基于结构方程模型的空巢老人抑郁现状及影响因素

薛雅卿; 张持晨; 赵慧宁; 郑晓; 蔡圆

doi:10.16462/j.cnki.zhjbkz.2019.10.005

基于结构方程模型的空巢老人抑郁现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2019.10.005

薛雅卿¹,
张持晨^{2, 3, ,},
赵慧宁¹,
郑晓¹,
蔡圆¹

1.
030001 太原, 山西医科大学管理学院
2.
030001 太原, 山西医科大学管理学院, 卫生管理与政策研究中心
3.
310058 杭州, 浙江大学医学院

基金项目:

国家自然科学基金 71874104

国家自然科学基金 71403155

山西省留学回国人员科技活动择优资助项目 2017-16

山西省软科学研究计划项目 2017041039-2

山西省高等学校人文社会科学重点研究基地项目 201801019

详细信息

通讯作者:
张持晨, E-mail: zhangchichen@sina.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2019-03-05
- 修回日期: 2019-05-25
- 刊出日期: 2019-10-10

Depression status and influencing factors of empty-nest elderly based on structural equation model

1.
School of Management, Shanxi Medical University, Taiyuan 030001, China
2.
School of Management, Center for Health Management and Policy, Shanxi Medical University, Taiyuan 030001, China
3.
Zhejiang University School of Medicine, Hangzhou 310058, China

Funds:

National Natural Science Foundation of China 71874104

National Natural Science Foundation of China 71403155

Fund Program for the Scientific Activities of Selected Returned Overseas Professional in Shanxi Province 2017-16

Soft Science Research Program in Shanxi 2017041039-2

Shanxi Provincial Higher Education Humanities and Social Sciences Key Research Base Project 201801019

More Information

Corresponding author: ZHANG Chi-chen, E-mail: zhangchichen@sina.com

摘要

摘要: 目的了解山西省空巢老人抑郁现状，通过结构方程模型探讨其相关影响因素，为预防和干预空巢老人抑郁提供科学依据。方法运用抑郁自评量表和一般情况调查表对山西省4 901名空巢老人进行问卷调查，并拟合结构方程模型。结果山西省空巢老人抑郁症状检出率为64.21%。结构方程模型分析结果发现，健康状况对抑郁症状有直接影响（P=0.028），总效应为-0.978；经济状况对抑郁症状的作用大小为0.086（P=0.030），社会功能对抑郁症状的直接影响无统计学意义（P=0.173），其可通过与健康状况、经济状况的相关来作用于抑郁症状。三个潜变量之间相关（均有P < 0.05），健康状况与社会功能相关性最强（r=0.942），其次是与经济状况（r=0.718），社会功能与经济状况相关性为0.683。结论本次调查的空巢老人大部分存在抑郁症状。健康状况是空巢老人抑郁症状最直接、最重要的影响因素，社会功能通过影响健康状况、经济状况进而作用于抑郁症状。
- 空巢老人 /
- 抑郁 /
- 影响因素 /
- 结构方程模型
Abstract: Objective To clarify the depression status of empty-nest elderly in Shanxi Province, to explore the related influencing factors by structural equation model, and to provide scientific basis for the prevention and intervention of depression for empty nesters. Methods A questionnaire survey was conducted among 4 901 empty-nest elderly in Shanxi Province by self-rating depression scale and general situation questionnaire, and the model was established. Results The prevalence of depressive symptoms among empty nesters in Shanxi Province was 64.21%. The model demonstrated that health status had a direct impact on depressive symptoms (P=0.028), the total effect was -0.978; the effect of economic status on depressive symptoms was 0.086 (P=0.030), and social function had no significant impact on depressive symptoms (P=0.173), which could affect depressive symptoms through affecting health status and economic status. There was a significant correlation between the three latent variables (P < 0.05). Health status had the strongest correlation with social function (r=0.942), followed by economic status (r=0.718), and the correlation between social function and economic status was 0.683. Conclusions In this research, most of the empty-nest elderly suffer from depressive symptoms. Health status is the most direct and important influencing factor of depressive symptoms in empty nesters. Social function affects depressive symptoms through influencing health status and economic status.
- Empty-nest elderly /
- Depression /
- Influencing factors /
- Structural equation model

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图 1 空巢老人抑郁症状影响因素的路径分析

Figure 1. Path analysis of influencing factors of depressive symptoms in empty nesters

