老年人的社会隔离与健康相关生命质量的关联及中介效应分析  

Analysis on the association between social isolation and health-related quality of life and mediating effects

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作  者:刘奕彤 王亚南 田广玉[2] 褚俊峰[2] 仲亚琴[1] LIU Yi-tong;WANG Ya-nan;TIAN Guang-yu;CHU Jun-feng;ZHONG Ya-qin(School of Public Health,Nantong University,Nantong,Jiangsu 226019,China;不详)

机构地区:[1]南通大学公共卫生学院,江苏南通226019 [2]扬州市江都人民医院

出  处:《现代预防医学》2024年第21期3848-3853,共6页Modern Preventive Medicine

基  金:国家社科基金(23BSH151);教育部人文社科基金(21YJA840018)。

摘  要:目的 了解老年人的社会隔离现状及其与健康相关生命质量之间的关系,并探讨孤独感在其中的作用机制。方法采用整群随机抽样,对扬州市1 349名老年人进行面对面问卷调查。社会隔离的测量选取三个社会接触问题,采用孤独感短版量表(UCLA-3)测量孤独感,健康相关生命质量选用欧洲五维度生命质量量表进行测量。利用倾向得分匹配法(PSM)对存在社会隔离与不存在社会隔离的老年人进行无放回的1∶1匹配。利用蒙特卡洛模拟分析法检验孤独感的中介作用。结果 PSM后共718名老年人纳入研究。社会隔离与老年人健康相关生命质量呈负相关(β=-0.016,95%CI:-0.030~-0.002,P<0.05),与老年人的孤独感呈正相关(β=0.142,95%CI:0.047~0.237,P<0.01);孤独感在老年人社会隔离与健康相关生命质量的路径中起完全中介作用(β=-0.005,95%CI:-0.008~-0.001,P<0.01),间接效应占总效应的31.25%。结论 社会隔离通过增加老年人的孤独感,间接影响他们的健康相关生命质量。应为老年人提供更多社会参与的机会,减少其孤独感,进而改善该整体的生命质量。Objective To understand the current state of social isolation among the elderly and its relationship with health-related quality of life,as well as to explore the mediating role of loneliness in this relationship.Methods A face-to-face questionnaire survey was conducted among 1 349 elderly individuals in Yangzhou using cluster random sampling.Social isolation was measured through three questions regarding social contact,loneliness was assessed using the UCLA Loneliness Scale(short version),and health-related quality of life was evaluated using the EuroQol five-dimensional questionnaire.Propensity score matching(PSM) was employed to match elderly individuals with and without social isolation in a 1:1 ratio without re-placement.The mediating effect of loneliness was tested using Monte Carlo simulation analysis.Results A total of 718 elderly individuals were included in the study after matching.Social isolation was negatively correlated with health-related quality of life(β=-0.016,95%CI:-0.030 to-0.002,P<0.05) and positively correlated with loneliness(β=0.142,95%CI:0.047 to 0.237,P<0.01).Loneliness acted as a complete mediator in the pathway between social isolation and health-related quality of life a-mong the elderly(β=-0.005,95%CI:-0.008 to-0.001,P<0.01),with the indirect effect accounting for 31.25% of the total effect.Conclusion Social isolation indirectly affects the health-related quality of life of the elderly by increasing their feelings of loneliness.More opportunities for social participation should be provided to the elderly to reduce their loneliness and,consequently,improve their overall quality of life.

关 键 词:老年人 社会隔离 孤独感 健康相关生命质量 

分 类 号:R197[医药卫生—卫生事业管理]

 

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