社区空巢老人心理弹性和抑郁在社会支持与自我忽视间的中介效应

Mediating effect of resilience and depression between social support and self-neglect in empty-nest community-dwelling elderly

目的探讨心理弹性和抑郁在社区空巢老人社会支持与自我忽视之间的中介作用。方法2020年7~10月,采用社会支持评定量表、心理弹性量表、老年抑郁量表、老年自我忽视量表对549名社区空巢老人进行横断面调查。采用SPSS 22.0和AMOS 24.0软件,进行描述性分析、相关性分析和结构方程模型构建。结果社区空巢老人的社会支持、心理弹性和自我忽视得分依次为[(38.63±7.47)分]、[(64.30±14.57)分]和[(3.72±2.67)分],有抑郁症状者占31.70%(174/549)。自我忽视与社会支持(r=-0.597,P<0.01)和心理弹性(r=-0.557,P<0.01)均呈负相关,与抑郁呈正相关(r=0.675,P<0.01);社会支持与心理弹性呈正相关(r=0.531,P<0.01),与抑郁呈负相关(r=-0.597,P<0.01)。社会支持可直接影响自我忽视(β=-0.485,P<0.05),还可通过心理弹性和抑郁间接影响自我忽视(β=-0.451,P<0.05);心理弹性和抑郁的中介效应分别占总效应的12.18%和36.00%。结论社区空巢老人的社会支持可直接或通过心理弹性和抑郁间接影响自我忽视,应促进空巢老人多参与社会活动,提高其心理弹性,改善其不良情绪,减少自我忽视的发生。

Objective To explore the mediating effects of resilience and depression on the relationship between social support and self-neglect.Methods From July to October 2020,a cross-sectional survey was conducted among 549 empty-nest community-dwelling elderly in the community using the social support rating scale,Connor and Davidson resilience scale,geriatric depression scale and elderly self-neglect scale.SPSS 22.0 and AMOS 24.0 were used for data analysis,including descriptive analysis,correlation analysis and structural equation modeling.Results The scores of social support,resilience and self-neglect of the empty-nest elderly were(38.63±7.47),(64.30±14.57)and(3.72±2.67)respectively,and 31.70%(174/549)of the subjects had depressive symptoms.The score of self-neglect was negatively correlated with the score of social support(r=-0.597,P<0.01)and resilience(r=-0.557,P<0.01),and positively correlated with depression score(r=0.675,P<0.01).The score of social support was positively correlated with resilience score(r=0.531,P<0.01)and negatively correlated with depression(r=-0.597,P<0.01).Social support could affect self-neglect directly(β=-0.485,P<0.05),and it could also influence self-neglect indirectly through the partial mediating effect of resilience(β=-0.451,P<0.05).The mediating effect of resilience and depression accounted for 12.18%and 36.00%of the total effects respectively.Conclusion Social support could influence self-neglect directly or indirectly through resilience and depression.The empty-nesters should be encouraged to participate more in social activities so as to improve their resilience,reduce the occurrence of self-neglect.