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表 1 不同人口学特征空巢老人抑郁得分情况比较

Table 1. Comparison of depression scores among empty-nest elderly with different demographic characteristics

变量	人数[n(%)]	SDS得分(x±s)	t/F值
生活区域			-4.21^a
城市	1 714(34.97)	51.65±10.47
农村	3 187(65.03)	52.95±10.09
文化程度			20.46^a
文盲及半文盲	1 500(30.61)	54.25±10.10
小学	1 573(32.10)	52.76±9.85
初中	1 068(21.79)	51.38±10.22
高中/中专	531(10.83)	49.91±10.32
大专/高职	111(2.26)	49.77±9.66
本科及以上	118(2.41)	51.05±12.97
月收入(元)			39.59^a
无收入	1 676(34.20)	54.21±9.91
< 1 000	1 371(27.97)	52.88±9.96
1 000~	1 287(26.26)	51.30±10.05
≥3 000	567(11.57)	49.22±11.17
吸烟状况			1.39
从不吸烟	3 214(65.58)	52.63±10.26
已戒烟	709(14.47)	51.92±10.19
吸烟	978(19.95)	52.47±10.21
饮酒频率			1.79
从不	3 417(69.72)	52.60±10.27
偶尔	1 168(23.83)	52.48±9.91
经常	206(4.20)	51.92±11.28
每天	110(2.25)	50.38±10.50
锻炼频率(/每周)			55.56^a
从不	1 304(26.61)	54.46±10.11
1~	1 663(33.93)	53.35±9.61
3~	1 208(24.65)	51.62±9.90
≥6	726(14.81)	48.46±11.13
体检频率			54.28^a
从不	1 340(27.34)	51.99±10.33
不定期	2 256(46.03)	52.60±9.87
隔几年定期	380(7.75)	49.24±10.35
每年定期	925(18.88)	54.71±10.16
社会活动参与度			10.05^a
没有	730(14.89)	53.59±10.91
较少	2 309(47.11)	52.95±9.73
较多	1 445(29.48)	51.42±10.16
很多	417(8.52)	51.80±11.62
生活自理情况			199.68^a
不能自理	60(1.22)	61.60±9.72
部分自理	861(17.57)	57.55±8.63
完全自理	3 980(81.21)	51.26±10.16
注重日常饮食健康			42.37^a
非常不注重	152(3.10)	56.57±10.10
较不注重	1 326(27.06)	54.60±9.67
较注重	2 547(51.97)	51.91±9.82
非常注重	876 (17.87)	50.31±11.49
注：^aP < 0.05。

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表 2 模型适配指标值

Table 2. Model adaptation index value

指标	指标值	可接受值	拟合度
χ²/df	5.191	< 5.00	不符合
渐进残差均方和平方根	0.029	< 0.05	符合
拟合优度指数	0.996	>0.90	符合
调整后拟合优度指数	0.990	>0.90	符合
规范适配指数	0.982	>0.90	符合
非规范拟合指数	0.973	>0.90	符合
增值适配指数	0.986	>0.90	符合
比较拟合指数	0.986	>0.90	符合
简约拟合优度指数	0.420	>0.50	不符合
简约规范适配指数	0.518	>0.50	符合

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表 3 结构方程模型的测量模型与结构模型路径系数估计值

Table 3. Measurement model of structural equation model and estimation of path coefficient of structural model

	估计值	标准化估计值	s_x	临界比率	P值
社会活动参与度←社会功能	0.662	0.437	0.035	18.692	< 0.001
锻炼频率←社会功能	1.067	0.575	0.048	22.306	< 0.001
生活区域←社会功能	-0.294	-0.337	-0.019	-15.645	< 0.001
体检频率←社会功能	1.000	0.527
文化程度←-经济状况	1.134	0.639	0.038	29.799	< 0.001
月收入←经济状况	1.000	0.667
抑郁症状←健康状况	-114.782	-0.978	52.197	-2.199	0.028
抑郁症状←社会功能	10.677	0.570	7.843	1.361	0.173
抑郁症状←经济状况	1.298	0.086	0.598	2.171	0.030
生活自理情况←健康状况	1.000	0.203
注重日常饮食健康←健康状况	3.866	0.454	0.380	10.175	< 0.001
社会功能↔经济状况	0.254	0.683	0.013	19.547	< 0.001
社会功能↔健康状况	0.045	0.942	0.004	10.256	< 0.001
经济状况↔健康状况	0.043	0.718	0.004	10.086	< 0.001

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