云南省滇西地区农村老年人日常生活活动能力现状及其影响因素分析

Status and influencing factors of activities of daily living among rural elderly people in western Yunnan province:a cross-sectional survey

目的了解云南省滇西地区农村老年人日常生活活动能力(ADL)现状及其影响因素,为改善农村老年人的生命质量提供政策依据。方法于2021年7-8月采用多阶段随机整群抽样方法在云南省滇西地区抽取2287名≥60周岁农村老年人进行问卷调查、体格检查和骨密度检查,并应用AMOS 26.0统计软件构建结构方程模型分析农村老年人ADL的影响因素。结果云南省滇西地区农村老年人的ADL受损率为30.74%;以工具性日常生活能力(IADL)受损为主(24.70%),其中“打电话”的受损率最高(13.95%);躯体生活自理能力(PSMS)受损率为10.80%,其中“行走”的受损率最高(10.06%)。结构方程模型分析结果显示,生理因素对ADL具有直接效应(β=0.20);生活行为方式对ADL具有直接效应(β=0.13),并通过生理因素产生间接效应(β=0.01);心理因素对ADL具有直接效应(β=0.09);社会经济因素对ADL具有直接效应(β=0.08),并通过生活行为方式产生间接效应(β=0.01);社会支持对ADL不具有直接效应,但可通过心理因素产生间接效应(β=0.01)。结论云南省滇西地区农村老年人ADL受损率较高,老年人ADL状况与生理因素、生活行为方式、心理因素、社会经济因素和社会支持的相互作用有关,应重点针对高危人群采取针对性预防和干预措施以延缓ADL的丧失。

Objective To examine the status and influencing factors of activities of daily living(ADL)among rural elderly people in western Yunnan and to provide evidence for making policies on improving quality of life in the elderly.Methods The participants of the survey were 2287 adult permanent residents(60 years old)recruited with multistage random cluster sampling in rural regions of western Yunnan province.Face-to-face interview,physical examination and bone density test were conducted among the participants during July–August 2021.Chinese version scales including Physical Self-maintenance Scale(PSMS),Instrumental Activities of Daily Living Scale(IADL),2-Item Patient Health Questionnaire(PHQ-2),and 2-Item Generalized Anxiety Disorder(GAD-2)were adopted in the survey.Amos 26.0 statistical software was used to build structural equation models for analysis on influencing factors of ADL in the rural elderly.Results Valid information were collected from all the participants.The proportions of participants identified as with overall,instrumental,and physical ADL impairment were 30.74%,24.70%,and 10.80%,respectively,with 13.95%and 10.06%of the participants reporting difficulty in cell phone use and walking.The results of structural equation model analysis showed that physiological factors had direct effects on ADL(β=0.20);lifestyle had direct effect on ADL(β=0.13)and indirect effect through physiological factors(β=0.01);psychological factors had direct effects on ADL(β=0.09);socio-economic factors have direct effects on ADL(β=0.08)and indirect effects through lifestyle(β=0.01);social support has no direct effects on ADL but had indirect effects through psychological factors(β=0.01).Conclusion The prevalence of ADL impairment was relatively high and interactively influenced by physiological,psychological,and socio-economic factors and by lifestyle and social support among rural elderly in western Yunnan province.The results need to be concerned in developing interventions on ADL impairment in the population.