社区高龄独居老年人生活质量现状及影响因素分析

Quality of life and its associated factors among community dwelling oldest old persons living alone

目的调查社区高龄独居老年人生活质量现况,并分析其影响因素。方法采用便利抽样法于2021年5-7月在上海市区2个街道选取218名75岁及以上的高龄独居老年人作为研究对象。采用世界卫生组织生活质量量表老年模块(WHOQOL-OLD)评价高龄独居老年生活质量现况。采用自行设计的一般资料调查表、衰弱筛查量表(FRAIL量表)、老年抑郁量表简表(GDS-5)、Lubben社交网络量表(LSNS-6)和加利福尼亚大学洛杉矶分校孤独量表简表(UCLA-6)、调查研究对象的人口学特征、慢性病数目、躯体衰弱、抑郁、孤独感和社会隔离等资料,以分析其生活质量的影响因素。结果社区高龄独居老年人WHOQOL-OLD得分为(60.21±13.68)分,其中社会参与(56.97±17.80)、感觉能力(55.44±21.73)以及亲密关系(53.93±22.20)这3个维度得分最低。回归分析显示,年龄、多重用药、躯体衰弱、抑郁状态、社会隔离状态和孤独感是社区高龄独居老年人生活质量的影响因素(P<0.05),共解释52%的WHOQOL-OLD变异程度。其中,孤独感、社会隔离、抑郁、躯体衰弱、年龄和多重用药依次解释了WHOQOL-OLD得分13.06%、12.38%、9.74%、6.67%、3.59%和3.27%的变异度。结论社区高龄独居老年人的生活质量不理想。孤独感、社会隔离和抑郁状态是影响高龄独居老年人生活质量最重要的3个影响因素。社区卫生工作者应发展个体化的干预措施来延缓躯体衰弱、减少抑郁和孤独感、消除社会隔离,进而改善高龄独居老年人的生活质量。

Objective To investigate quality of life(QOL)and its associated factors among community-dwelling oldest old persons who live alone.Methods Using convenience sampling method,a sample of 218 community-dwelling older adults aged 75 years or above who live alone in Shanghai participated in this study during May-July,2021.QOL was assessed using the world 62 health organization quality of life instrument-older adults module(WHOQOL-OLD).Data on socio-demographics,number of chronic conditions assessed by self-designed general information questionnaire,physical frailty assessed by FRAIL scale,depression assessed by geriatric depression scale-5(GDS-5),loneliness assessed by short-form of the UCLA loneliness scale-6(UCLA-6)and social isolation assessed by Lubben social network Scale-6(LSNS-6)were also collected to examine the factors associated with QOL.Results The mean overall WHOQOL-OLD score for the participants was(60.21±13.68).QOL domains of social participation(60.21±13.68),sensory abilities(55.44±21.73),and intimacy(53.93±22.20)had the lowest mean scores.Results of linear regression model showed that age,polypharmacy,physical frailty,depression,loneliness,and social isolation were independently associated with overall WHOQOL-OLD score,accounting for 52%of the variance.The proportion of variance explained by loneness,social isolation,depression,physical frailty,age and polypharmacy on the overall WHOQOL-OLD scores was 13.06%,12.38%,9.74%,6.67%,3.59%and 3.27%respectively.Conclusion QOL of community-dwelling oldest old person living alone was not optimal.Loneliness,social isolation and depression were three of the most important factors associated with quality of life of oldest persons living alone.Primary health providers could develop tailored intervention to delay the progression of physical frailty,decrease depression and loneliness,and reduce social isolation in order to ultimately improve QOL of oldest old persons living alone.