新冠肺炎疫情前后山东省农村老年人睡眠质量与心理健康状况关系

李杰; 杨士鋆; 李智贤; 闫琛; 厉文娟; 桂珍; 周成超

doi:10.11847/zgggws1136867

新冠肺炎疫情前后山东省农村老年人睡眠质量与心理健康状况关系

doi: 10.11847/zgggws1136867

李杰^{1, 2},
杨士鋆^{1, 2},
李智贤^{1, 2},
闫琛^{1, 2},
厉文娟^{1, 2},
桂珍^{1, 2},
周成超^{1, 2, ,}

1.
山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心，山东济南 250012
2.
国家卫生健康委员会卫生经济与政策研究重点实验室（山东大学）

基金项目: 国家自然科学基金（71774104）

详细信息

作者简介:
李杰（1993 – ），男，山西长治人，硕士在读，研究方向：社会医学与卫生事业管理

通信作者:
周成超，E-mail：zhouchengchao@sdu.edu.cn

中图分类号: R 161.7
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- 被引次数: 0
出版历程
- 接收日期: 2021-09-11
- 网络出版日期: 2022-09-17
- 刊出日期: 2022-11-30

Relationship between sleep quality and mental health before and after COVID-19 epidemic among rural older adults in Shandong province

LI Jie^{1, 2},
YANG Shi-jun^{1, 2},
LI Zhi-xian^{1, 2},

1.
Center for Health Management and Policy Research, School of Public Health, Shandong University, Ji′nan, Shandong Province 250012, China

摘要

摘要: 目的了解新型冠状病毒肺炎（新冠肺炎）疫情发生前后山东省农村老年人睡眠质量与心理健康状况关系，为提高农村老年人睡眠质量及改善其心理健康状况提供理论依据。方法采用多阶段分层随机抽样方法在山东省威海市乳山市、济宁市曲阜市、德州市乐陵市抽取3600名农村老年人，分别于2019年5月和2020年8月新冠肺炎疫情前和疫情期间对其睡眠质量和心理健康状况进行问卷调查，并应用交叉滞后路径分析模型分析其新冠肺炎疫情前和疫情期间睡眠质量与心理困扰的因果关系。结果山东省最终纳入分析的2749名农村老年人新冠肺炎疫情前和疫情期间的匹兹堡睡眠质量指数（PSQI）得分分别为（7.82 ± 4.52）和（9.03 ± 4.31）分，凯斯勒心理困扰量表（K10）得分分别为（16.64 ± 7.44）和（18.23 ± 8.06）分，差异均有统计学意义（β = 1.21、1.59，均P < 0.001）；在调整了性别、年龄、文化程度、婚姻状况、家庭人均年收入、吸烟情况、饮酒情况、自评健康状况、是否患多重慢性病和身体锻炼情况等混杂因素后，交叉滞后路径分析模型结果显示，新冠肺炎疫情前睡眠质量可以预测疫情期间心理困扰（$\rho _1 $ = 0.041, P = 0.015），而心理困扰却不能预测疫情期间睡眠质量（$\rho _2 $ = − 0.005, P = 0.749），且两系数差异有统计学意义（$\rho _1 $ > $\rho _2 $, P < 0.001），睡眠质量与心理困扰存在单向因果时序关系。结论山东省农村老年人的睡眠质量和心理健康状况在新冠疫情发生后均较疫情发生前变差，且睡眠质量差的老年人更易出现心理困扰。
- 睡眠质量 /
- 心理健康状况 /
- 关系 /
- 新型冠状病毒肺炎(新冠肺炎)疫情 /
- 发生前后 /
- 农村老年人
Abstract: Objective To explore the relationship between sleep quality and mental health before and after the outbreak of coronavirus disease – 2019 (COVID-19) epidemic among rural older adults in Shandong province, and to provide evidence for improving sleep quality and mental health of the adults. Methods Using stratified multistage random sampling, 3600 rural adults aged 60 years and above were selected in three prefectures (Qufu, Laoling and Rushan), Shandong province for a baseline survey during May 2019 and a follow-up survey during August 2020. Face-to-face interviews were conducted among the adults with a self-designed questionnaire, Pittsburgh Sleep Quality Index (PSQI), and the Kessler Psychological Distress Scale (K10) to collect relevant information. The cross-lagged path analysis was used to test causal relationship between sleep quality and psychological distress before and during the COVID-19 epidemic. Results Among a total of 2 749 adults completing the base line and follow-up survey, significantly increased PSQI score (9.03 ± 4.31 vs. 7.82 ± 4.52, β = 1.21) and K10 score (18.23 ± 8.06 vs. 16.64 ± 7.44, β = 1.59) during the epidemic period were observed in contrast to those 14 months ago (both P < 0.001). After adjusting for gender, age, education, marital status, annual household income per capita, smoking, alcohol drinking, self-rated health status, comorbidity of chronic diseases, and physical exercise, the results of cross-lagged path analysis showed that sleep quality before the epidemic could predict psychological distress during the epidemic ($\rho _1 $ = 0.041, P = 0.015), but psychological distress before the epidemic could not predict sleep quality during the epidemic ($\rho _2 $ = − 0.005, P = 0.749), with a significant disparity in the difference between the values of the two coefficients ($\rho _1 $ > $\rho _2 $, P < 0.001), which suggested that there was a one-way causal temporal relationship between sleep quality and psychological distress. Conclusion The sleep quality and mental health status of rural older adults in Shandong province were worsen after the outbreak of the COVID-19 epidemic and the older adults with poor sleep quality are more likely to have psychological distress.
- sleep quality /
- mental health status /
- relationship /
- coronavirus diseases 2019 /
- before and after epidemic outbreak /
- rural older adults

HTML全文

图 1 心理困扰和睡眠质量的交叉滞后路径分析模型

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表 1 山东省农村老年人疫情发生前后睡眠质量和心理健康状况得分情况及其相关分析

项目	得分（分，$\bar x \pm s$）	相关分析（r）^a
项目	得分（分，$\bar x \pm s$）	疫情前睡眠质量	疫情期间睡眠质量	疫情前心理健康状况
疫情前睡眠质量	7.82 ± 4.52
疫情期间睡眠质量	9.03 ± 4.31	0.592 ^b
疫情前心理健康状况	16.64 ± 7.44	0.365 ^b	0.211 ^b
疫情期间心理健康状况	18.23 ± 8.06	0.248 ^b	0.325 ^b	0.582 ^b
注：a 调整了性别、年龄、文化程度、婚姻状况、家庭人均年收入、吸烟情况、饮酒情况、自评健康状况、是否患多重慢性病和身体锻炼情况等混杂因素；b P＜0.001。

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