孤独在老年慢性病患者社会支持与自我感知老化间的中介效应

doi:10.16460/j.issn1008-9969.2022.04.059

摘要/Abstract

摘要： 目的探讨孤独在社会支持与自我感知老化间的中介作用,从而为改善老年慢性病患者消极的自我感知老化提供理论依据。方法本研究采取整群随机抽样法抽取石河子市2所社区卫生服务站530例老年慢性病患者,使用简版自我感知老化量表、孤独量表和社会支持量表进行问卷调查,运用SPSS 20.0和Process宏程序进行统计分析。结果老年慢性病患者孤独、社会支持和自我感知老化得分分别为（37.84±9.42）、（35.54±7.27）和（48.91±7.52）分。社会支持与自我感知老化、孤独得分均呈负相关（r=-0.330、r=-0.421,P<0.001）;孤独与自我感知老化得分呈正相关（r=0.535,P<0.001）。社会支持可直接影响老年慢性病患者的自我感知老化,还可通过孤独的中介作用间接影响自我感知老化,中介效应占总效应的61.21%。结论孤独是老年慢性病患者社会支持和自我感知老化之间的中介变量,社会医护工作人员应采取有效干预方法降低其孤独感和提高社会支持水平,从而减轻消极的自我感知老化,最终推进和实现成功老龄化。

关键词: 慢性病, 孤独, 自我感知老化, 社会支持, 中介效应

Abstract: Objective To To explore the mediating role of loneliness in social support and self-perceived aging, to provide a theoretical basis for improving the negative self-perceived aging in elderly patients with chronic diseases. Methods In this study, 530 cases of elderly chronically ill patients in 2 community health service stations in Shihezi City were selected by cluster random sampling method, and the Simplified Self-perceived Aging Scale (B-APQ), Loneliness Scale (UCLA) and Social Support Scale (SSRS) were used to conduct a questionnaire survey and SPSS20.0 and Process macro programs for statistical analysis. Results The score of loneliness, social support and self-perceived aging in elderly patients with chronic disease was 37.84±9.42, 35.54±7.27 and 48.91±7.52 respectively. Social support was negatively correlated with self-perceived aging and loneliness scores (r=-0.330, r=-0.421, P<0.001); loneliness and self-perceived aging scores were positively correlated (r=0.535, P<0.001). Social support can directly affect self-perceived aging of elderly chronically ill patients, and indirectly affect self-perceived aging through the intermediary effect of loneliness. The intermediary effect accounted for 61.21% of the total effect. Conclusion Loneliness is an intermediary variable between social support and self-perceived aging in elderly chronically ill patients. Effective intervention measure should be taken to reduce their loneliness and improve social support, thereby reducing negative self-perceived aging, and ultimately promote successful aging.

Key words: chronic diseases, loneliness, self-perceived aging, social support, mediating effect

中图分类号:

R473.59

张智月, 董奥, 冉明, 张国琴. 孤独在老年慢性病患者社会支持与自我感知老化间的中介效应[J]. 护理学报, 2022, 29(4): 59-63.

ZHANG Zhi-yue, DONG Ao, RAN Ming, ZHANG Guo-qin. Mediating Effect of Loneliness between Self-perceived Aging and Social Support in Elderly Chronically Ill Patients[J]. Journal of Nursing, 2022, 29(4): 59-63.

