Correlation between depressive symptoms and health promotion behavior in the elderly—based on structural equation model
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摘要:
目的 探讨老年人抑郁症状与健康促进行为的相关关系, 为完善老年人心理干预措施提供参考。 方法 采用随机整群抽样的方法, 于2021年5月6日-7月31日对宁夏回族自治区1 949名老年人展开调查, 应用抑郁症筛查量表-9(Patient Health Questionnare-9, PHQ-9)和健康促进生活方式自评量表(Health Promoting Lifestyle Profile, HPLP-C)进行测评, 利用X2检验、二元logistic回归分析模型探讨抑郁症状的影响因素并建立抑郁症状与健康促进行为的结构方程模型。 结果 共有1 937人有效完成问卷, 其中760人有抑郁症状。二元logistic回归分析模型显示: 年龄越大、女性、健康行为等级为不健康的老年人更容易出现抑郁症状(均有P<0.05)。结构方程模型中健康责任(β=0.20)与抑郁症状呈正相关, 自我实现(β=-0.15)、人际关系(β=-0.06)与抑郁症状呈负相关。 结论 老年人抑郁症状与健康促进行为存在相关关系, 可以通过改善老年人的健康行为方式来预防抑郁症状的发生。 Abstract:Objective To explore the relationship between depressive symptoms and health promotion behaviors in the elderly, and to provide a reference for improving psychological intervention measures for the elderly. Methods A random cluster sampling method was used to survey 1 949 elderly people in Ningxia Hui Autonomous Region from May 6-July 31, 2021.The Depression Screening Scale (patient health questionnaire, PHQ-9) and the Health Promotion Lifestyle Self-rating Scale (health-promoting lifestyle profile, HPLP-C) were used for evaluation, and the chi-square test and binary logistic regression model were used to explore the influencing factors of depressive symptoms and establish a structural equation model of depressive symptoms and health promotion behaviors. Results A total of 1 937 people completed the questionnaire, and 760(39.2%) people were found to have depressive symptoms.Binary logistic regression showed that older, female, and unhealthy seniors were more likely to have depressive symptoms (all P<0.05).In the structural equation model, there was a positive correlation between health responsibility (β=0.20) and depressive symptoms, while self-actualization (β=-0.15) and interpersonal relationships (β=-0.06) were negatively correlated with depressive symptoms. Conclusions There is a correlation between depressive symptoms and health promotion behaviors in the elderly, and the occurrence of depressive symptoms can be prevented by improving the healthy behaviors of the elderly. -
Key words:
- The elderly /
- Depressive symptoms /
- Health-promotion behavior
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图 1 老年人抑郁症状与健康促进行为相关关系的结构方程模型
Figure 1. Structural equation modeling of the relationship between depressive symptoms and health-promoting behaviors in older adults
表 1 不同特征社区老年人抑郁症状分布情况[n(%)]
Table 1. Distribution of depressive symptoms among the elderly in different characteristics of the community [n(%)]
变量 总人数 发生抑郁症状 X2值 P值 年龄(岁) a 16.362 < 0.001 65~<75 1 305 (67.4) 477 (36.6) 75~<85 575 (29.7) 249 (43.3) ≥85 57 (2.9) 34 (59.6) 性别 18.041 < 0.001 男 919 (47.4) 315 (34.3) 女 1 018 (52.6) 445 (43.7) 户籍 < 0.001 0.999 城镇 892 (46.1) 350 (39.2) 农村 1 045 (53.9) 410 (39.2) 文化程度a 4.871 0.027 文盲 914 (47.2) 376 (41.1) 小学 499 (25.8) 203 (40.7) 初中 341 (17.6) 115 (33.7) 高中及以上 183 (9.4) 66 (36.1) 婚姻状况 4.711 0.095 未婚 17 (0.9) 7 (41.2) 已婚 1 507 (77.8) 572 (38.0) 离异/丧偶 413 (21.3) 181 (43.8) 经济状况(元/月) a 4.676 0.031 <2 000 1 190 (61.4) 484 (40.7) 2 000~5 000 684 (35.3) 260 (38.0) >5 000 63 (3.3) 16 (25.4) 居住方式 2.227 0.328 独居 293 (15.1) 126 (43.0) 与伴侣同住 1 300 (67.1) 498 (38.3) 与子女或其他家人同住 344 (17.8) 136 (39.5) 健康行为等级 9.904 0.002 不健康 618 (31.9) 274 (44.3) 健康 1319 (68.1) 486 (36.8) 注：a等级变量，采用趋势X2检验。 
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表 2 抑郁症状与健康行为关联的多因素非条件logistic回归分析模型分析
Table 2. Multivariate unconditional logistic regression analysis of the association between depressive symptoms and health behavior
变量 β值 X2值 P值 OR(95% CI)值 年龄(岁) 65~<75 1.000 75~<85 0.302 7.897 0.005 1.353(1.096~1.670) ≥85 1.053 13.624 < 0.001 2.867(1.639~5.015) 性别 男 1.000 女 0.372 12.653 < 0.001 1.451(1.182~1.781) 经济状况(元/月) ＜2 000 1.000 2 000~5 000 -0.149 1.376 0.241 0.862(0.672~1.105) >5000 -0.653 3.855 0.050 0.520(0.271~0.999) 文化程度 文盲 1.000 小学 0.099 0.678 0.410 1.104(0.872~1.399) 初中 -0.085 0.307 0.579 0.919(0.680~1.240) 高中及以上 0.088 0.194 0.659 1.092(0.739~1.614) 健康行为等级 不健康 1.000 健康 -0.281 6.862 0.009 0.755(0.612~0.932)
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表 3 抑郁症状与健康行为及其各维度的单因素非条件logistic回归分析模型分析
Table 3. Univariate unconditional logistic regression analysis of depressive symptoms and health behaviors and their dimensions
变量 β值 X2值 P值 OR(95% CI)值 健康行为 -0.008 13.277 0.001 0.992(0.988~0.996) 营养 -0.048 9.268 0.002 0.953(0.924~0.983) 健康责任 0.032 15.161 0.001 1.032(1.016~1.049) 自我实现 -0.065 59.728 0.001 0.937(0.922~0.953) 人际关系 -0.078 44.277 0.001 0.925(0.904~0.947) 体力活动 -0.010 0.500 0.479 0.991(0.965~1.017) 压力管理 -0.021 7.588 0.006 0.979(0.964~0.994)
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