高龄老年人心理健康状况及影响因素
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摘要
目的了解高龄老年人的心理健康状况及其影响因素。方法于2018年1月～3月,采用症状自评量表(symptom check list 90,SCL-90)对我国60岁及以上老年人进行方便抽样调查,本研究抽取80岁及以上老年人作为研究对象,应用χ~2检验和二元Logistic回归模型分析其心理健康的影响因素。结果高龄老年人共485例,SCL-90总体阳性检出率为20.21%。检出率最高的四个因子分别是躯体化(39.38%)、其他(反映睡眠及饮食等情况)(25.15%)、强迫症(24.33%)和抑郁(22.68%)。体质指数(body mass index, BMI)正常(OR=0.537, 95%CI:0.250～0.857,P=0.027)和居住在县城城关区的高龄老人(OR=0.224, 95%CI:0.075～0.667,P=0.007)总体阳性检出率较低;受教育1～5年(OR=11.092,95%CI:4.446～27.671,P<0.001)、6～8年(OR=9.800,95%CI:3.464～27.721,P<0.001)、9～11年(OR=19.279, 95%CI:6.722～55.297,P<0.001)、12年及以上(OR=24.321, 95%CI:7.894～74.929,P<0.001)者较未受教育者总体阳性检出率高;家庭经济状况自评越富裕的高龄老年人阳性检出率越低(OR<1)。结论高龄老年人的心理健康主要受居住地、受教育年限、家庭经济状况自评、BMI的影响。
Objective To assess the current status and factors associated with the mental health condition of older adults. Methods A convenience sampling survey was conducted using symptom check list 90(SCL-90) among the Chinese older adults aged 60 or above from January to March, 2018. The older adults aged 80 or above were selected for this study. Chi-square test and binary logistic regression model were used to analyze the influencing factors. Results The total participants were 485. The SCL-90 positive detection rate was 20.21%. The symptoms of the four highest detection rates were somatization(39.38%), others(25.15%), obsessive-compulsive symptoms(24.33%) and depression(22.68%). The older adults with normal BMI(OR=0.537, 95% CI: 0.250-0.857, P=0.027) and lived in county town(OR=0.224, 95% CI:0.075-0.667, P=0.007) showed lower SCL-90 positive detection rate. These who had been educated for 1-5 years(OR=11.092, 95% CI: 4.446-27.671, P<0.001), 6-8 years(OR=9.800, 95% CI: 3.464-27.721, P<0.001), 9～11 years(OR=19.279, 95% CI : 6.722-55.297, P<0.001), 12 years and above(OR=24.321, 95% CI: 7.894-74.929, P<0.001) had higher SCL-90 positive detection rate compared with those who were uneducated. Conclusion The mental health condition of Chinese older adults is mainly influenced by residence place, education level, family income self-evaluation and BMI status.
Objective To assess the current status and factors associated with the mental health condition of older adults. Methods A convenience sampling survey was conducted using symptom check list 90(SCL-90) among the Chinese older adults aged 60 or above from January to March, 2018. The older adults aged 80 or above were selected for this study. Chi-square test and binary logistic regression model were used to analyze the influencing factors. Results The total participants were 485. The SCL-90 positive detection rate was 20.21%. The symptoms of the four highest detection rates were somatization(39.38%), others(25.15%), obsessive-compulsive symptoms(24.33%) and depression(22.68%). The older adults with normal BMI(OR=0.537, 95% CI: 0.250-0.857, P=0.027) and lived in county town(OR=0.224, 95% CI:0.075-0.667, P=0.007) showed lower SCL-90 positive detection rate. These who had been educated for 1-5 years(OR=11.092, 95% CI: 4.446-27.671, P<0.001), 6-8 years(OR=9.800, 95% CI: 3.464-27.721, P<0.001), 9～11 years(OR=19.279, 95% CI : 6.722-55.297, P<0.001), 12 years and above(OR=24.321, 95% CI: 7.894-74.929, P<0.001) had higher SCL-90 positive detection rate compared with those who were uneducated. Conclusion The mental health condition of Chinese older adults is mainly influenced by residence place, education level, family income self-evaluation and BMI status.
引文
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[7] 曾光霞. 中国人口老龄化新特点及影响 [J]. 重庆大学学报(社会科学版), 2014,20(2):136-139.DOI: 10.11835 /j.issn.1008-5831.2014.02.019. Zeng GX. The new characteristics and influence of population aging in China [J]. Journal of Chongqing University( Social Science Edition), 2014,20(2):136-139. DOI: 10.11835 /j.issn.1008-5831.2014.02.019.
