基于健康生态学模型的失能老年人抑郁状况及相关因素识别研究  

Study on the Identification of Depressive Status of Disabled Older Adults and Related Factors Based on Health Ecology Modeling

作　　者：董士红 葛怀举 苏文钰 官为民 于晴 柳言 齐元涛 马桂峰 Dong Shihong(School of Public Health,Shandong Second Medical University,Weifang,P.R.China)

机构地区：[1]山东第二医科大学公共卫生学院,山东潍坊261053 [2]山东省肿瘤医院

出　　处：《中国卫生事业管理》2025年第1期101-106,共6页Chinese Health Service Management

基　　金：国家自然科学基金“我国卫生总费用风险预警系统研究”(71673202);国家食品安全风险中心联合攻关计划项目“食品安全风险监测预警体系的评价与优化路径研究”(LH2022GG06);潍坊医学院教学改革项目“人文终极关怀视角下医学生通识课程体系构建与实践研究”(2023YBC008)。

摘　　要：目的:基于健康生态学模型,分析失能老年人抑郁现状及其相关因素,为改善失能老年人心理健康状况提供科学参考。方法:选取中国健康与养老追踪调查2020追踪数据库中年龄≥60岁的老年人,根据IADL量表测定≥60岁老年人失能状况,依据CESD-10量表检出抑郁症状,最终纳入样本2207名。基于健康生态学模型回顾文献纳入自变量,用stata17.0进行单因素检验和logistic多因素回归模型,分析失能老年人抑郁的相关因素。结果:≥60岁失能老年人抑郁发生率为65.02%(1435/2207)。多因素logistic回归分析结果显示,个人特质中男性(OR=0.564, 95%CI:0.407,0.782)、80岁及以上(OR=0.605,95%CI:0.417,0.782),行为特征中夜晚睡眠时间6~8小时(OR=0.507,95%CI:0.399,0.644)和8小时及以上(OR=0.448,95%CI:0.339,0.592),生活和工作条件中收入在5万元以上(OR=0.356,95%CI:0.145,0.877)、居住在非农村(OR=0.754,95%CI:0.592,0.962)是失能老年人抑郁发生的低风险因素;行为特征层中度失能(OR=1.364,95%CI:1.042,1.785)、重度失能(OR=2.342,95%CI:1.481,3.704)、对生活比较满意(OR=1.539,95%CI:1.210,1.958)和不太满意(OR=5.465,95%CI:3.535,8.449)、自评健康不好(OR=2.514,95%CI:1.738,3.638),人际网络层对子女比较满意(OR=1.529,95%CI:1.207,1.937)和不太满意(OR=1.808,95%CI:1.084,3.017),生活和工作条件层未受过正规教育(OR=1.761,95%CI:1.007,3.079)是抑郁发生的高风险因素,且均有统计学意义(P<0.05)。且均有统计学意义(P<0.05)。结论:失能老年人抑郁的发生率较高,应高度重视失能老年人心理健康。抑郁影响因素在健康生态学模型的各个维度都有涉及,建议从多维度、多层次对失能老年人抑郁提供科学干预措施,提升失能老年人幸福感。Objective To analyze the current status of depression among disabled older adults and its related factors based on the health ecology model,and provide scientific references for improving the mental health status of disabled older adults.Methods Older adults aged≥60 years in the China Health and Aging Tracking Survey 2020 tracking database were selected to determine the status of dysfunction in older adults aged≥60 years based on the IADL scale,and detect their depressive symptoms based on the CESD-10 scale.Based on the health ecology model,independent variables were included by reviewing the text.Stata17.0 was used for one-way test and logistic multifactorial regression to analyze the factors associated with the occurrence of depression in older adults with incapacitation.Results The prevalence of depression among disabled older adults aged over 60-year-old was 65.02%(1435/2207).The results of multifactorial logistic regression analysis showed that the personal traits of male and 80 years and older,and the behavioral traits of 6-8 hours of sleep at night and 8 hours and more,living and working conditions with income of 50,000 yuan or more,and living in a non-rural area were the low-risk factors for the occurrence of depression among older adults with disabilities.While the behavioral characteristics stratum of moderate disablement,severe disablement,being more satisfied with their lives and being less satisfied,and poor self-rated health,the interpersonal network stratum of more and less satisfied with their children,and the living and working conditions stratum of without formal education was the high risk factors for the occurrence of depression,all of which were statistically significant(P<0.05).Conclusion The prevalence of depression in disabled older adults is high.The mental health of disabled older adults should be highly emphasized.The influencing factors of depression were involved in all dimensions of the health ecology model.It is recommended to provide scientific interventions for depression in d

关 键 词：失能老年人 抑郁 健康生态学模型 影响因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]