社区老人生活质量及其相关影响因素特征

Quality of life and the characteristics of its influencing factors in community elderly people

目的:调查社区老年人生活质量状况及相关的影响因素。方法:调查于2005-04/09在广州市东山区白云街各居委会完成,采用分层随机抽样法选择350名常住社区老年人为调查对象。纳入标准:年龄60岁及以上,能够独立完成问卷,采取自愿原则。排除意识障碍、严重认知功能障碍、严重精神疾病无法单独完成问卷调查及严重躯体疾病病情不稳定者。问卷采用自评的方法,所有被试完成下列人口学资料和量表评定。一般人口学资料包括姓名、性别、职业、受教育程度、婚姻状况及健康状况等。评估量表包括3个量表,均为自评量表。①世界卫生组织生活质量测定量表简表中文版共26个条目,每个条目分5个等级(1～5),包括生理领域、心理领域、社会关系领域及环境领域等4个方面。得分标化转为百分制,得分越高,生活质量越好,最高为100分。②症状自评量表由90个条目组成,每个条目5级评分(0～4分,0=无,4=严重),包括9个症状因子。③睡眠状况自评量表共有10个项目,每个项目分5级评分(1～5),总分数愈低睡眠问题愈少,总分数愈高睡眠问题愈严重、愈多。结果:在回收的350份问卷中,内容详实问卷共323份,有效率为92.3%。①老年人生活质量与年龄、性别、文化程度及躯体患病情况的关系:社区老年人生活质量的生理、心理、社会关系、环境4个领域评分与年龄呈显著负相关(P<0.01),与文化程度呈正相关(P<0.01);老年男性在生理、社会关系及环境3个领域评分显著高于老年女性(P<0.05)。社区老年人中脑力劳动者生活质量的各领域评分高于体力劳动者(P<0.01);患有慢性病者生活质量各领域评分低于无慢性病者(P<0.05～0.01)。②老年人生活质量与心理健康状况及睡眠状况的关系:症状自评量表各因子评分均与生活质量各领域评分呈负相关(P<0.01);睡眠状况评分与生活质量各领域评分呈负相关(P<0.01)。结论:老年人总体生活质量随着年龄的增长而下降,老年人的文化程度、慢性疾病、心理健康水平及睡眠状况均是老年人生活质量的印象因素,因而有必要在社区中大力防治慢性疾病并进行心理干预,以改善社区老年人的生活质量。

AIM： To investigate the life quality of community elders and relevant influencing factors. METHODS： The investigation was conducted in the Neighborhood Committee of Baiyun Street, Dongshan District of Guangzhou from April to September 2005. Stratified randomization was adopted to selected 350 elderly residents of community. Inclusion criteria： People older than 60 years, who were able to finish the questionnaires alone and took part in voluntarily. Subjects with consciousness disorder, serious cognitive function disorder or mental disease and could not finish the questionnaire alone with unstable serious body disease were excluded. The questionnaire was performed in self-evaluated manner, and all subjects finished the following scales. General demography data included name, sex, profession, educational degree, marriage and health status. The Evaluation scale included 3 scales, which were self-evaluated scales. ① WHOQOL-BREF was composed of 26 items with 5 grades in each items, including physiological region, psychological region, social relationship region and environmental region. The score was calculated by hundred-mark system, and the higher the score was, the better the life quality was with the maximum score of 100 points. ② The SCL-90 was consisted of 90 items with 5 grades for each item （0-4 points, zero as none and 4 points as severe）, including 9 symptom factors. ③ The SRSS was composed of 10 items with 5 grades （1-5） for each item. The less the total score was, the less the sleep problems were, and the higher the total score was, the more and the severer the problems were. RESULTS： Of 350 questionnaires collected, 323 ones were detailed in content with the effective rate of 92.3%. ① Correlation between the life quality of elderly people and their sexes, ages, cultural degree and diseases： The scores of physiology, psychology, social relationship and environment of elderly people were negatively correlated with their life qualities （P 〈 0.01）, while were positively correlated with their educational level （P 〈 0.01）. Aged males got higher scores than aged females in three aspects of physiology, social relations and environment （P 〈 0.05）. Elderly mental worker in community enjoyed a higher life quality in all aspects than elderly laborers, and the differences were distinctly different （P 〈 0.01）. The scores of all items in life quality of elderly patients with chronic disease were lower than those of elderly people without chronic disease （P 〈 0.05-0.01）. ② Relationship between the life quality of elderly people and their psychological status as well as their sleeping condition： All factors in SCL-90 were in negative correlation with every aspect of the life quality （P 〈 0.01）, and the score of sleeping quality was negatively related with all aspects of life quality （P 〈 0.01）. CONCLUSION： In general, the elders＇ life quality is poorer with their age growing, and the education background, chronic disease, mental health condition and sleeping quality all influence the life quality of elders. Therefore, it is of great necessity to deepen the efforts in preventing and treating chronic disease as well as carry out mental help within the communities, so to improve the life quality of senior citizens.