[8] 程显英,田苗苗,陈长香,等. 河北省城乡老年人心理健康的影响因素分析 [J]. 中国老年学杂志, 2015,35(8):2218-2220.DOI:10.3969/j.issn.1005-9202.2015.08.097. Chen XY, Tian MM, Chen CX, et al. Analysis of influential factors of mental health of urban and rural elderly in Hebei province [J]. Chin J Gerontol, 2015,35(8):2218-2220. DOI:10.3969/j.issn.1005-9202.2015.08.097.
[9] 姜向群,魏蒙. 中国高龄老年人日常生活自理能力及其变化情况分析 [J]. 人口与发展, 2015,21(2):93-100,92.DOI:10.3969/j.issn.1674-1668.2015.02.012. Jiang XQ,Wei M. Activity of daily living of the Chinese oldest-old and its change between 2002 and 2011 [J]. Population and Development, 2015,21(2):93-100,92. DOI:10.3969/j.issn.1674-1668.2015.02.012.
[10] 王双双,陈庆荣. 江苏省老年人心理健康状况及其影响因素 [J].中国老年学杂志, 2017,37(16):4089-4092.DOI:10.3969/j.issn.1005-9202.2017.16.083. Wang SS, Chen QR. Mental health of the elderly in Jiangsu province and its influence factors [J]. Chin J Gerontol, 2017,37(16):4089-4092.DOI:10.3969/j.issn.1005-9202.2017.16.083.
[11] 田云霞,张琳,宁艳花,等. 银川市老年人体质指数与常见慢性病的相关性 [J]. 中国老年学杂志, 2011,31(21):4219-4221. DOI:10.3969/j.issn.1005-9202.2011.21.059. Tian YX, Zhang L, Ning YH, et al. The study on the relationship between body mass index and chronic diseases of Yinchuan old residences [J]. Chin J Gerontol, 2011,31(21):4219-4221. DOI:10.3969/j.issn.1005-9202.2011.21.059.
[12] 李珍,傅昌,毛宗福. 中国老年人不同体质指数与抑郁之间的关系研究 [J]. 中华疾病控制杂志, 2018,22(6):577-580.DOI:10.16462/j.cnki.zhjbkz.2018.06.009. Li Z,Fu C,Mao ZF.Association between body mass index and depression among the Chinese elderly [J]. Chin J Dis Control Prev, 2018,22(6):577-580. DOI:10.16462/j.cnki.zhjbkz.2018.06.009.
[13] van Gool CH, Kempen GI, Bosma H, et al. Associations between lifestyle and depressed mood: longitudinal results from the Maastricht aging study [J]. Am J Public Health, 2007,97(5):887-894. DOI:10.2105/AJPH.2004.053199.
[14] 孙鹃娟,冀云. 家庭“向下”代际支持行为对城乡老年人心理健康的影响——兼论认知评价的调节作用 [J]. 人口研究, 2017,41(6):98-109. Sun JJ, Ji Y. The influences of “downward” intergenerational support on mental health of the Chinese elderly: the moderating effects of cognitive evaluation [J]. Population Research, 2017,41(6):98-109.
[15] 任一波,葛国宏. 不同城市化程度下老年人心理健康状况比较 [J]. 中国老年学杂志, 2015,35(10):2807-2808. DOI:10.3969/j.issn.1005-9202.2015.10.108. Ren YB, Ge GH. Comparison of mental health status of the elderly under different degrees of urbanization [J]. Chin J Gerontol, 2015,35(10):2807-2808. DOI:10.3969/j.issn.1005-9202.2015.10.108.
[16] 谢颖,陈小异. 重庆市老年人心理健康及影响因素 [J]. 中国老年学杂志, 2017,37(12):3060-3062.DOI:10.3969/j.issn.1005-9202.2017.12.092. Xie Y, Chen XY. Mental health and influencing factors of the elderly in Chongqing [J]. Chin J Geronto, 2017,37(12):3060-3062. DOI:10.3969/j.issn.1005-9202.2017.12.092.
[17] 叶晓梅,梁文艳. 教育对中国老年人健康的影响机制研究——来自2011年CLHLS的证据 [J]. 教育与经济, 2017,33(3):68-76,96. DOI:10.3969/j.issn.1003-4870.2017.03.009. Ye XM, Liang WY. The influencing mechanism of education on the health of the aged in China: evidence from CLHLS in 2011 [J]. Education & Economy, 2017,33(3):68-76,96. DOI:10.3969/j.issn.1003-4870.2017.03.009.
