The influencing factors of depression status of the disabled elderly in rural areas of China
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摘要:
目的 了解农村失能老年人抑郁状况，并探讨其影响因素。 方法 基于2015年中国健康与养老追踪调查数据（China health and retirement longitudinal study，CHARLS），纳入836名受访者。运用order logit模型分析中国农村失能老年人抑郁状况的影响因素，并通过分失能程度估计研究样本异质性。 结果 有55.74%的农村失能老年人精神亚健康，其中抑郁状况一般的为35.05%，抑郁状况差的为20.69%。基本特征、生活状况、健康状况、社会经济特征、代际支持五方面变量在不同程度上影响农村失能老年人抑郁状况。儿女数量对总样本抑郁状况的影响差异无统计学意义，但女儿数量（OR=1.416，95%CI：1.055~1.901，P=0.020）和儿子数量（OR=2.012，95%CI：1.579~2.564，P=0.043）分别对中度和重度农村失能老年人抑郁状况产生负向影响，与孙辈同村（OR=0.732，95%CI：0.554~0.966，P=0.028）对农村失能老年人抑郁状况的影响差异有统计学意义，对重度失能老年人抑郁状况产生正向影响（OR=0.527，95%CI：0.341~0.813，P=0.034）。 结论 农村失能老年人抑郁状况受多元因素共同影响。"养儿防老"与"多子多福"现象正在逐渐消失，"隔辈亲"现象依旧存在。 -
关键词:
- 农村失能老年人 /
- 抑郁 /
- 多元有序Logistic回归
Abstract:Objective To underst and the depression status of disabled elderly in rural areas and to explore its influencing factors. Methods Based on the data of China health and retirement longitudinal study (China health and retirement longitudinal study, CHARLS) in 2015, 836 respondents were enrolled. Order logit model was used to analyze the influencing factors of depression status of disabled elderly in rural areas of China and the heterogeneity of the sample was estimated by the degree of disability. Results 55.74% of the disabled elderly in rural areas had mental sub-health, of which 35.05% were in general depression status and 20.69% were in poor depression status.The basic characteristics, living conditions, health status, socio-economic characteristics and intergenerational support affected the depression status of rural disabled elderly in varying degrees. There was no statistically difference in the influence of the number of children on the depression status in the total sample, but the number of daughters (OR=1.416, 95% CI: 1.055-1.901, P=0.020) and sons (OR=2.012, 95% CI: 1.579-2.564, P=0.043) had negative effect on the depression status of moderate and severe rural disabled elderly respectively. Same village with grandchildren (OR=0.732, 95% CI: 0.554-0.966, P=0.028) had statistically difference in the influence on the depression status of rural disabled elderly, it had positive effect on the depression status of severe rural disabled elderly (OR=0.527, 95% CI: 0.341-0.813, P=0.034). Conclusion The depression status of the disabled elderly in rural areas is affected by multiple factors. The phenomena of "raising children and preventing old age" and "more children and more happiness" are gradually disappearing. The phenomenon of "next generation relatives" still exists. -
表 1 自变量及赋值
Table 1. independent variables and their assignment
变量 赋值 年龄(岁) 60~ 其他=0，60~=1 70~ 其他=0，70~=1 ≥80 其他=0，≥80=1 性别 女性=0，男性=1 睡眠时间(h) 连续变量 生活满意度 不满 其他=0，不满=1 一般 其他=0，一般=1 满意 其他=0，满意=1 配偶状况 无配偶=0，有配偶=1 健康自评 差 其他=0，差=1 一般 其他=0，一般=1 好 其他=0，好=1 失能程度 重度 其他=0，重度=1 中度 其他=0，中度=1 轻度 其他=0，轻度=1 患慢性病数量(种) ≥3 其他=0, ≥3=1 2 其他=0, 2=1 1 其他=0, 1=1 0 其他=0，0=1 家庭年收入(对数) 连续变量 文化程度 文盲 其他=0，文盲=1 小学 其他=0，小学=1 初中及以上 其他=0，初中及以上=1 照护依靠 没有=0，有=1 儿子数量(个) 定距变量 女儿数量(个) 定距变量 子女见面频率 每年数次 其他=0，每年数次=1 每月数次 其他=0，每月数次=1 每天 其他=0，每天=1 与孙辈同村 否=0，是=1 
