觉知压力和社会支持在独居老人孤独感与心理健康间的作用

The effect of perceived stress and social support between loneliness and mental health among the solitary elderly

目的探讨觉知压力和社会支持在独居老人孤独感与心理健康间的作用,为改善社区独居老人孤独感和心理健康提供理论支持。方法在浙江省湖州市采用多阶段抽样的方法选取社区独居老年人385名(年龄60~97岁),使用中国心理健康量表(老年版)(CMHI-E)、孤独感量表(UCLA)、觉知压力量表(CPSS)、社会支持量表(SSRS)进行调查,采用AMOS模型和PROCESS程序检验有调节的中介模型。结果 CMHI-E总分[(136.37±15.42)分]与UCLA总分[(53.61±8.45)分]、CPSS总分[(28.27±2.76)分]呈负相关(r=-0.577、-0.515,P<0.01),而与SSRS总分[(35.49±6.47)分]呈正相关(r=0.199,P<0.01)。觉知压力在孤独感与心理健康间起部分中介作用,中介作用占总效应的23.90%。社会支持负向调节孤独感与觉知压力之间的路径系数,调节效应明显(β=-0.003,P<0.01),社会支持正向调节觉知压力与心理健康之间的路径系数,调节效应明显(β=0.007,P<0.01);在低社会支持水平下中介效应成立(95%CI:0.09~0.18),高社会支持的情况下中介效应不存在(95%CI:-0.07~0.16)。结论觉知压力在孤独感与心理健康间的中介效应受社会支持的调节作用。

Objective To analyze the effect of perceived pressure and social support between loneliness and mental health among the solitary elderly in the community,so as to provide theoretical support for the improvement of loneliness and the maintenance of mental health.Methods Multi-stage sampling method was adopted to select 385 solitary elderly(aged 60 to 97 years old)in Huzhou,Chinese mental health questionnaire(elderly edition,CMHI-E),loneliness scale(UCLA),perceived stress scale(CPSS),and Social support scale(SSRS)were used in this survey,the moderating mediation model was tested by the structure equation model and the PROCESS add-on SPSS.Results CMHI-E scores[(136.37±15.42)point]were negatively correlated with UCLA scores[(53.61±8.45)point]and CPSS scores[(28.27±2.76)point,P<0.01],but positively correlated with SSRS scores[(35.49±6.47)point,r=0.199,P<0.01].Perceived stress partly mediated the relationship between mental health and loneliness,and the value of mediating effect was 23.90%.Social support negatively adjusted the path coefficient between loneliness and perceived stress,the regulation effect was significant(β=-0.003,P<0.01),social support positively adjusted the path coefficient between perceived stress and mental health,the regulation effect was significant(β=0.007,P<0.01);the mediating effect was valid(95%CI:0.09-0.18)while the scores of social support were lower,the mediating effect was not valid(95%CI:-0.07-0.16)while the scores of social support were higher.Conclusion The mediating effect of perceived stress between loneliness and mental health is mediated by social support.