退休人群抑郁影响因素及其相互作用分析

Depression of retirees and its influencing factors

目的了解退休人群的抑郁影响因素及潜在的作用机制。方法本研究采用抑郁自评量表(self rating depression scale,SDS)、SF-36健康调查简表(the MOS item short from health survey,SF-36)及社会支持评定量表(social support rating scale,SSRS)对北京市朝阳区符合纳入标准的400例退休人员,运用多阶段整群随机抽样的方法进行问卷调查,并收集该样本群体的社会人口学特征信息进行分组描述统计和组间差异分析。采用结构方程模型(structural equation modeling,SEM)分析退休人群的生活质量、社会支持分别与抑郁情绪的关系,以及该人群生活质量的中介效应。应用偏差校正非参数百分位Bootstrap法估算中介效应的大小。结果在391份有效样本中,67例(17.14%)退休人员处于抑郁状态,轻度抑郁44例(65.67%),中度抑郁21例(31.34%),重度抑郁2例(2.99%)。婚姻状况是退休人群抑郁情绪的影响因素(F=4.24,P=0.01)。分析SEM结果发现,退休人群的生活质量和社会支持与抑郁得分均呈负相关。在结构模型中,生活质量和社会支持分别与抑郁之间的标准化路径系数为-0.160、-0.224(P<0.01)。退休人群生活质量的中介效应可以解释总效应的14.80%。结论无配偶(未婚、离异、丧偶)的退休人员更容易产生抑郁情绪。相对于生活质量而言,社会支持更有助于避免退休人群处于抑郁状态,社会支持可以通过影响生活质量进而作用于抑郁情绪,通过提高社会支持中的主观支持避免该人群产生抑郁情绪应受到重视。

Objective To understand the depression of retirees and to discuss its influencing factors. Methods A multi-stage cluster sampling method was used to randomly select 400 retirees in Beijing Chaoyang district and a questionnaire survey was conducted using the self rating depression scale(SDS), the MOS item short from health survey(SF-36)and the social support rating scale(SSRS)to collect social-demographical information which was analyzed descriptively for the differences between groups.Structural equation modeling(SEM) was used to analyze the mediating effect of the quality of life and social support on depression, which was assessed by Bootstrap. Results Among 391 retiree with valid questionnaire, 67(17.14%) were depressed, and 44(65.67%) with mild depression, 21(31.34%) with moderat depression and 2(2.99%) with severe depression.Marital status was found to be the influencing factor of retiree depression(F=4.42, P=0.01).SEM analysis showed that the quality of life and social support of retirees were negatively correlated with depression scores.In the structural model, the standardized path coefficients of the quality of life and the social support to depression were-0.160 and-0.224, respectively(P< 0.01).The mediating effect of the quality of life contributed to 14.80% of the total effect. Conclusions Single retiree(unmarried, divorced, widowed) is more prone to be depressed.Compared with the quality of life, social support is more helpful for retirees to avoid being depressed,especially subjective support.Social support may affect depression by directly affecting the quality of life.