[18] 陶慧文,张晓,汪圳. 我国东中西部地区的农村老年人抑郁状况及影响因素 [J]. 中华疾病控制杂志, 2018,22(7):696-699.DOI:10.16462/j.cnki.zhjbkz.2018.07.010. Tao WH, Zhang X, Wang Z. The eastern-middle-western depression and the determinants among Chinese rural elderly [J]. Chin J Dis Control Prev, 2018,22(7):696-699. DOI:10.16462/j.cnki.zhjbkz.2018.07.010.
[19] 徐光兴,肖三蓉. 文化适应的心理学研究 [J]. 江西社会科学, 2009(4):234-237. Xu GX, Xiao SR. Psychological research on cultural adaptation [J]. Jiangxi Social Sciences, 2009(4):234-237.
[20] 程菲,李树茁,悦中山. 文化适应对新老农民工心理健康的影响 [J]. 城市问题, 2015,(6):95-103. DOI:10.13239/j.bjsshkxy.cswt.150615. Cheng F, Li SZ, Yue ZS. The influence of cultural adaptation on the mental health status of migrant workers from two generations [J]. Urban Problems. 2015(6):95-103. DOI:10.13239/j.bjsshkxy.cswt.150615.
[2] Fang EF, Scheibye-Knudsen M, Jahn HJ, et al. A research agenda for aging in China in the 21st century [J]. Ageing Res Rev, 2015,24(Part B):197-205. DOI:10.1016/j.arr.2015.08.003.
[3] 翟振武,陈佳鞠,李龙. 中国人口老龄化的大趋势、新特点及相应养老政策 [J]. 山东大学学报(哲学社会科学版), 2016,1(3):27-35. Zhai ZW, Chen JJ, Li L. Aging in China: general trends, new characteristics and corresponding policies [J]. Journal of Shandong University, 2016,1(3):27-35.
[4] 韩金松,姜天娇,王礼华,等. 鞍山市市区老年人生命质量及影响因素分析 [J]. 中国公共卫生, 2015,31(2):144-148. DOI:10.11847/zgggws2015-31-02-05. Han JS, Jiang TJ, Wang LH, et al. Quality of life and its influencing factors among urban elderly in Anshan city [J]. Chin J Public Heal, 2015,31(2):144-148. DOI:10.11847/zgggws2015-31-02-05.
[5] Derogatis LR, Unger R. Symptom Checklist-90-Revised [M]. Oxford: John Wiley & Sons,Inc. ,2010. p1-7.
[6] 王殿玺,姚林. 中国老年人的心理健康对死亡风险的影响研究 [J]. 西北人口, 2018,39(2):81-87.DOI:10.15884/j.cnki.issn.1007-0672.2018.02.011 Wang DX, Yao L. The influence of the Chinese elderly’s mental health on their mortality hazard rate [J]. Northwest Population Journal, 2018,39(2):81-87. DOI:10.15884/j.cnki.issn.1007-0672.2018.02.011.
[7] 曾光霞. 中国人口老龄化新特点及影响 [J]. 重庆大学学报(社会科学版), 2014,20(2):136-139.DOI: 10.11835 /j.issn.1008-5831.2014.02.019. Zeng GX. The new characteristics and influence of population aging in China [J]. Journal of Chongqing University( Social Science Edition), 2014,20(2):136-139. DOI: 10.11835 /j.issn.1008-5831.2014.02.019.
[8] 程显英,田苗苗,陈长香,等. 河北省城乡老年人心理健康的影响因素分析 [J]. 中国老年学杂志, 2015,35(8):2218-2220.DOI:10.3969/j.issn.1005-9202.2015.08.097. Chen XY, Tian MM, Chen CX, et al. Analysis of influential factors of mental health of urban and rural elderly in Hebei province [J]. Chin J Gerontol, 2015,35(8):2218-2220. DOI:10.3969/j.issn.1005-9202.2015.08.097.
[9] 姜向群,魏蒙. 中国高龄老年人日常生活自理能力及其变化情况分析 [J]. 人口与发展, 2015,21(2):93-100,92.DOI:10.3969/j.issn.1674-1668.2015.02.012. Jiang XQ,Wei M. Activity of daily living of the Chinese oldest-old and its change between 2002 and 2011 [J]. Population and Development, 2015,21(2):93-100,92. DOI:10.3969/j.issn.1674-1668.2015.02.012.
