空巢与非空巢老人失能状况及影响因素研究
|
摘要
背景残疾问题不仅影响老年人自身的生活质量和身心健康,而且给家庭和社会带来沉重负担。空巢与非空巢老人在心理健康和社会支持等多方面存在差异,因此,预测其在失能状况方面可能也存在差异。目的研究我国空巢与非空巢老人失能状况及影响因素,为把握老年人养老需求、实现健康老龄化提供可鉴之据。方法 2017年10月,从2015年中国健康与养老追踪调查(CHARLS)全国追访调查数据中,选取≥60岁的空巢老人2 023人和非空巢老人2 141人,运用日常生活活动能力(ADL)量表进行失能判定。采用二分类Logistic回归分析空巢老人和非空巢老人失能的影响因素。结果与非空巢老人相比,空巢老人大多配偶健在、喜饮酒、有更高的文化程度且分布在东/中部、城镇地区(P<0.05)。空巢老人总失能率为8.1%,非空巢老人为8.9%,两者比较,差异无统计学意义(P>0.05)。年龄、自评健康状况、心理健康状况(沮丧)是空巢和非空巢老人失能的共同影响因素(P<0.05),睡眠障碍和饮酒情况是空巢老人失能的影响因素(P<0.05),性别、慢性病患病种数则是非空巢老人失能的影响因素(P<0.05)。结论空巢老人与非空巢老人失能率无差异,但影响因素却不尽相同。在对老年人采取综合干预措施的同时,还应针对其是否空巢采取有针对性的预防措施。
Background The problem of disability not only affects the quality of life and physical and mental health of the elderly,but also puts tremendous pressure and burden on the family and society.There are differences between empty nesters and non-empty nesters in mental health and social support,so there is a reason to speculate that there may be differences in disability status between them.Objective To get a general idea of disability status and its influencing factors between the empty nesters and non-empty nesters in China and provide references for the recognition of the elderly health care needs to achieve the healthy aging.Methods The data of 2 023 empty nesters and 2 141 non-empty nesters aged 60 and older were picked out from China Health and Retirement Longitudinal Study(CHARLS)of 2015 in October 2017.The Activities of Daily Living(ADL)scale was used to conduct disability assessments.Binary Logistic regression was used to analyze the influencing factors of the disability in empty nesters and non-empty nesters.Results Compared with non-empty nesters,most of empty nesters whose spouses were still living enjoyed drinking with a higher education level,and lived in the eastern and central urban areas of China(P<0.05).The total disability rate of empty nesters was 8.1%,and that of non-empty nesters was 8.9%.There was no statistical difference(P>0.05).Binary Logistic regression analysis showed that the common influencing factors between empty nesters and non-empty nesters included age,self-rated health status,mental health(frustration)(P<0.05).The influencing factors of empty nesters included sleep disorders and drinking,while sex and the number of chronic diseases were the influencing factors of non-empty nesters(P<0.05).Conclusion The incidence of disability in empty nesters is similar to that in non-empty nesters,but the factors affecting their disability are different.While taking comprehensive interventions for the elderly,targeted prevention measures should be taken respectively for empty nesters and non-empty nesters.
Background The problem of disability not only affects the quality of life and physical and mental health of the elderly,but also puts tremendous pressure and burden on the family and society.There are differences between empty nesters and non-empty nesters in mental health and social support,so there is a reason to speculate that there may be differences in disability status between them.Objective To get a general idea of disability status and its influencing factors between the empty nesters and non-empty nesters in China and provide references for the recognition of the elderly health care needs to achieve the healthy aging.Methods The data of 2 023 empty nesters and 2 141 non-empty nesters aged 60 and older were picked out from China Health and Retirement Longitudinal Study(CHARLS)of 2015 in October 2017.The Activities of Daily Living(ADL)scale was used to conduct disability assessments.Binary Logistic regression was used to analyze the influencing factors of the disability in empty nesters and non-empty nesters.Results Compared with non-empty nesters,most of empty nesters whose spouses were still living enjoyed drinking with a higher education level,and lived in the eastern and central urban areas of China(P<0.05).The total disability rate of empty nesters was 8.1%,and that of non-empty nesters was 8.9%.There was no statistical difference(P>0.05).Binary Logistic regression analysis showed that the common influencing factors between empty nesters and non-empty nesters included age,self-rated health status,mental health(frustration)(P<0.05).The influencing factors of empty nesters included sleep disorders and drinking,while sex and the number of chronic diseases were the influencing factors of non-empty nesters(P<0.05).Conclusion The incidence of disability in empty nesters is similar to that in non-empty nesters,but the factors affecting their disability are different.While taking comprehensive interventions for the elderly,targeted prevention measures should be taken respectively for empty nesters and non-empty nesters.