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表 2 农村失能老年人抑郁状况影响因素回归结果
Table 2. Regression results of influencing factors on depression status of disabled elderly in rural areas
变量 β sx OR(95% CI)值 P值 年龄(岁) 60~ 1.000 70~ -0.473 0.180 0.623(0.437~0.887) 0.009 ≥80 -0.949 0.264 0.387(0.231~0.649) ＜0.001 性别 女 1.000 男 -0.336 0.174 0.714(0.508~1.005) 0.054 睡眠时间(h) -0.154 0.031 0.857(0.807~0.911) ＜0.001 生活满意度 不满 1.000 一般 -0.774 0.210 0.461(0.306~0.695) ＜0.001 满意 -1.062 0.220 0.346(0.225~0.532) ＜0.001 配偶状况 无配偶 1.000 有配偶 -0.360 0.189 0.698(0.481~1.011) 0.057 健康自评 好 1.000 一般 0.888 0.305 2.430(1.337~4.417) 0.004 差 1.638 0.301 5.147(2.855~9.278) ＜0.001 失能程度 轻度 1.000 中度 0.694 0.218 2.001(1.305~3.068) 0.001 重度 0.418 0.264 1.520(0.905~2.551) 0.114 患慢性病数量(种) 0 1.000 1 0.155 0.251 1.168(0.714~1.910) 0.536 2 0.343 0.260 1.409(0.847~2.343) 0.186 ≥3 0.195 0.229 1.216(0.775~1.906) 0.395 家庭年收入(对数) -0.097 0.054 0.910(0.816~1.009) 0.072 文化程度 文盲 1.000 小学 0.229 0.171 1.252(0.898~1.759) 0.182 初中及以上 0.054 0.280 1.022(0.610~1.825) 0.848 照护依靠 没有 1.000 有 -0.331 0.155 0.734(0.530~0.973) 0.032 儿子数量 0.016 0.062 1.016(0.900~1.147) 0.796 女儿数量 0.043 0.058 1.044(0.932~1.169) 0.460 子女见面频率 每天 1.000 每月数次 0.016 0.168 1.016(0.731~1.413) 0.925 每年数次 0.317 0.206 1.373(0.917~2.056) 0.124 与孙辈同村 否 1.000 是 -0.313 0.142 0.732(0.554~0.966) 0.028
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表 3 农村失能老年人抑郁状况分失能程度影响因素回归结果a
Table 3. Regression results of influencing factors of depression status disability among rural disabled elderlya
变量 轻度失能 中度失能 OR(95% CI)值 P值 OR(95% CI)值 P值 年龄(岁) 60~ 1.000 1.000 70~ 0.577(0.385~0.865) 0.008 0.931(0.329~2.635) 0.893 ≥80 0.514(0.280~0.942) 0.031 0.375(0.097~1.457) 0.157 性别 女性 1.000 1.000 男性 0.743(0.496~1.112) 0.149 0.815(0.323~2.056) 0.665 睡眠时间(h) 0.856(0.798~0.918) ＜0.001 0.809(0.688~0.951) 0.010 生活满意度 不满 1.000 1.000 一般 0.497(0.305~0.809) 0.005 0.315(0.095~1.042) 0.058 满意 0.320(0.193~0.530) ＜0.001 0.448(0.124~1.618) 0.220 配偶状况 无配偶 1.000 1.000 有配偶 0.725(0.472~1.114) 0.166 0.643(0.211~1.956) 0.437 健康自评 好 1.000 1.000 一般 2.409(1.187~4.888) 0.015 3.392(1.731~6.647) 0.114 差 5.295(2.625~10.682) ＜0.001 8.549(6.165~11.856) 0.007 患慢性病数量(种) 0 1.000 1.000 1 0.815(0.458~1.451) 0.487 6.735(4.427~10.246) 0.003 2 1.021(0.560~1.862) 0.946 3.480(1.800~6.728) 0.095 ≥3 0.980(0.573~1.677) 0.942 2.066(0.619~6.895) 0.238 家庭年收入(对数) 0.847(0.791~0.907) 0.045 0.875(0.647~1.183) 0.387 文化程度 文盲 1.000 1.000 小学 1.076(0.726~1.594) 0.715 2.008(0.801~5.031) 0.137 初中及以上 0.806(0.424~1.536) 0.513 1.774(0.602~5.229) 0.521 照护依靠 没有 1.000 1.000 有 0.738(0.534~1.020) 0.065 0.767(0.296~1.991) 0.586 儿子数量 0.967(0.835~1.120) 0.656 0.934(0.699~1.248) 0.644 女儿数量 0.977(0.851~1.122) 0.746 1.416(1.055~1.901) 0.020 子女见面频率 每天 1.000 1.000 每月数次 1.076(0.734~1.575) 0.708 0.762(0.303~1.918) 0.564 每年数次 1.460(0734~1.575) 0.099 1.199(0.355~4.043) 0.770 与孙辈同村 否 1.000 1.000 是 0.655(0.372~1.156) 0.144 0.994(0.285~3.470) 0.993 注：a由于篇幅，未汇报重度农村失能老年人回归结果，感兴趣的读者可与作者索要。
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