衰弱和健康素养在老年人社会支持与生命质量间的双重中介作用  

Dual mediating effects of frailty and health literacy on the relationship between social support and quality of life in older adults

作　　者：马晓龙 王燕 王爱敏 王国文 陈士福 王强 MA Xiao-long;WANG Yan;WANG Ai-min;WANG Guo-wen;CHEN Shi-fu;WANG Qiang(Department of Public Administration,School of Medicine Management,Shandong First Medical University,Tai'an,Shandong 271016,China;不详)

机构地区：[1]山东第一医科大学医药管理学院公共管理系,山东泰安271016 [2]山东第一医科大学医药管理学院科研管理办公室,山东泰安271016 [3]山东第一医科大学附属省立医院教学部 [4]山东第一医科大学附属省立医院组织人事部,山东济南250021

出　　处：《现代预防医学》2025年第5期880-886,共7页Modern Preventive Medicine

基　　金：中国科学技术协会“科创中国”研究课题(2022YGKT09);山东省社科规划研究项目(24CRKJ02);山东省医药卫生科技项目(202315010337);山东省人文社会科学课题(24BGL219)。

摘　　要：目的 基于健康生态学模型,探讨衰弱和健康素养在社会支持与老年人生命质量间的双重中介作用。方法 采用方便抽样法,使用一般资料调查问卷、社会网络关系量表、Tilbrug衰弱评估量表、健康素养评估量表、SF-6Dv2生命质量评估量表对1 497名老年人进行调查。对数据进行描述性统计、非参数检验及相关性分析,应用SPSS 26.0中的PROCESS宏程序构建多重中介效应模型。结果 不同居住地(Z=-4.171,P<0.001)、性别(Z=-2.378,P<0.05)、年龄(H=58.938,P<0.001)、文化程度(H=66.224,P<0.001)、职业(H=78.662,P<0.001)、收入来源(H=87.730,P<0.001)的老年人生命质量得分有差异,差异具有统计学意义。社会支持与衰弱呈显著负相关(r=-0.314,P<0.01),与健康素养(r=0.398,P<0.01)、生命质量(r=0.253,P<0.01)呈显著正相关;衰弱与健康素养(r=-0.320,P<0.01)、生命质量(r=-0.391,P<0.01)呈显著负相关,健康素养与生命质量呈显著正相关(r=0.219,P<0.01)。衰弱(效应值=0.094,95%CI:0.071~0.119)和健康素养(效应值=0.011,95%CI:0.012~0.037)在社会支持对生命质量的影响中起部分中介作用,分别占总效应的43.7%和5.1%。结论 衰弱和健康素养在社会支持与老年人生命质量间发挥双重中介效应。应重视并采取干预措施帮助老年人拓展社会支持网络,降低衰弱程度,提高健康素养水平,进而改善生命质量状况。Objective To investigate the dual mediating effects of frailty and health literacy on the relationship between social support and quality of life among older adults based on the health ecological model.Methods A convenience sampling method was employed to survey 1497 older adults using a general information questionnaire,social network relationship scale,Tilburg Frailty Indicator,health literacy assessment scale,and SF-6Dv2 quality of life assessment scale.Descriptive statistics,non-parametric tests,and correlation analyses were performed on the data,and the PROCESS macro in SPSS 26.0 was used to construct a multiple mediation effect model.Results Significant differences in quality-of-life scores among older adults were observed based on different living areas(Z=-4.171,P<0.001),gender(Z=-2.378,P<0.05),age(H=58.938,P<0.001),education level(H=66.224,P<0.001),occupation(H=78.662,P<0.001),and income sources(H=87.730,P<0.001).Social support was significantly negatively correlated with frailty(r=-0.314,P<0.01),while positively correlated with health literacy(r=0.398,P<0.01)and quality of life(r=0.253,P<0.01).Frailty was significantly negatively correlated with health literacy(r=-0.320,P<0.01)and quality of life(r=-0.391,P<0.01),whereas health literacy was significantly positively correlated with quality of life(r=0.219,P<0.01).Frailty(effect size=0.094,95%CI:0.071-0.119)and health literacy(effect size=0.011,95%CI:0.012-0.037)partially mediated the effect of social support on quality of life,accounting for 43.7%and 5.1%of the total effect,respectively.Conclusion Frailty and health literacy play dual mediating roles in the relationship between social support and quality of life among older adults.It is essential to implement interventions that help older adults expand their social support networks,reduce levels of frailty,and enhance health literacy to improve their quality of life.

关 键 词：老年人 社会支持 衰弱 健康素养 生命质量 

分 类 号：C913.6[经济管理]