空巢老年人健康相关生存质量及空巢社会因素研究

Study on social determinants and health-related quality of life among the ＇empty nest＇ （lonely） elderly Chinese people

目的分析≥60岁空巢老年人健康相关生存质量现状及空巢相关社会因素，为制定健康老龄化相关策略和措施提供依据。方法采用整群抽样方法选取浙江省部分地区城乡≥60岁老年人4995名。采用逐步logistic回归进行空巢社会因素的多因素分析。用多元线性回归模型在校正混杂因素后，比较空巢和非空巢老年人的健康相关生存质量。结果逐步logistic回归分析显示，与非空巢老年人相比较，空巢老年人年龄多集中在70，79岁（P=0．0417），文化程度高（P〈0．0001），以及居住于农村（P〈0．0001）和低收入者（P=0．0178，P=0．0049）趋向于空巢的概率较大。空巢老年人较非空巢者对生活的满意度较高（P=0．0070，P=0．0035），情绪状态较好（P=0．0371）。多元线性回归在校正了年龄、性别、婚姻状况、文化程度、居住地、个人年收入以及生活满意度评分和情绪评分等因素后，结果显示空巢老年人在生理领域中的躯体疼痛（P=0．0032）维度，心理领域的情感所致功能限制（P=0．0033）维度以及心理领域（P=0．0342）的得分较非空巢老年人低。结论空巢老年人的健康相关生存质量低于非空巢者，尤其体现在心理功能方面。空巢老年人具有高文化程度、低收入以及居住于农村等特征，是实施健康老龄化需要重点关注的对象。

Objective To study the social determinants and health-related quality of life among the Chinese ＇ empty nest＇ （lonely） elderly. Methods A total of 4995 elderly, aged 60 or over were recruited in rural and urban areas of Zhejiang province, under a cluster sampling method. Stepwise logistic regression analysis was performed to analyze the social determinants on the ＇empty nest＇ elderly. Health-related quality of life was assessed by SF-36 and compared between the ＇empty nest＇ and ＇non-empty nest＇ elderly, using multiple linear regression analysis after adjusting for confounding factors. Results Comparing with the ＇non-empty nest＇ elderly, the characteristics of the empty nest population were as follows：age at 70 to 79 （P= 0.0417）, having higher education level （P〈0.0001）, living in rural area （P〈0.0001）, lower income level （P=0.0178, P=0.0049）, with higher level of satisfaction of life （P=0.0070, P=0.0035） and lower level of depressive mood （P= 0.0371）. ＇Empty nest＇ elderly people had lower scores of SF-36 in BP （P=0.0032） dimension of physical function, and RE （P=0.0033） dimension of psychological fimction as well as MCS （P=0.0342） after adjusting for age, gender, marriage status, education level, residential areas, personal income, scores for satisfaction of life and depressive mood. Conclusion The ＇empty nest＇ elderly people with the characteristics such as higher education level, lower income level and living in the rural areas should be under greater concern, especially on those people with lower health-related quality of life or poorer psychological function.