[10] 王双双,陈庆荣. 江苏省老年人心理健康状况及其影响因素 [J].中国老年学杂志, 2017,37(16):4089-4092.DOI:10.3969/j.issn.1005-9202.2017.16.083. Wang SS, Chen QR. Mental health of the elderly in Jiangsu province and its influence factors [J]. Chin J Gerontol, 2017,37(16):4089-4092.DOI:10.3969/j.issn.1005-9202.2017.16.083.
[11] 田云霞,张琳,宁艳花,等. 银川市老年人体质指数与常见慢性病的相关性 [J]. 中国老年学杂志, 2011,31(21):4219-4221. DOI:10.3969/j.issn.1005-9202.2011.21.059. Tian YX, Zhang L, Ning YH, et al. The study on the relationship between body mass index and chronic diseases of Yinchuan old residences [J]. Chin J Gerontol, 2011,31(21):4219-4221. DOI:10.3969/j.issn.1005-9202.2011.21.059.
[12] 李珍,傅昌,毛宗福. 中国老年人不同体质指数与抑郁之间的关系研究 [J]. 中华疾病控制杂志, 2018,22(6):577-580.DOI:10.16462/j.cnki.zhjbkz.2018.06.009. Li Z,Fu C,Mao ZF.Association between body mass index and depression among the Chinese elderly [J]. Chin J Dis Control Prev, 2018,22(6):577-580. DOI:10.16462/j.cnki.zhjbkz.2018.06.009.
[13] van Gool CH, Kempen GI, Bosma H, et al. Associations between lifestyle and depressed mood: longitudinal results from the Maastricht aging study [J]. Am J Public Health, 2007,97(5):887-894. DOI:10.2105/AJPH.2004.053199.
[14] 孙鹃娟,冀云. 家庭“向下”代际支持行为对城乡老年人心理健康的影响——兼论认知评价的调节作用 [J]. 人口研究, 2017,41(6):98-109. Sun JJ, Ji Y. The influences of “downward” intergenerational support on mental health of the Chinese elderly: the moderating effects of cognitive evaluation [J]. Population Research, 2017,41(6):98-109.
[15] 任一波,葛国宏. 不同城市化程度下老年人心理健康状况比较 [J]. 中国老年学杂志, 2015,35(10):2807-2808. DOI:10.3969/j.issn.1005-9202.2015.10.108. Ren YB, Ge GH. Comparison of mental health status of the elderly under different degrees of urbanization [J]. Chin J Gerontol, 2015,35(10):2807-2808. DOI:10.3969/j.issn.1005-9202.2015.10.108.
[16] 谢颖,陈小异. 重庆市老年人心理健康及影响因素 [J]. 中国老年学杂志, 2017,37(12):3060-3062.DOI:10.3969/j.issn.1005-9202.2017.12.092. Xie Y, Chen XY. Mental health and influencing factors of the elderly in Chongqing [J]. Chin J Geronto, 2017,37(12):3060-3062. DOI:10.3969/j.issn.1005-9202.2017.12.092.
[17] 叶晓梅,梁文艳. 教育对中国老年人健康的影响机制研究——来自2011年CLHLS的证据 [J]. 教育与经济, 2017,33(3):68-76,96. DOI:10.3969/j.issn.1003-4870.2017.03.009. Ye XM, Liang WY. The influencing mechanism of education on the health of the aged in China: evidence from CLHLS in 2011 [J]. Education & Economy, 2017,33(3):68-76,96. DOI:10.3969/j.issn.1003-4870.2017.03.009.
[18] 陶慧文,张晓,汪圳. 我国东中西部地区的农村老年人抑郁状况及影响因素 [J]. 中华疾病控制杂志, 2018,22(7):696-699.DOI:10.16462/j.cnki.zhjbkz.2018.07.010. Tao WH, Zhang X, Wang Z. The eastern-middle-western depression and the determinants among Chinese rural elderly [J]. Chin J Dis Control Prev, 2018,22(7):696-699. DOI:10.16462/j.cnki.zhjbkz.2018.07.010.
[19] 徐光兴,肖三蓉. 文化适应的心理学研究 [J]. 江西社会科学, 2009(4):234-237. Xu GX, Xiao SR. Psychological research on cultural adaptation [J]. Jiangxi Social Sciences, 2009(4):234-237.
[20] 程菲,李树茁,悦中山. 文化适应对新老农民工心理健康的影响 [J]. 城市问题, 2015,(6):95-103. DOI:10.13239/j.bjsshkxy.cswt.150615. Cheng F, Li SZ, Yue ZS. The influence of cultural adaptation on the mental health status of migrant workers from two generations [J]. Urban Problems. 2015(6):95-103. DOI:10.13239/j.bjsshkxy.cswt.150615.