引文
[1]苏群,彭斌霞,陈杰.我国失能老人长期照料现状及影响因素:基于城乡差异的视角[J].人口与经济,2015,36(4):69-76.DOI:10.3969/j.issn.1000-4149.2015.04.008.SU Q,PENG B X,CHEN J.An analysis on long-term care and influencing factors of the disabled elders:based on rural-urban difference[J].Population&Economics,2015,36(4):69-76.DOI:10.3969/j.issn.1000-4149.2015.04.008.
[2]杜鹏,武超.中国老年人的生活自理能力状况与变化[J].人口研究,2006,30(1):50-56.DU P,WU C.The status and changes of self-care ability of Chinese elderly[J].Population Research,2006,30(1):50-56.
[3]张斌,郭秀芝,夏雪雁,等.社区失能老年人长期照护服务体系的探索[J].中国全科医学,2013,16(29):2774-2777,2781.DOI:10.3969/j.issn.1007-9572.2013.08.072.ZHANG B,GUO X Z,XIA X Y,et al.Exploration on long term care system for the disabled community elderly[J].Chinese General Practice,2013,16(29):2774-2777,2781.DOI:10.3969/j.issn.1007-9572.2013.08.072.
[4]李琼莲,梁细静,韦良家,等.某市空巢老人生命质量及其影响因素研究[J].中国现代医学杂志,2018,28(1):56-60.DOI:10.3969/j.issn.1005-8982.2018.01.011.LI Q L,LIANG X J,WEI L J,et al.Investigation on quality of life and influencing factors of Baise empty nesters[J].China Journal of Modern Medicine,2018,28(1):56-60.DOI:10.3969/j.issn.1005-8982.2018.01.011.
[5]张持晨,赵慧宁,郑晓,等.中国空巢老人领域研究现状及热点[J].中国老年学杂志,2018,38(2):421-424.DOI:10.3969/j.issn.1005-9202.2018.02.071.ZHANG C C,ZHAO H N,ZHENG X,et al.Analysis of research hotspots and status of empty-nest elderly study in China[J].Chinese Journal of Gerontology,2018,38(2):421-424.DOI:10.3969/j.issn.1005-9202.2018.02.071.
[6]ZHANG C,ZHU R,LU J,et al.Health promoting lifestyles and influencing factors among empty nesters and non-empty nesters in Taiyuan,China:a cross-sectional study[J].Health Qual Life Out,2018,16(1):103.DOI:10.1186/s12955-018-0936-5.
[7]GUO Y Q,ZHANG C C,HUANG H,et al.Mental health and related influencing factors among the empty-nest elderly and the non-empty-nest elderly in Taiyuan,China:a cross-sectional study[J].Public Health,2016,141:210-217.DOI:10.1016/j.puhe.2016.09.005.
[8]刘亚飞,胡静.谁来照顾老年父母?机会成本视角下的家庭分工[J].人口学刊,2017,39(5):67-76.DOI:10.16405/j.cnki.1004-129X.2017.05.007.LIU Y F,HU J.Who will take care of the elderly parents? The division of labor from the perspective of opportunity cost[J].Population Journal,2017,39(5):67-76.DOI:10.16405/j.cnki.1004-129X.2017.05.007.
[9]王玉环,冯雅楠,侯蔚蔚,等.援疆汉族失能老年人及居家照护者对长期照护需求的调查研究[J].中国全科医学,2013,16(14):1268-1273.DOI:10.3969/j.issn.1007-9572.2013.04.058.WANG Y H,FENG Y N,HOU W W,et al.Long-term care need of the Xinjiang aiding han national disabled elderly and their home caregivers[J].Chinese General Practice,2013,16(14):1268-1273.DOI:10.3969/j.issn.1007-9572.2013.04.058.
