社区居家老年人慢性疾病共病对社会参与水平的影响分析  

Impact of chronic disease comorbidities on social participation among elderly people living at home in community

作　　者：宋旭辉 梁笑笑 董海颖 王新乐 祁琳 何燕 SONG Xu-hui;LIANG Xiao-xiao;DONG Hai-ying;WANG Xin-le;QI Lin;HE Yan(School of Management,Hainan Medical University,Haikou 57119,China)

机构地区：[1]海南医学院管理学院,海南海口571199 [2]郑州大学公共卫生学院,河南郑州450001

出　　处：《中国健康教育》2025年第3期238-243,共6页Chinese Journal of Health Education

基　　金：2021年河南省重点研发与推广专项(科技攻关)项目(212102310814)。

摘　　要：目的探讨社区居家老年人慢性疾病共病情况对社会参与水平的影响,为提高老年人社会参与水平提供帮助。方法于2021年9—10月采用多阶段分层整群随机抽样法对青岛市、广州市和苏州市的社区居家老年人开展问卷调查,问卷内容包括一般情况、服务需求情况、自主参与量表、欧洲五维健康量表4个部分。采用χ^(2)检验分析不同社会人口学特征和共病情况老年人的社会参与水平,通过多因素Logistic回归分析共病情况对老年人社会参与水平的影响。结果本次调查共发放问卷1380份,有效问卷1195份,有效回收率为86.60%。纳入的调查对象平均年龄(74.55±9.53)岁,其中男性535例(44.77%),非独居老人949例(79.41%),文化程度为小学352例(29.46%),月收入≤1000元459例(38.41%)。不同年龄、婚姻状况、文化程度、职业、医保、独居情况、探望频率、收入、饮酒和外出频率的老年人社会参与水平比较,差异均有统计学意义(P均<0.05)。是否患有慢性疾病、慢性疾病的数量以及不同二元慢性疾病共病模式的老年人社会参与水平比较,差异均有统计学意义(P均<0.05)。多因素Logistic回归分析显示,非慢性疾病共病老年人社会参与水平是慢性疾病共病老年人的2.187倍(OR=2.187,95%CI:1.725~2.775,P<0.05);与患有共病相比,未患心血管疾病+脑血管疾病、心血管疾病+呼吸系统疾病、肌肉骨骼疾病+风湿性疾病这3种常见慢性疾病共病模式下老年人社会参与水平的O R值分别为2.117(95%CI:1.227~3.653)、2.818(95%CI:1.586~5.007)、1.849(95%CI:1.050~3.257),P均<0.05。结论慢性疾病共病模式对社区居家老年人社会参与水平会产生不同影响,应重视不同慢性疾病共病老年人的身心状况,采取针对性措施,提高其社会参与水平。Objective To explore the impact of chronic disease comorbidities on social participation among elderly people living at home in communities,and to provide evidence for improving their level of social participation.Methods From September to October 2021,a multi-stage stratified cluster random sampling method was used to conduct a questionnaire survey on the elderly at home in Qingdao City,Guangzhou City and Suzhou City,and the questionnaire content included four parts:general situation,service demand,self-participation scale,and European five-dimensional health scale.F-test was used to analyze the social participation level of the elderly with different sociodemographic characteristics and comorbidities,and the impact of comorbidities on social participation of the elderly was analyzed by multivariate logistic regression.Results A total of 1380 questionnaires were distributed in this survey,and 1195 valid questionnaires were issued,with an effective recovery rate of 86.60%.The average age of the included subjects was(74.55±9.53)years,including 535 males(44.77%),949(79.41%)non-living alone,352(29.46%)with primary school education and 459(38.41%)with a monthly income under 1000 yuan.There were statistically significant differences in the levels of social participation among the elderly with different ages,marital status,education level,medical insurance,whether living alone,visiting frequency,income,alcohol consumption and outing frequency(all P<0.05).There were significant differences in whether there were chronic diseases,the number of chronic diseases,and the level of social participation among the elderly with different binary chronic disease comorbidities(all P<0.05).Multivariate logistic regression analysis showed that the level of social participation of the elderly with non-chronic diseases was 2.183 times that that of the elderly with chronic diseases(OR-2.187,95%CI:1.725-2.775,P<0.05).The OR values of social participation in the three common chronic diseases of musculoskeletal diseases+rheumatic diseases

关 键 词：慢性疾病共病 社会参与水平 社区居家老年人 

分 类 号：R193[医药卫生—卫生事业管理]