老年人孤独感严重程度以及社交孤独、情感孤独的影响因素——以上海市3个区为例

Severity of loneliness and factors associated with social and emotional loneliness among the elderly in three districts in Shanghai

目的调查上海市社区老年人孤独感现状,并分别从社交孤独和情感孤独两个维度对影响老年人孤独感的因素进行探究。方法采用横断面研究,在2021年3—6月于上海市浦东新区、黄浦区、静安区3个区对65岁及以上的社区老年人进行问卷调查。依照上海市居民年龄、性别比例,浦东新区采用多阶段、分层随机抽样,黄浦区及静安区采用方便抽样。最终纳入研究对象635人。采用De Jong Gierveld孤独感量表测定老年人孤独感,包括社交孤独和情感孤独2个维度。使用Logistic回归模型对社交孤独和情感孤独的影响因素进行分析。结果在635位社区老年人中,仅有53位(8.4%)老年人报告不孤独。女性(OR=0.46,95%CI:0.31~0.70)、较高的自我效能得分(OR=0.97,95%CI:0.94~1.00)、较高的社会支持总分(OR=0.96,95%CI:0.93~0.99)与较低的社交孤独显著相关。较高的受教育水平(初高中或中专,OR=0.56,95%CI:0.34~0.95;大学及以上,OR=0.30,95%CI:0.11~0.83)、较高的自我效能得分(OR=0.96,95%CI:0.93~0.99)与较低的情感孤独显著相关,而较低的社会资本(OR=2.02,95%CI:1.29~3.16)及有抑郁症状(OR=3.41,95%CI:1.76~6.60)则与较高的情感孤独显著相关。结论调查样本中高达91.6%的老年人存在中度及以上的孤独感。社交孤独可能的影响因素为自我效能、性别及社会支持;情感孤独可能的影响因素为自我效能、受教育水平、抑郁和社会资本。

Objective To explore the severity of loneliness among the elderly in communities in Shanghai,and to identify factors associated with social and emotional loneliness respectively.Methods A cross-sectional study was conducted in older adults aged 65 years or above in Pudong New Area,Jing’an District and Huangpu District in Shanghai from Mar to Jun 2021.In Pudong New Area,multi-stage stratified random sampling was conducted based on the age and gender distribution of Shanghai,while in Huangpu District and Jing'an District convenience sampling was conducted.A total of 635 samples were included in the study.Loneliness was assessed using the De Jong Gierveld Loneliness Scale with social and emotional loneliness subscales.Logistic regression analyses were conducted to identify factors associated with social and emotional loneliness.Results Among the 635 participants,only 53 older adults(8.4%)were not lonely.Female(OR=0.46,95%CI:0.31-0.70),higher self-efficacy(OR=0.97,95%CI:0.94-1.00),more objective social support(OR=0.96,95%CI:0.93-0.99)were associated with less severe social loneliness.Meanwhile,higher level of education(secondary education,OR=0.56,95%CI:0.34-0.95;college or above,OR=0.30,95%CI:0.11-0.83)and higher self-efficacy(OR=0.96,95%CI:0.93-0.99)were associated with less severe emotional loneliness,while depression(OR=3.41,95%CI:1.76-6.60)and worse social capital(OR=2.02,95%CI:1.29-3.16)were associated with more severe emotional loneliness.Conclusion Up to 91.6%of the elderly in our study sample were moderately lonely or above.The factors associated with social loneliness include self-efficacy,gender and social support.The factors associated with emotional loneliness are self-efficacy,education level,depression,and social capital.