Mental health status and its influencing factors of the elderly
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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。 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. -
Key words:
- 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 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 阴性 阳性 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。 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 -
[1] 国家统计局. 中华人民共和国2017年国民经济和社会发展统计公报. [EB/OL]. (2018-02-28)[2018-10-08]. http://www.stats.gov.cn/tjsj/zxfb/201802/t20180228_1585631.html.National Bureau of Statistic. Statistical Communiqué of the 2017 National Economic and Social Development of the People's Republic of China[EB/OL]. (2018-02-28)[2018-10-08]. http://www.stats.gov.cn/tjsj/zxfb/201802/t20180228_1585631.html. [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. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZS201603003.htmZhai 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. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZS201603003.htm [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.1007-0672.2018.02.011Wang 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. https://www.cnki.com.cn/Article/CJFDTOTAL-RKYZ201706008.htmSun 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. https://www.cnki.com.cn/Article/CJFDTOTAL-RKYZ201706008.htm [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.