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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

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

  • 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。

     

    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.

     

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