	是	65.30 ± 13.56 ^a	63.73 ± 14.52 ^c	67.25 ± 12.28	63.73 ± 12.61
日常生活能力	正常	66.63 ± 13.15	67.08 ± 13.16	68.23 ± 12.30	64.92 ± 12.54
	下降	65.52 ± 12.26	61.69 ± 14.29	66.11 ± 10.78	62.69 ± 10.85
	障碍	55.87 ± 14.76 ^c	48.46 ± 17.62 ^c	59.97 ± 12.65 ^c	54.77 ± 12.06 ^c
是否抑郁	否	66.96 ± 12.73	66.51 ± 13.67	68.35 ± 11.68	64.91 ± 12.10
	是	49.71 ± 13.12 ^c	48.72 ± 15.29 ^c	55.88 ± 15.35 ^c	51.81 ± 13.49 ^c
心理弹性	低	52.72 ± 10.84	54.64 ± 13.56	57.34 ± 12.50	55.10 ± 10.16
	中等	61.11 ± 12.16	66.48 ± 12.65	67.92 ± 10.32	64.71 ± 10.48
	高	67.28 ± 13.55 ^c	72.05 ± 12.12 ^c	72.96 ± 11.43 ^c	70.47 ± 12.71 ^c
注：各组内比较，a P < 0.05，b P < 0.01，c P < 0.001。

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表 2 马鞍山市社区空巢老年人生活质量影响因素广义估计方程多因素分析

领域	因素		参照组	β	$S_{\bar x}$	Wald χ² 值	P 值
心理	年龄（岁）	70～79	60～69	– 1.855	0.359	26.597	< 0.001
		≥ 80		– 2.475	0.609	16.501	< 0.001
	自评经济水平	中等	差	1.126	0.372	9.126	0.003
		好		2.978	0.649	21.040	< 0.001
	吸烟情况	吸烟	不吸烟	1.551	0.641	5.851	0.016
	饮酒情况	饮酒	不饮酒	3.013	0.699	18.566	< 0.001
	参与体育锻炼情况	参与	不参与	1.181	0.403	8.558	0.003
	日常生活能力	下降	正常	0.539	0.666	0.652	0.419
		障碍		– 3.462	0.736	22.095	< 0.001
	是否抑郁	是	否	– 8.241	0.701	138.144	< 0.001
	心理弹性	中等	低	6.557	0.410	255.578	< 0.001
		高		11.978	0.538	495.679	< 0.001
生理	年龄（岁）	70～79	60～ 69	– 1.569	0.399	15.386	< 0.001
		≥ 80		– 1.535	0.702	4.781	0.029
	文化程度	小学	文盲/半文盲	– 1.566	0.508	9.487	0.002
		初中及以上		– 2.286	0.511	19.985	< 0.001
	居住状况	独居	非独居	– 1.280	0.552	5.367	0.021
	自评经济水平	中等	差	1.812	0.406	19.867	< 0.001
		好		3.404	0.651	27.256	< 0.001
	吸烟情况	吸烟	不吸烟	1.354	0.658	4.222	0.040
	饮酒情况	饮酒	不饮酒	3.071	0.696	19.414	< 0.001
	参与体育锻炼情况	参与	不参与	1.052	0.450	5.444	0.020
	是否患慢性病	是	否	– 3.352	0.438	58.376	< 0.001
	日常生活能力	下降	正常	– 4.330	0.719	36.258	< 0.001
		障碍		– 12.462	0.838	220.745	< 0.001
	是否抑郁	是	否	– 10.397	0.813	163.516	< 0.001
	心理弹性	中等	低	8.351	0.440	359.420	< 0.001
		高		12.893	0.530	591.543	< 0.001
社会关系	性别	女性	男性	0.809	0.394	4.202	0.040
	年龄（岁）	70～79	60～69	– 1.148	0.362	10.005	0.002
		≥ 80		0.304	0.628	0.234	0.629
	居住状况	独居	非独居	– 2.485	0.559	19.756	< 0.001
	自评经济水平	中等	差	1.106	0.398	7.707	0.005
		好		1.561	0.582	7.185	0.007
	饮酒情况	饮酒	不饮酒	1.406	0.660	4.534	0.033
	日常生活能力	下降	正常	– 0.168	0.633	0.070	0.791
		障碍		– 3.340	0.740	20.365	< 0.001
	是否抑郁	是	否	– 6.666	0.873	58.270	< 0.001
	心理弹性	中等	低	9.115	0.446	416.053	< 0.001
		高		13.736	0.554	614.555	< 0.001
环境	自评经济水平	中等	差	3.532	0.354	99.238	< 0.001
		好		6.704	0.585	130.970	< 0.001
	吸烟情况	吸烟	不吸烟	1.539	0.603	6.506	0.011
	饮酒情况	饮酒	不饮酒	1.805	0.677	7.106	0.008
	参与体育锻炼情况	参与	不参与	0.885	0.375	5.554	0.018
	日常生活能力	下降	正常	– 0.281	0.521	0.292	0.589
		障碍		– 3.679	0.604	37.007	< 0.001
	是否抑郁	是	否	– 7.269	0.762	90.879	< 0.001
	心理弹性	中等	低	7.705	0.374	424.062	< 0.001
		高		12.673	0.502	635.768	< 0.001

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