互联网使用对中国老年慢性病患者抑郁症状的影响——社会隔离的中介效应  

The influence of internet use on depressive symptoms in older patients with chronic diseases in China:the mediating effect of social isolation

作　　者：张瑞芹[1] 孙俊俊 聂丽[2] 张会敏[1] 朱丽丽[1] 孙翠勇[2] ZHANG Ruiqin;SUN Junjun;NIE Li;ZHANG Huimin;ZHU Lili;SUN Cuiyong(School of Nursing,Xinxiang Medical University,Xinxiang,Henan Province 453003,China;不详)

机构地区：[1]新乡医学院护理学院,河南省新乡453003 [2]新乡医学院管理学院,河南省新乡453003

出　　处：《中国慢性病预防与控制》2025年第1期15-21,共7页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：2022年国家社会科学基金项目(22BGL213);2023年河南省高校人文社会科学研究一般项目(2023-ZDJH-159);2023年河南省软科学研究项目(232400410214)。

摘　　要：目的探讨互联网使用对老年慢性病患者抑郁症状的影响,并分析社会隔离的中介效应,为缓解老年慢性病患者抑郁症状提供参考依据。方法采用中国健康与养老追踪调查项目(CHARLS)2020年数据库,选取9552例60岁及以上老年慢性病患者。使用Stata 18.0软件进行最小二乘法回归、分位数回归、工具变量法、倾向匹配得分检验及Sobel方法中介检验分析。结果中国老年慢性病患者互联网使用比例达25.28%,出现抑郁症状者占45.49%。最小二乘法回归结果表明互联网使用可以显著减少老年慢性病患者抑郁症状(β=-1.915),分位数(P_(25)、P_(50)、P_(75))回归验证了这一结果(β分别为-1.667、-1.807和-2.225)。工具变量法中二阶段最小二乘法、分位数回归分析表明互联网对抑郁症状影响系数绝对值变大(β分别为-2.850、-2.603、-2.293、-2.651)。最小近邻匹配、卡尺匹配、核匹配3种倾向得分匹配法中,互联网使用对抑郁影响的平均处理效应(ATT)分别为-1.676、-1.865、-1.868,均通过显著性检验(P<0.01)。Bootstrap法检验结果显示,社会隔离在老年慢性病患者互联网使用与抑郁症状之间有部分中介效应,占总效应的13.84%。结论老年慢性病患者互联网使用率较低,抑郁症状检出率较高。互联网使用与老年慢性病患者抑郁症状密切相关,社会隔离在其中有中介效应。增加互联网使用和减少社会隔离可以改善老年慢性病患者抑郁症状。Objective To explore the influence of internet use on depressive symptoms among older patients with chronic diseases in China,analyze the mediating effect of social isolation,and provide the reference basis for alleviating depressive symptoms of the older patients with chronic diseases.Methods The China Health and and Retirement Longitudinal Study(CHARLS)2020 database was used to select 9552 older patents(>60 years old)as the subjects.Least squares regression,quantile regression,instrumental variable method,propensity matching score test and Sobel method mediation test were used to analyze the data,the used software was Stata 18.0.Results The proportion of Internet use by older patients with chronic diseases in China reached 25.28%,the detection of the depressive symptoms was 45.49%.Least squares regression results showed that internet use could significantly reduce depressive symptoms in older patients with chronic diseases(β=-1.915),and quantile(P_(25),P_(50),P_(75))regression validated the result(βvalues were-1.667,-1.807 and-2.225,respectively).The two-stage least square method and quantile regression analysis in the instrumental variable method showed that the absolute coefficient of the influence of internet on depressive symptoms became larger(βvalues were-2.850,-2.603,-2.293 and-2.651,respectively).The average processing effect(ATT)of internet use on depression among the three propensity score matching methods of nearest neighbor matching,caliper matching and kernel matching was-1.676,-1.865 and-1.868,respectively(P<0.01).The results of the Bootstrap method showed that the social isolation had a partial mediating effect between internet use and depressive symptoms in older patients with chronic diseases,accounting for 13.84%of the total effect.Conclusion The internet usage rate is low and the detection rate of depressive symptoms is relatively high in older patients with chronic diseases.Internet use is strongly associated with depressive symptoms in older patients with chronic diseases,and the social

关 键 词：互联网使用 抑郁症状 社会隔离 老年慢性病患者 

分 类 号：R749.4[医药卫生—神经病学与精神病学]