家庭关怀与孤独感在失能老年人失能程度和心理痛苦中的链式中介效应  

The chain mediating effect of family care and loneliness on the degree of disability and psychological distress in disabled elderly people

作　　者：揣新慧 李宁宁 张冬雪 郭全荣 田苗苗[2] 郝习君 CHUAI Xinhui;LI Ningning;ZHANG Dongxue;GUO Quanrong;TIAN Miaomiao;HAO Xijun(School of Nursing and Rehabilitation,North China University of Science and Technology,Tangshan 063210,China;Department of Surgery,Jinan Hospital of Traditional Chinese Medicine,Jinan 250012,China)

机构地区：[1]华北理工大学护理与康复学院,河北唐山063210 [2]济南市中医医院外科,山东济南250012

出　　处：《老年医学研究》2025年第2期54-58,共5页Geriatrics Research

基　　金：河北省社会科学基金项目(HB23SH012,失能老人养老模式之家庭照料能力提升的典型经验研究)。

摘　　要：目的 探讨家庭关怀与孤独感在失能老年人失能程度和心理痛苦中的链式中介效应。方法 2023年8月—2024年2月,采取随机抽样法选取唐山市工人医院直属的5个社区卫生服务中心辖区内居住的361例失能老年人为研究对象,采用一般资料调查表、Barthel指数、家庭关怀度指数问卷、孤独量表简化版、心理痛苦温度计进行调查。采用Pearson相关分析探究失能老年人失能程度、孤独感、家庭关怀与心理痛苦的相关性。采用AMOS24.0软件进行链式中介效应分析。结果 失能老年人心理痛苦得分为(5.60±2.63)分,Barthel指数得分为(54.09±15.48)分,家庭关怀得分为(6.07±2.28)分,孤独感得分为(12.36±3.57)分。失能老年人Barthel指数、家庭关怀与心理痛苦呈负相关(r分别为-0.517、-0.540,P均<0.001),孤独感与心理痛苦呈正相关(r=0.586,P<0.001)。家庭关怀与孤独感在失能老年人失能程度与心理痛苦之间存在链式中介作用(间接效应占总效应的12.19%)。结论 失能老年人心理痛苦程度较高,失能程度、家庭关怀与孤独感对心理痛苦有显著影响,家庭关怀与孤独感在失能程度与心理痛苦之间存在链式中介作用。Objective To explore the chain mediating effect of family care and loneliness on the degree of disability and psychological distress in disabled elderly people.Methods From August 2023 to February 2024,a random sampling method was adopted to select 361 disabled elderly people who lived within the jurisdiction of 5 community health service centers directly affiliated to Tangshan Workers'Hospital.General data questionnaire,Barthel index,Family APGAR(Family Care Index),ULS-6(Short-form Loneliness Scale),and DT(Distress Thermometer)were used to investigate.Pearson correlation analysis was used to explore the correlations among the degree of disability,loneliness,family care,and psychological distress of disabled elderly people.The AMOS24.0 software was employed to conduct the analysis of the chain mediating effect.Results The DT scores of the disabled elderly were 5.60±2.63,the Barthel index,Family APGAR and ULS-6 scores of the disabled elderly were 54.09±15.48,6.07±2.28,and 12.36±3.57,respectively.Barthel index,family care and psychological distress were negatively correlated(r=-0.517,-0.540,P<0.001),loneliness and psychological distress were positively correlated(r=0.586,P<0.001).Family care and loneliness had a chain mediation effect between the degree of disability and psychological distress in disabled elderly(indirect effect accounted for 12.19%of the total effect).Conclusions The degree of disability,family care and loneliness have significant effects on psychological distress.There is a chain mediation between the degree of disability and psychological distress.

关 键 词：失能 心理痛苦 孤独感 家庭关怀 老年人 中介效应 

分 类 号：R47[医药卫生—护理学]