[10]张立龙,张翼.中国老年人失能时间研究[J].中国人口科学,2017,31(6):94-104,128.ZHANG L L,ZHANG Y.Study on the disability time of the elderly in China[J].Chinese Journal of Population Science,2017,31(6):94-104,128.
[11]KATZS,DOWNSTD,CASHHR,etal.Progressin development of the index of ADL[J].Gerontologist,1970,10(1):20.DOI:10.1093/geront/10.1_Part_1.20.
[12]周绪凤,马亚娜.中国农村老年人失能状况及影响因素分析[J].中国公共卫生,2017,33(11):1665-1668.DOI:10.11847/zgggws2017-33-11-32.ZHOU X F,MA Y N.Prevalence and impact factors of disability among elderly people in rural China[J].Chinese Journal ofPublicHealth,2017,33(11):1665-1668.DOI:10.11847/zgggws2017-33-11-32.
[13]尹志勤,杨玉霞,陈丽莉,等.浙江省农村老年人健康状况及影响因素分析[J].中国公共卫生,2012,28(3):293-295.YIN Z Q,YANG Y X,CHEN L L,et al.Health status and its influencial factors among rural elderly in Zhejiang Province[J].Chinese Journal of Public Health,2012,28(3):293-295.
[14]翟淑云.我国中老年人健康需求影响因素的实证研究:基于CHARLS数据的分析[J].特区经济,2014,32(9):226-228.ZHAI S Y.An empirical study on the factors affecting the health needs of middle-aged and aged people in China:based on the analysis of CHARLS data[J].Special Zone Economy,2014,32(9):226-228.
[15]胡月,龚磊,陈福宽,等.农村老年人自评健康状况的影响因素分析[J].中国卫生统计,2013,30(2):232-234.HU Y,GONG L,CHEN F K,et al.Analysis of influencing factors of self-evaluation health status of rural elderly[J].Chinese Journal of Health Statistics,2013,30(2):232-234.
[16]陈长香.老年护理学[M].北京:人民卫生出版社,2009:54.
[17]CHEN G,CUI B,ZHANG L.Study on the prevention and strategy of disability in China[J].Procedia-Social and Behavioral Sciences,2010,2(5):6906-6913.DOI:10.1016/j.sbspro.2010.05.041.
[18]陈炜,郝世超,茅范贞,等.厦门市老年人失能现状及其影响因素研究[J].中国卫生统计,2015,32(5):770-773.CHEN W,HAO S C,MAO F Z,et al.Research on the situation of elderly disability and its impact factors in Xiamen[J].Chinese Journal of Health Statistics,2015,32(5):770-773.
[2]杜鹏,武超.中国老年人的生活自理能力状况与变化[J].人口研究,2006,30(1):50-56.DU P,WU C.The status and changes of self-care ability of Chinese elderly[J].Population Research,2006,30(1):50-56.
[3]张斌,郭秀芝,夏雪雁,等.社区失能老年人长期照护服务体系的探索[J].中国全科医学,2013,16(29):2774-2777,2781.DOI:10.3969/j.issn.1007-9572.2013.08.072.ZHANG B,GUO X Z,XIA X Y,et al.Exploration on long term care system for the disabled community elderly[J].Chinese General Practice,2013,16(29):2774-2777,2781.DOI:10.3969/j.issn.1007-9572.2013.08.072.
[4]李琼莲,梁细静,韦良家,等.某市空巢老人生命质量及其影响因素研究[J].中国现代医学杂志,2018,28(1):56-60.DOI:10.3969/j.issn.1005-8982.2018.01.011.LI Q L,LIANG X J,WEI L J,et al.Investigation on quality of life and influencing factors of Baise empty nesters[J].China Journal of Modern Medicine,2018,28(1):56-60.DOI:10.3969/j.issn.1005-8982.2018.01.011.
[5]张持晨,赵慧宁,郑晓,等.中国空巢老人领域研究现状及热点[J].中国老年学杂志,2018,38(2):421-424.DOI:10.3969/j.issn.1005-9202.2018.02.071.ZHANG C C,ZHAO H N,ZHENG X,et al.Analysis of research hotspots and status of empty-nest elderly study in China[J].Chinese Journal of Gerontology,2018,38(2):421-424.DOI:10.3969/j.issn.1005-9202.2018.02.071.