参考文献

[1] 胡蕴琦. 老年人自我感知老化及相关因素研究[D]. 上海:第二军医大学. DOI:2013.10.7666/d.Y2340092.
[2] D Gu, Brown BL , Qiu L. Self-perceived Uselessness Is Associated with Lower Likelihood of Successful Aging Among Older Adults in China[J].BMC Geriatr, 2016,16(1):172.DOI:10.1186/s12877-016-0348-5.
[3] Wurm S, Wolff JK, Schuz B.Primary Care Supply Moderates the Impact of Diseases on Self-perceptions of Aging[J]. Psychol Aging, 2014,29(2):351-358.DOI:10.1037/a0036248.
[4] Barker M, O'Hanlon A, McGee HM, et al. Cross-sectional Validation of the Aging Perceptions Questionnaire: A Multidimensional Instrument for Assessing Self-perceptions of Aging[J].BMC Geriatr, 2007,7(1):9.DOI:10.1186/1471-2318-7-9.
[5] 纪竞垚,代丽丹. 中国老年人的老化态度:基本状况、队列差异与影响因素[J]. 南方人口, 2018,33(4):57-70.DOI:CNKI:SUN:LFRK.0.2018-04-006
[6] 吴晶. 欧洲社会福利和家庭背景下老年人群的自杀与健康研究:对相关理论的重新讨论[J].伤害医学(电子版),2017,6(4):62-66.DOI:CNKI:SUN:SHYD.0.2017-04-014.
[7] Sexton E, King-Kallimanis BL, Morgan K, et al.Development of the Brief Ageing Perceptions Questionnaire(B-Apq): A Confirmatory Factor Analysis Approach to Item Reduction[J].BMC Geriatr,2014,14(1):1-11.DOI:10.1186/1471-2318-14-44.
[8] 白燕平,杨坤,邓梦,等.社会支持在老年人自我感知老化和健康行为之间的中介效应[J].中国健康教育, 2018,34(9):804-807.DOI:10.16168/j.cnki.issn.1002-9982.2018.09.009.
[9] Zhao Y, Sautter J M, Qiu L, et al.Self-perceived Uselessness and Associated Factors Among Older Adults in China[J]. BMC Geriatr,2017,17(1):12.DOI:10.1186/s12877-016-0406-z.
[10] 扈娜,孟令弟,刘堃.简版自我感知老化量表在社区老年人中应用的信效度研究[J].现代预防医学,2018,45(4):655-658.
[11] Russell DW. UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure[J]. J Pers Assess, 1996,66(1):20-40.DOI:10.1207/s15327752jpa6601_2.
[12] 王登峰. Russell孤独量表的信度与效度研究[J]. 中国临床心理学杂志, 1995(1):23-25.
[13] 肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994(2):98-100.
[14] Preacher KJ, Hayes AF.SPSS and SAS Procedures for Estimating Indirect Effects in Simple Mediation Models[J]. Behav Res Methods Instrum Comput, 2004, 36(4):717-731.DOI:10.3758/BF03206553.
[15] 郑俊侃,胡蓉蓉,洪紫静,等.城乡老年人认知能力与负性情绪的相关性[J].中国健康心理学杂志, 2020,28(1):142-145.DOI:10.13342/j.cnki.cjhp.2020.01.034.
[16] 麻超,骆丹,周旭峰,张天文,等.石河子市社区老年人的心理服务需求分析[J].兵团教育学院学报,2016,26(2):31-35.DOI:10.3969/j.issn.1009-1548.2016.02.007.
[17] 梁辰. 老年人孤独感现状及影响因素研究[D]. 济南:山东大学,2018.
[18] 金雅茹. 社区老年人衰弱与抑郁:社会支持的中介及调节作用[D].济南:山东大学,2019.
[19] Domenech-Abella J, Mundo J, Haro JM, et al.Anxiety, Depression, Loneliness and Social Network in the Elderly:Longitudinal Associations from the Irish Longitudinal Study On Ageing(TILDA)[J].J Affect Disord,2019,246:82-88. DOI:10.1016/j.jad.2018.12.043.
[20] 扈娜. 社区老年人自我感知老化、抑郁情绪和生命质量的相关性研究[D].锦州:锦州医科大学,2019.
[21] 刘怡萍. 老年人的老化态度及其影响因素研究[D].南京:南京师范大学,2015.
[22] 赵淼. 老年人自我感知老化、健康行为与housebound的关系[D].唐山:华北理工大学,2017.
[23] 龚艳琳,毛雯凌,谢玉霞,等.377名长沙某社区老年人怀旧感孤独感与社会支持相关性研究[J].护理学报,2017,24(11):56-58.DOI:10.16460/j.issn1008-9969.2017.11.056.
[24] Kuluski K, Ho JW, Hans PK, et al.Community Care for People with Complex Care Needs:Bridging the Gap Between Health and Social Care[J]. Int J Integr Car,2017,17(4):2. DOI:10.5334/ijic.2944.
[25] 刘玉珍,安思琪,宋琼,等.唐山市高龄失能老人孤独感与家庭社会支持的相关性[J].护理研究,2018, 32(7):1057-1060.DOI:10.3969/j.issn.1009-6493.2018.07.016.
[26] 宁红婷,蒲元清,胡燕.涉及老人认知及态度的研究进展[J].中国健康心理学杂志,2017,25(4):636-640.DOI:10.13342/j.cnki.cjhp.2017.04.042.

