安徽城市社区老年人自我忽视现状研究

Elder self-neglect and related influencing factors among community-dwelling older residents in Anhui

目的本研究旨在了解安徽省城市社区老年人自我忽视现状及其影响因素,为做好预防干预提供参考依据。方法2020年8月—2021年5月,通过分层抽样在皖北、皖中及皖南城市社区抽取部分老年人,采用老年自我忽视自制问卷、简版老年抑郁量表(geriatric depression scale-15,GDS-15)、日常生活能力量表(activity of daily living scale,ADL)等进行面对面调查。运用t/F检验、多元线性回归分析老年人自我忽视的影响因素。结果共计调查1050名老年人,有效应答1005(95.71%)名。研究结果显示,自我忽视得分>0分者有949(94.42%)名,总得分为(28.07±11.19)分,自我忽视状况严重;其中生活方式维度得分为(5.16±3.24)分,居住环境维度得分为(3.61±3.18)分,医疗保健维度得分为(4.10±2.94)分,社会交往维度得分为(15.19±6.16)分。多元线性回归分析显示,年龄越大(β=0.09,95%CI:0.02~0.16)、自评健康越差(β=1.48,95%CI:0.42~2.54)、失能程度越严重(轻度失能β=4.60,95%CI:3.25~5.96;重度失能β=11.35,95%CI:9.65~13.06)、有抑郁(β=5.96,95%CI:4.49~7.42)、小学及以下文化(β=4.48,95%CI:2.08~6.87)的老年人自我忽视状况越严重;女性(β=-2.53,95%CI:-3.67~-1.39)、可支配收入越高(1000~<3000元/月β=-3.15,95%CI:-4.39~-1.90;≥3000元/月β=-6.20,95%CI:-7.82~-4.57)的老年人越不易自我忽视。结论安徽省城市社区老年人自我忽视状况严重;社区工作人员及卫生保健提供者应重点关注高龄、男性、低收入、低学历、自评健康差、轻/重度失能和抑郁的老年人,积极预防和干预老年自我忽视。

Objective To understand the current status of elder self-neglect(ESN)among community-dwelling older residents in Anhui,and to discuss its influencing factors.Methods From August 2020 to May 2021,a total of 1050 elder residents were randomly recruited using stratified sampling method from urban communities in northern,central and southern Anhui,and a face-to-face survey was conducted using the self-designed ESN questionnaire,geriatric depression scale-15(GDS-15)and activity of daily living scale(ADL).T/F test and multiple linear regression were used to analyze the influencing factors of self-neglect in the elderly.Results Out of 1050 participants,1005(95.71%)valid questionnaires were obtained.949(94.42%)participants had ESN score of>0 and the total ESN score was(28.07±11.19),including the lifestyle dimension score of(5.16±3.24),living environment dimension score of(3.61±3.18),medical care dimension score of(4.10±2.94)and social life dimension score of(15.19±6.16).Multiple linear regression analysis showed that participants with older age(β=0.09,95%CI:0.02-0.16),poor self-assessed health(β=1.48,95%CI:0.42-2.54),severe disability(β=11.35,95%CI:9.65-13.06),depression(β=5.96,95%CI:4.49-7.42)and with low level of education(elementary school or bellow)(β=4.48,95%CI:2.08-6.87)were more likely to have severe ESN,while older ladies(β=-2.53,95%CI:-3.67--1.39)and participants with higher family income(1000-<3000 yuan/month:β=-3.15,95%CI:-4.39--1.90;≥3000 yuan/month:β=-6.20,95%CI:-7.82--4.57)were less likely to have ESN.Conclusions The prevalence of ESN among community-dwelling older residents in Anhui is high,and is influenced by age,gender,education,income and health.Therefore,community workers and health providers should take proper interventions to effectively prevent the ESN among the elderly.