[6]ZHANG C,ZHU R,LU J,et al.Health promoting lifestyles and influencing factors among empty nesters and non-empty nesters in Taiyuan,China:a cross-sectional study[J].Health Qual Life Out,2018,16(1):103.DOI:10.1186/s12955-018-0936-5.
[7]GUO Y Q,ZHANG C C,HUANG H,et al.Mental health and related influencing factors among the empty-nest elderly and the non-empty-nest elderly in Taiyuan,China:a cross-sectional study[J].Public Health,2016,141:210-217.DOI:10.1016/j.puhe.2016.09.005.
[8]刘亚飞,胡静.谁来照顾老年父母?机会成本视角下的家庭分工[J].人口学刊,2017,39(5):67-76.DOI:10.16405/j.cnki.1004-129X.2017.05.007.LIU Y F,HU J.Who will take care of the elderly parents? The division of labor from the perspective of opportunity cost[J].Population Journal,2017,39(5):67-76.DOI:10.16405/j.cnki.1004-129X.2017.05.007.
[9]王玉环,冯雅楠,侯蔚蔚,等.援疆汉族失能老年人及居家照护者对长期照护需求的调查研究[J].中国全科医学,2013,16(14):1268-1273.DOI:10.3969/j.issn.1007-9572.2013.04.058.WANG Y H,FENG Y N,HOU W W,et al.Long-term care need of the Xinjiang aiding han national disabled elderly and their home caregivers[J].Chinese General Practice,2013,16(14):1268-1273.DOI:10.3969/j.issn.1007-9572.2013.04.058.
[10]张立龙,张翼.中国老年人失能时间研究[J].中国人口科学,2017,31(6):94-104,128.ZHANG L L,ZHANG Y.Study on the disability time of the elderly in China[J].Chinese Journal of Population Science,2017,31(6):94-104,128.
[11]KATZS,DOWNSTD,CASHHR,etal.Progressin development of the index of ADL[J].Gerontologist,1970,10(1):20.DOI:10.1093/geront/10.1_Part_1.20.
[12]周绪凤,马亚娜.中国农村老年人失能状况及影响因素分析[J].中国公共卫生,2017,33(11):1665-1668.DOI:10.11847/zgggws2017-33-11-32.ZHOU X F,MA Y N.Prevalence and impact factors of disability among elderly people in rural China[J].Chinese Journal ofPublicHealth,2017,33(11):1665-1668.DOI:10.11847/zgggws2017-33-11-32.
[13]尹志勤,杨玉霞,陈丽莉,等.浙江省农村老年人健康状况及影响因素分析[J].中国公共卫生,2012,28(3):293-295.YIN Z Q,YANG Y X,CHEN L L,et al.Health status and its influencial factors among rural elderly in Zhejiang Province[J].Chinese Journal of Public Health,2012,28(3):293-295.
[14]翟淑云.我国中老年人健康需求影响因素的实证研究:基于CHARLS数据的分析[J].特区经济,2014,32(9):226-228.ZHAI S Y.An empirical study on the factors affecting the health needs of middle-aged and aged people in China:based on the analysis of CHARLS data[J].Special Zone Economy,2014,32(9):226-228.
[15]胡月,龚磊,陈福宽,等.农村老年人自评健康状况的影响因素分析[J].中国卫生统计,2013,30(2):232-234.HU Y,GONG L,CHEN F K,et al.Analysis of influencing factors of self-evaluation health status of rural elderly[J].Chinese Journal of Health Statistics,2013,30(2):232-234.
[16]陈长香.老年护理学[M].北京:人民卫生出版社,2009:54.
[17]CHEN G,CUI B,ZHANG L.Study on the prevention and strategy of disability in China[J].Procedia-Social and Behavioral Sciences,2010,2(5):6906-6913.DOI:10.1016/j.sbspro.2010.05.041.
[18]陈炜,郝世超,茅范贞,等.厦门市老年人失能现状及其影响因素研究[J].中国卫生统计,2015,32(5):770-773.CHEN W,HAO S C,MAO F Z,et al.Research on the situation of elderly disability and its impact factors in Xiamen[J].Chinese Journal of Health Statistics,2015,32(5):770-773.