相关文章 15

[1]	王利敏, 方继红, 武凤芹, 朱晶, 陈婉宣. 运动恐惧在学龄期四肢骨折患儿自我效能与早期功能锻炼依从性间的中介效应[J]. 护理学报, 2025, 32(3): 1-5.
[2]	谭丘羽, 邓一芯, 冀婉倩, 王冬华. 农村老年人自我刻板化与主观记忆抱怨在自我感知老化与痴呆恐惧间的链式中介效应[J]. 护理学报, 2025, 32(1): 56-61.
[3]	王子萱, 原振青, 赵一鋆, 王惠平, 洪菲菲, 邹敏. 体面劳动感在三级甲等医院手术室护士反思能力与创新行为的中介效应[J]. 护理学报, 2025, 32(1): 62-67.
[4]	林丽华, 盖薇, 王语璇, 尹丽丽, 吕郑晗, 陶艳玲. 自我同情在脑卒中患者社会支持与病耻感的中介作用[J]. 护理学报, 2024, 31(9): 15-19.
[5]	李爱群, 李利花, 王芳, 蒋源元, 蔡益民. 慢性病资源利用在冠心病PCI术后患者自我超越与自我管理行为间的中介效应[J]. 护理学报, 2024, 31(6): 13-17.
[6]	林育鹏, 张丽. 231例炎症性肠病复发患者挫败感现状及影响因素分析[J]. 护理学报, 2024, 31(6): 18-21.
[7]	胡晓涵, 占婷婷, 何望生, 乔疏桐, 李雪. 肝豆状核变性患者自我管理体验的质性研究[J]. 护理学报, 2024, 31(5): 17-21.
[8]	郑晓婷, 田霞, 王峥, 肖文莉. King达标理论在慢性病家庭护理中应用的范围综述[J]. 护理学报, 2024, 31(5): 56-60.
[9]	张许婷, 罗彩凤, 魏兰芝, 邵校, 尚彬, 卞泽坤, 吕妃, 孙炜怡. 实习护生体面劳动感的潜在剖面分析及影响因素研究[J]. 护理学报, 2024, 31(3): 12-16.
[10]	何洪, 王佳琳, 袁中清, 滕梅, 任黔黔, 蔚萌. 领悟社会支持在护士应急能力与心理负荷的中介效应分析[J]. 护理学报, 2024, 31(3): 63-67.
[11]	米娇, 谭煜炜, 唐小燕, 刘蕾, 袁榕. 负性情绪在ICU护士心理负荷与报警疲劳的中介效应[J]. 护理学报, 2024, 31(3): 68-72.
[12]	吴萍, 于宛辰, 柳嘉怡, 王汕珊, 胡燕. 糖尿病前期人群社会支持研究的范围综述[J]. 护理学报, 2024, 31(21): 49-54.
[13]	明清, 陶艳玲, 王明珠, 胡思鸿, 刘艳. 慢性病共病患者治疗负担相关体验的Meta整合[J]. 护理学报, 2024, 31(21): 55-61.
[14]	李明哲, 田一川, 王成龙, 王晶晶. 社会网络在智能手机使用与老年人孤独感的因果中介作用[J]. 护理学报, 2024, 31(20): 45-49.
[15]	罗苏娴, 曾超男, 张静华, 白阳娟, 周洁. 护士长真实型领导与护士角色模糊和离职倾向的关系研究[J]. 护理学报, 2024, 31(2): 44-47.

Metrics

Viewed

Full text

Abstract

Cited

Shared