健康城市参与度在成人心理健康与主观幸福感间的中介效应分析

Mediating role of participation in Healthy City Project on association between mental health and subjective well-being among adultss

目的 探讨健康城市参与度在心理健康相关状况(包括失眠、焦虑和抑郁)与主观幸福感间的中介效应。方法 采用一般资料问卷、阿森斯失眠量表、广泛性焦虑量表、10项流调中心抑郁量表、健康城市参与度问卷以及世界卫生组织幸福感指数量表,于2020年9月对南京市溧水区1031例常住成年居民进行调查。运用回归模型和中介检验分析健康城市参与度在心理健康与主观幸福感间的中介效应。结果 失眠、焦虑和抑郁均与健康城市参与度、主观幸福感呈显著负相关(r<0,P<0.05),而健康城市参与度与主观幸福感则呈显著正相关(r=0.258,P<0.001)。健康城市参与度在失眠与主观幸福感间以及焦虑与主观幸福感间存在显著的中介效应,在控制所有潜在混杂变量后,其中介效应值分别为-0.036(95%CI:-0.057~-0.015)和-0.025(95%CI:-0.047~-0.004),中介效应占比分别为4.98%和3.65%。控制了性别、年龄、婚姻、教育、收入和职业后,健康城市参与度在抑郁与主观幸福感关系间的中介效应具有统计学意义(间接效应值=-0.022,P<0.05;中介占比3.58%)。结论 健康城市参与度在心理健康相关状况与主观幸福感间起部分中介效应。本研究提示促进居民心理健康水平和提升其健康城市参与度,对于改善个体主观幸福感具有现实意义。

Objective To examine the mediating role of participation in healthy city project on association between mental health symptoms(including insomnia,anxiety and depression)and subjective well-being.Methods A total of 1031 adults residing in Lishui District were interviewed during September 2020,a series of structured questionnaires were used for investigation included general information,the Athens Insomnia Scale,the Generalized Anxiety Disorder-7 Scale,the 10-item Center for Epidemiological Studies Depression Scale,healthy city participation,and the World Health Organization Well-Being Scale.We used regression models and mediation tests to analyze the mediating effect of healthy city participation on association between mental health and subjective well-being.Results Insomnia,anxiety and depression were all significantly negatively correlated with healthy city project and subjective well-being(r<0,P<0.05),while healthy city participation was significantly positively correlated with subjective well-being(r=0.258,P<0.001).Healthy city participation was a significant mediator in the association of insomnia or anxiety with subjective well-being.After controlling for all potential confounders,the mediating effect for insomnia and anxiety was-0.036(95%confidence interval:-0.057,-0.015)and-0.025(95%confidence interval:-0.047,-0.004),respectively.The proportion of mediating effect was 4.98%and 3.65%,respectively.The mediating effect of healthy city participation on the association between depression and subjective well-being was only statistically significant after adjusted for gender,age,marriage,education,income and occupation(indirect effect=-0.022,P<0.05;proportion of mediation=3.58%).Conclusion Healthy city participation partially mediates the association between mental health symptoms and subjective well-being.Findings from this study suggest that promoting mental health and enhancing participation in healthy city project are practically important for improving individuals'subjective well-being.