高龄老年人心理健康状况及影响因素

王进松; 刘晓君; 侯宜坦; 何美坤; 吴玉攀; 谭安然; 张芳婕; 毛宗福

doi:10.16462/j.cnki.zhjbkz.2019.03.013

高龄老年人心理健康状况及影响因素

doi: 10.16462/j.cnki.zhjbkz.2019.03.013

430071 武汉, 武汉大学全球健康研究中心

基金项目:

武汉大学“双一流”建设引导专项 2018

详细信息

通讯作者:
毛宗福, E-mail: zfmao@whu.edu.cn

中图分类号: R197
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- 被引次数: 0
出版历程
- 收稿日期: 2018-10-08
- 修回日期: 2018-11-21
- 刊出日期: 2019-03-10

Mental health status and its influencing factors of the elderly

Global Health Institute, Wuhan University, Wuhan 430071, China

摘要

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χ²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。
- 心理健康 /
- 高龄老年人 /
- 检出率 /
- SCL-90
Abstract: 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.
- Mental health /
- Elderly people /
- Detection rate /
- SCL-90

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表 1 症状自评量表(SCL-90)检出情况(n=485)

Table 1. Detection rate of SCL-90 (n=485)

变量	频数	有效百分比(%)	阳性率排序
躯体化			1
阴性	294	60.62
阳性	191	39.38
强迫症状			3
阴性	367		75.67
阳性	118	24.33
人际关系敏感			6
阴性	399	82.27
阳性	86	17.73
抑郁			4
阴性	375	77.32
阳性	110	22.68
焦虑			7
阴性	402	82.89
阳性	83	17.11
敌对			8
阴性	404	88.30
阳性	81	16.70
恐怖			5
阴性	398	82.06
阳性	87	17.94
偏执			9
阴性	411	84.74
阳性	74	15.26
精神病性			10
阴性	412	84.95
阳性	73	15.05
其他			2
阴性	363	74.85
阳性	122	25.15
总检出			-
阴性	387	79.79
阳性	98	20.21

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表 2 SCL-90总检出率单因素分析(n=485)

Table 2. Single factor analysis for the total detection rate of SCL-90 (n=485)

因素	总检出		χ²值	P值
因素	阴性	阳性	χ²值	P值
性别			5.760	0.016
男	193(84.65)	35(15.35)
女	192(75.89)	61(24.11)
BMI(kg/m²)			22.031	<0.001
过低(<18.5)	54(72.00)	21(28.00)
正常(18.5~)	286(85.63)	48(14.37)
超重或肥胖(>24)	45(63.38)	26(36.62)
户口			1.308	0.253
农业	223(78.25)	62(21.75)
非农业	156(82.54)	33(17.46)
现居住地			21.032	<0.001
自然村	112(74.17)	39(25.83)
乡镇、城乡结合区	85(80.19)	21(19.81)
县城城关区	103(94.50)	6(5.50)
主城区	83(72.81)	31(27.19)
受教育年限(年)			44.889	<0.001
0~	181(94.27)	11(5.73)
1~	80(74.07)	28(25.93)
6~	47(77.05)	14(22.95)
9~	35(63.64)	20(36.36)
≥12	30(63.83)	17(36.17)
是否在婚			1.564	0.211
是	165(77.10)	49(22.90)
否	219(81.72)	49(18.28)
个人储蓄(万)			6.390	0.041
≤1	203(82.86)	42(17.14)
1	80(83.33)	16(16.67)
≥3	102(72.86)	38(27.14)
家庭人均年收入(万)			12.494	0.006
0~	103(70.55)	43(29.45)
1.5~	86(83.50)	17(16.50)
3~	96(84.96)	17(15.04)
≥4.5	96(84.96)	17(15.04)
家庭经济状况自评			11.061	0.004
贫穷	91(70.54)	38(29.46)
一般	241(83.39)	48(16.61)
富裕	52(86.67)	8(13.33)
居住安排			8.450	0.015
独居	49(75.38)	16(24.62)
仅与老伴同住	64(70.33)	27(29.67)
其他	271(83.38)	54(16.62)
注：因每个变量均存在缺失值，因此合计不等于485。

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表 3 SCL-90总检出率多因素二元Logistic逐步回归模型(n=485)

Table 3. Binary Logistic stepwise regression analysis for the total detection rate of SCL-90 (n=485)

影响因素	β值	Wald值	OR (95% CI)值	P值
BMI(kg/m²)
过低(<18.5)	1.000
正常(18.5~)	-0.622	5.136	0.537 (0.250~0.857)	0.027
超重或肥胖(>24)	0.650	2.053	1.915 (0.787~4.658)	0.152
现居住地
自然村	1.000
乡镇、城乡结合区	-0.177	0.169	0.838 (0.360~1.951)	0.681
县城城关区	-1.498	7.217	0.224 (0.075~0.667)	0.007
主城区	-0.509	1.261	0.601 (0.247~1.461)	0.261
受教育年限(年)
0	1.000
1~	2.406	26.616	11.092 (4.446~27.671)	<0.001
6~	2.282	18.506	9.800 (3.464~27.721)	<0.001
9~	2.959	30.296	19.279 (6.722~55.297)	<0.001
≥12	3.191	30.901	24.321 (7.894~74.929)	<0.001
家庭经济状况自评
贫穷	1.000
一般	-0.927	5.363	0.396 (0.181~0.867)	0.021
富裕	-1.544	7.090	0.213 (0.068~0.665)	0.008

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