慢性病对老年人生命质量影响:睡眠质量的中介作用和社会参与调节作用

The impact of chronic disease number on quality of life among older adults:the mediating effect of sleep quality and moderating role of social engagement

目的 本研究旨在探讨老年人慢性病数量和生命质量的关系,并验证睡眠质量的中介作用和社会参与的调节作用。方法 采用匹兹堡睡眠质量指数、生命质量调查表(EQ-5D-5L)等测量工具对老年人进行调查。采用SPSS 23.0软件进行数据处理和统计分析。利用Cronbach’s α评估量表的内部一致性。结果 共调查老年人3 250人,问卷有效回收率为99.51%。睡眠质量得分为(5.08±3.44)分;社会参与得分为(3.65±3.06)分;生命质量效用值得分为(0.87±0.22)分。慢性病数量不仅能够直接负向预测老年人的生命质量(B=-0.014,P<0.01),还能够通过睡眠质量的中介作用对老年人生命质量产生影响,中介效应为57.14%;慢性病数量对老年人生命质量的直接作用以及睡眠质量的中介作用均受到社会参与水平的调节,对于社会参与水平较低的老年人,慢性病数量对其睡眠质量和生命质量的预测作用更加显著(B_(simple)=0.647、-0.026,P<0.01)。结论 慢性病数量通过睡眠质量影响老年人的生命质量,社会参与调节了慢性病数量与睡眠质量、生命质量之间的关系。

Objective To explore the impact of chronic disease number on quality of life(QoL)among older adults,and to verify the mediating effect of sleep quality and moderating role of social engagement.Methods A survey was conducted using Pittsburgh Sleep Quality Index and European Quality of Life-Five Dimension-Five Level Scale Questionnaire(EQ-5D-5L).SPSS 23.0 software was used for data process and statistical analysis.Cronbach'sαwas used to evaluate the internal consistency.Results A total of 3250 valid questionnaires(99.51%)were included in the analysis.The overall scores of sleep quality and social engagement were(5.08±3.44)and(3.65±3.06).The utility socore of QoL was(0.87±0.22).The number of chronic diseases not only directly and negatively predicted the QoL of older adults(B=-0.014,P<0.01),but also affected the QoL through the mediating role of sleep quality with the mediating effect accounting for 57.14%.The direct impact of chronic disease number on QoL and the mediating effect of sleep quality were moderated by social engagement.Additionally,the predictive effect of number of chronic diseases on both sleep quality and QoL were stronger for the older adults with lower levels of social engagement(B_(simple)=0.647,-0.026,P<0.01).Conclusions The number of chronic diseases has a direct effect on QoL and an indirect effect through sleep quality among older adults.Social engagement moderates the effects of chronic disease number on sleep quality and QoL.This study reveals the relationship and internal mechanism of chronic disease number on QoL,which has implications for QoL improvement among older adults.